The key difference between whole-cell and acellular pertussis vaccine is that whole-cell pertussis vaccine contains inactivated whole cells of the Bordetella pertussis bacteria, while acellular pertussis vaccine contains one or more antigens of the Bordetella pertussis.
Pertussis is a common pediatric respiratory illness caused by Bordetella pertussis bacteria. It is a globally endemic disease prominent in developing countries. Initially, it was a common pediatric disease; however, recent data has revealed that it infects patients of all ages and genders with a persistent cough. In the 1940s, inactivated Bordetella pertussis was coupled with diphtheria and tetanus to prevent pertussis. The whole-cell pertussis vaccine contains all major pertussis antigens, such as pertussis toxin (PT), adenylate cyclase toxin, lipooligosaccharide, filamentous hemagglutinin, and agglutinogens. However, due to the low efficacy associated with the vaccine, the acellular pertussis vaccine was developed and introduced in 1981. The acellular vaccines comprise the individual antigens of Bordetella pertussis, such as pertussis toxin, pertactin, fimbriae, and adenylate cyclase. The acellular vaccine is more effective, with lesser side effects. Therefore, many countries have already switched to the acellular pertussis vaccine to treat pertussis.
CONTENTS
1. Overview and Key Difference
2. What is Whole-Cell Pertussis Vaccine
3. What is Acellular Pertussis Vaccine
4. Similarities – Whole-Cell and Acellular Pertussis Vaccine
5. Whole-Cell vs Acellular Pertussis Vaccine in Tabular Form
6. Summary – Whole-Cell vs. Acellular Pertussis Vaccine
What is a Whole-Cell Pertussis Vaccine?
Whole-cell pertussis vaccine contains inactivated or killed whole cells of Bordetella pertussis bacteria and other components, such as inactivated diphtheria and tetanus toxoids, Haemophilusinfluenzae type b (Hib) and hepatitis B (HepB) antigens. Nevertheless, the bacteria are inactivated or killed, and they have the potential to provoke an immune response. The vaccine was highly used in the past; however, it was associated with a higher incidence of side effects, including fever, local reaction at the injection site, and more serious adverse events in rare cases.
Figure 01: Gram Stain of the Bacteria Bordetella pertussis
This vaccine is prepared by growing Bordetella pertussis in a liquid medium and aliquoted after the inactivation. The antigen content varies between different manufacturers, owing to variations of the immunogenicity among the vaccines. Due to these variations, the efficacy of the vaccines is also varied and reported to be between 36% to 98%.
What is Acellular Pertussis Vaccine?
Acellular pertussis vaccines are designed using the purified components of the bacteria instead of whole cells to provide immunity against pertussis. The vaccine comprises diphtheria, tetanus toxoids, and specific antigens of Bordetella pertussis bacteria. The most common antigens of the acellular pertussis vaccines include pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin (PRN), and fimbriae (FIM).
Acellular vaccines are associated with lesser side effects than whole-cell vaccines while offering effective protection against the disease. The vaccine’s composition may vary based on the manufacturer and the country where the vaccine is used.
What are the Similarities Between Whole-Cell and Acellular Pertussis Vaccine?
- Whole-cell and acellular pertussis vaccines target Bordetella pertussis.
- Both vaccines aim to induce an immune response to protect individuals from pertussis infection and associated symptoms.
- They are often combined with vaccines for diseases like diphtheria and tetanus.
- Whole-cell and acellular pertussis vaccines usually require multiple doses or booster shots to establish and maintain long-lasting immunity.
- They have played a significant role in reducing the incidence and severity of pertussis worldwide.
What is the Difference Between Whole-Cell And Acellular Pertussis Vaccine?
Whole-cell and acellular pertussis vaccines are used in combatting Bordetella pertussis. The key difference between whole-cell and acellular pertussis vaccine is that whole-cell pertussis vaccines comprise inactivated or killed whole cells of Bordetella pertussis, while acellular pertussis vaccines are purified antigens from the same bacteria. Whole-cell vaccines have effectively reduced pertussis incidence but are associated with more side effects. In contrast, acellular vaccines display lesser durable protection but have a more favorable safety profile. Moreover, whole-cell vaccines induce cellular immunity and require fewer booster doses, whereas acellular vaccines primarily stimulate antibody production and require more frequent boosters. In addition, whole-cell vaccines are still available in some countries, but many have shifted to acellular vaccines due to improved safety. The manufacturing process for whole-cell vaccines is simpler, and they have better stability.
Below is a summary of the difference between whole-cell and acellular pertussis vaccine in tabular form for side by side comparison.
Summary – Whole-Cell vs. Acellular Pertussis Vaccine
Whole-cell and acellular pertussis vaccines are used combatting Bordetella pertussis. The key difference between whole-cell and acellular pertussis vaccine is that whole-cell pertussis vaccines contain inactivated whole cells of Bordetella pertussis, while acellular pertussis vaccines consist of purified antigens from the same bacteria. Whole-cell vaccines have been associated with more side effects but have effectively reduced pertussis incidence. In contrast, acellular vaccines have a more favorable safety profile but may display lesser durable protection. Whole-cell vaccines induce cellular immunity, while acellular vaccines primarily stimulate antibody production. Whole-cell vaccines provide longer-lasting immunity and require fewer booster doses, while acellular vaccines may require more frequent boosters. However, determining the correct immunization strategy will primarily depend on factors such as pertussis surveillance in the community, adverse event monitoring, and financial consideration.
Reference:
1. Alghounaim, Mohammad, et al. “Whole-Cell and Acellular Pertussis Vaccine: Reflections on Efficacy.” Medical Principles and Practice, vol. 31, no. 4, 2022, pp. 313–321.
2. Perez Chacon, Gladymar, et al. “Whole-Cell Pertussis Vaccine in Early Infancy for the Prevention of Allergy in Children.” Cochrane Database of Systematic Reviews, vol. 2021, no. 9, 2021.
Image Courtesy:
1. “Person Holding Syringe and Vaccine Bottle” (CC0) via Pexels
2. “Bordetella pertussis” By CDC Public Health Image Library – from the Centers for Disease Control and Prevention – Public Health Image Library (PHIL) (Public Domain) via Commons Wikimedia
