Vaccine History

Bordetella pertussis bacteria was first identified and grown at the Pasteur institute, in 1906. Nineteen years after this discovery, the first killed whole cell pertussis immunization (wP) was attempted by Madsen. He studied the vaccine during a pertussis epidemic in the Faroe Islands . Madsen learned that those who had the received the vaccination were far less likely to face the harsh symptoms of the disease (7). This work was followed in the 1940's with further experimentation by Pearl Kendrick at the State of Michigan Health department. Kendrick also included aluminum adjuvant as well as diphtheria and tetanus toxoids into one DTwP vaccine in 1942. She discovered that the vaccine worked better in the presence of the diphtheria and tetanus toxoids, that the three components acted as adjuvants for one another (9). Pearl Kendrick's vaccine and regimen is still used throughout most of the world today (9). DTwP vaccine was first marketed in the US beginning in 1948. DTwP vaccination practices spread quickly throughout the first world, and by 1957 vaccination was a requirement for all British children. The effects of pertussis vaccination are quite compelling, with the year 1976 bringing the lowest US totals of pertussis incidence at 1010 cases (1).

Though effective, the wP vaccines provided the possibility of unwanted side-effects that included inflammation, sepsis, and possibly even encephalopathy (1). While causation was proven in some of these disorders, others were not, though horrific cases were well documented and published. Vaccine unease permeated the public mindset during the late 1970's and early 1980's. Vaccinations dropped and pertussis cases rose(1). In response to this, acellular (toxoid and component) pertussis vaccines (aP) were developed throughout the 1980's. The first of these was approved for use in Japan (for children of three years or older) in 1981, though the same vaccine was not approved for younger children (older that three months) until 1989(2).

The first DTaP vaccine saw FDA licensure in 1991. Large clinical studies in Italy and Sweden in 1991-1992 demonstrated that the DTaP vaccines were just as effective as the DTwP vaccines, but did not present the same side effects (9). There are currently six DTaP and one DTaPHBV-IPV vaccine sold in the United States (10). Whole cell vaccines were removed from the American market in 2001. While acellular vaccines are quite prevalent in the developed world, the majority of vaccines administered are still of the whole cell variety(2).