Cellular and acellular pertussis vaccines in adults.

Immunization against pertussis after childhood previously was considered unnecessary, because severe illness and complications rarely developed in older persons. The rising incidence of pertussis among older adolescents and adults and the transmission of infection from adults to infants suggest that booster immunization may be necessary to more effectively control pertussis in all age groups. Whole cell pertussis vaccines are regarded as unsuitable for routine use in adults because of reports of frequent moderate to severe reactogenicity at the injection site and occasional systemic reactions. The introduction of safe and effective acellular pertussis vaccines provides us with an opportunity to reconsider booster immunization of adolescents and adults. Several vaccines containing purified component(s) of Bordetella pertussis have been well tolerated and highly immunogenic when given to healthy adults. A clear understanding of the impact of pertussis in adolescents and adults will help to define the need for booster immunization after childhood.