Is there any relationship between the use of acellular pertussis vaccines and the latest outbreaks of pertussis?

During the 1990s, United States gradually switched from whole cell (DTwP) to acellular pertussis vaccine (DTaP) due to safety concerns.

This case-control study evaluates the impact of the vaccination change on the incidence rate of whooping cough (diagnosed by pertussis polymerase chain reaction) among adolescents during an outbreak of the disease in 2010.

The results show that adolescents who received 4 doses of DTwP in the first two years of life were better protected against the disease than those who received 4 doses of DTaP. For those who received a mixed vaccination (DTwP and DTaP) there was a clear relationship between the number of doses of DTaP received and the likelihood of pertussis, with an increased risk of 40% for each DTaP additional dose.

The widespread use of acellular whooping cough vaccines has been related to the resurgence of disease outbreaks in recent years. Although causes are complex, the waning of vaccine-induced immunity appears to play an important role.