Whooping cough and whooping cough vaccine: the risks and benefits debate

Miller, D.L.; Alderslade, R.; Ross, E.M.

Epidemiologic Reviews 4: 1-24

1982


ISSN/ISBN: 0193-936X
PMID: 6128242
DOI: 10.1093/oxfordjournals.epirev.a036242
Document Number: 424828
There has been extensive debate in Great Britain regarding the risks and benefits of routine infant immunization against whooping cough. As a result of highly publicized cases of brain damage alleged to have been caused by the vaccine, immunization acceptance rates have dropped dramatically and epidemics of the disease have recurred. On the basis of a review of the current state of knowledge on whooping cough, the vaccine, and vaccine safety, the authors conclude that the dangers of the disease outweigh any known hazards of the vaccine. Although whooping cough is less important a cause of death and disability at present, it remains a potentially lethal disease that should be controlled. The safety of the vaccine is an especially critical question, however, since it is being advocated for use on a mass scale in previously healthy children. The results of studies such as the National Childhood Encephalopathy Study suggest DPT vaccination is associated with a greater frequency of acute neurological illnesses than would be expected by chance. On the other hand, most cases of such complications were not time-associated with DPT vaccination and may have resulted from the less purified vaccines used in the past. The most critical element in decision making is the readiness of parents and doctors to accept the fact that active preventive measures such as pertussis immunization sometimes carry unavoidable risks that have to be weighed against the risk of nonintervention.

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