Sir.—Despite the efficacy of phase I whole-cell and, later, partially purified vaccines, the occurrence of local and/or systemic reactions was impetus for a more aggressive search toward a "safer and less toxic" vaccine. The first of these "safer" vaccines was the Japanese acellular type, officially named purified pertussis vaccine, which has been in use in Japan since 1981.1
Current literature, media commentary, and public sentiment point to a consensus that modern whole-cell and partially purified pertussis vaccines are "inherently toxic" and adverse reactions could be reduced or even eliminated by substituting the purified pertussis vaccine. In my opinion the literature does not support an inherent toxicity in the modern whole-cell or partially purified vaccines (vaccines that have passed the "toxicity" or body-weight-gain test), but rather supports an allergic reaction following inoculation into an already actively or passively immunized individual. Vaccine lots passing the toxicity test contain insufficient toxin
WILKINS J. Pertussis Agglutinogen: An Immunogen and an Allergen. Am J Dis Child. 1986;140(6):507. doi:10.1001/archpedi.1986.02140200017016
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