Originally created 01/31/98

Old whooping cough vaccine should not be abandoned, study says



LONDON -- Wealthy nations are gradually replacing the original whooping cough vaccine after decades of controversy over its safety, but developing nations should not be afraid to use the old vaccine, a study published Friday says.

Researchers from the Gangarosa International Health Foundation say the risks attributed to the whole-cell pertussis vaccine, introduced in the late 1940s to control whooping cough, have been misunderstood.

In an article in the British medical journal The Lancet, they contend the vaccine is particularly important for developing nations that cannot afford the newer formula, which began use two years ago in the United States and Europe.

The old vaccine is cheaper and more effective, and serious side effects, contrary to what some believe, are "so rare that they defy measurement," the researchers argue.

Severe side effects that have been attributed to the vaccine include brain damage and seizures. Experts disagree about a link to brain damage, but agree that if the vaccine does cause such damage, it does so only rarely.

The study noted that although lawsuits in the United States have favored plaintiffs alleging severe side effects, Britain's high court has ruled that a casual link has not been proven.

Of the vaccine-preventable diseases, whooping cough, or pertussis, rivals measles and tetanus in importance and severity among children in developing nations, the researchers said.

Millions of cases and hundreds of thousands of deaths occur every year and complications are common. Because the disease is so difficult to treat, prevention is crucial, the study said.

As whooping cough has become rarer with increased vaccination rates, attention has shifted from the disease to the side effects of the vaccine.

In several countries, controversy over side effects gave rise to anti-vaccine campaigns and, in some cases, withholding of the vaccine, said Dr. Eugene Gangarosa, senior author of the study.

Gangarosa and his colleagues explored the impact of the anti-vaccine campaigns on the control of whooping cough and the future role the original vaccine should have.

They compared the incidence of whooping cough in countries that have maintained vaccination programs, such as Hungary, the former East Germany, Poland and the United States, with those known to have been affected by anti-vaccine campaigns, such as Britain, Japan, Sweden and the former Soviet Union.

They found that in countries where the community lost confidence in the vaccine because of concerns over safety, immunization rates dropped and reported cases increased.

"Despite the advantages of (the newer) vaccines, we believe that lower costs and better protection are compelling reasons for use of (the older) vaccines in several countries, particularly those with limited resources," the study said.

Rosemary Fox, founder of the Association of Parents of Vaccine-Damaged Children in Britain, where one of the more active campaigns occurred, objected to that view.

"It's not fair to have a safe one and one that is more toxic," Fox said. "Just because people are poor, it doesn't mean they should be treated any differently."