A critical level of serum IgG pertussis toxin antibody is both essential and sufficient to confer individual and herd immunity to pertussis. Monocomponent pertussis toxoid conferred such immunity in Sweden and in Denmark. We refute the notion that filamentous hemagglutinin, pertactin, and fimbriae add to the immunity conferred by pertussis toxoid and describe the artifact created when efficacy is estimated for multicomponent pertussis vaccines. Lastly, the genetically-inactivated mutant pertussis toxoid is safer, more immunogenic, and should be more effective than the current chemically-inactivated pertussis toxin.
From the *Fogarty International Center, National Institute of Health, Bethesda, MD; †University of Gothenburg, Gothenburg, Sweden; and ‡Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Accepted for publication August 14, 2008.
Presented in part at International Bordetella pertussis Assay Harmonization and Standardization Meeting, July 19–20, 2007, Centers for Disease Control and Prevention, Atlanta, GA.
The authors declare that they have no conflicts of interest and did not receive funding for writing this review.
Address for correspondence: John B. Robbins, MD, Co-Chief, Program on Developmental and Molecular Immunity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 31 Center Drive, Rm 2A25, Bethesda, MD 20892-2423. E-mail: robbinsJo@mail.nih.gov.