Logan Reed
In 1979, the Swedish government abandoned the whole-cell pertussis vaccine, commonly known as the whooping cough vaccine, due to concerns about its safety and efficacy. This decision was made in anticipation of a new, safer, and more effective vaccine. As a result, between 1979 and 1996, Sweden experienced a resurgence of pertussis, with annual incidences exceeding global rates. In 1996, Sweden introduced acellular pertussis vaccines, which led to a significant decline in pertussis cases, emphasizing the crucial role of immunization in controlling infectious diseases.
| Characteristics | Values |
|---|---|
| Year of abandonment | 1979 |
| Reason for abandonment | The Swedish-made vaccine had become ineffective and there were concerns about its safety |
| Years without vaccination | 1979-1996 |
| Impact | Increase in annual incidence for children aged 0-4 years to 3370 per 100000 |
| Replacement | In 1996, 17 years later, the Swedish government introduced the diphtheria–tetanus-acellular pertussis vaccine (DTPa) |
| Impact of replacement | Widespread decline in pertussis incidence throughout the country |
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What You'll Learn
In 1979, Sweden abandoned the whole-cell pertussis vaccine
During this time, the annual incidence of pertussis in children aged 0-4 years increased significantly, with rates of serious complications approaching global rates. Sweden reported more than 10,000 cases annually, with an incidence rate exceeding 100 per 100,000, comparable to some developing countries. This resurgence of pertussis highlighted the importance of general vaccination against the disease.
In 1996, Sweden introduced acellular pertussis vaccines, which have improved safety profiles compared to whole-cell vaccines. The acellular vaccines were included in the Swedish vaccination programme for children at 3, 5, and 12 months of age. Within a few years, there was a widespread decline in pertussis incidence throughout the country, with an 80-90% decrease in culture-confirmed cases compared to before the introduction of acellular vaccines.
The success of the acellular pertussis vaccines in Sweden demonstrates the effectiveness of vaccination in controlling and reducing the incidence of whooping cough. It also underscores the importance of vaccine safety and efficacy in maintaining public health and preventing the spread of infectious diseases.
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The decision was based on concerns about safety and efficacy
In 1979, Sweden abandoned the whole-cell pertussis vaccine, commonly known as the DPT vaccine, which protects against whooping cough. This decision was based on concerns about the safety and efficacy of the vaccine.
At the time, there were concerns that the DPT vaccine was linked to sudden infant death syndrome (SIDS). However, these claims were later disproven, as rates of SIDS did not decrease when Sweden stopped using the DPT vaccine. Nevertheless, the decision to suspend the vaccine was made out of an abundance of caution while awaiting the development of a new, safer, and more effective alternative.
The suspension of the DPT vaccine had significant consequences. Between 1980 and 1983, the annual incidence of whooping cough in children aged 0-4 years surged to 3,370 per 100,000, with serious complications approaching global rates. Sweden continued to report more than 10,000 cases annually, with an incidence exceeding 100 per 100,000. This resurgence of whooping cough highlighted the importance of vaccination in controlling the disease.
In 1996, 17 years after the withdrawal of the whole-cell pertussis vaccine, Sweden introduced a new acellular pertussis vaccine as part of its national vaccination program. This new vaccine was deemed safer and more effective, addressing the initial concerns that led to the suspension of the previous vaccine. The acellular pertussis vaccine was administered at 3, 5, and 12 months of age, rapidly achieving coverage of more than 98%.
The introduction of the acellular pertussis vaccine in Sweden had a significant impact on reducing the incidence of whooping cough. National data showed a decline in the annual incidence of culture-confirmed whooping cough from 89-150 per 100,000 to 17-26 per 100,000. This decline was most noticeable after the second dose and remained stable for 4-5 years without the need for a booster dose.
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Pertussis cases rose sharply after the suspension of the vaccine
In 1979, Sweden abandoned the whole-cell pertussis vaccine due to concerns about its safety and efficacy. The decision was made by the Swedish medical society, which opted to wait for a new, safer, and more effective vaccine. This strategy was soon adopted as national policy, and vaccination against pertussis, also known as whooping cough, was suspended.
The suspension of the pertussis vaccine had significant consequences for public health in Sweden. Between 1980 and 1983, the annual incidence of pertussis in children aged 0-4 years surged to 3370 per 100,000, with rates of serious complications approaching global rates. In the following years, Sweden reported more than 10,000 cases annually, with an incidence exceeding 100 per 100,000. This incidence rate was comparable to that of some developing countries.
A study published in 1990 provides further insight into the impact of the suspension. The study randomly selected 400 children born in 1980 from the population register of Göteborg, Sweden, and interviewed their parents in 1990 when the children were 10 years old. Of the 377 children whose parents were interviewed, 372 had not been vaccinated against pertussis. Among these unvaccinated children, 61% had experienced clinically typical whooping cough.
The resurgence of pertussis in Sweden due to the suspension of the vaccine underscores the critical role of vaccination in disease prevention. In 1996, 17 years after the initial withdrawal, Sweden introduced diphtheria-tetanus-acellular pertussis vaccines (DTPa) in its vaccination program for infants at 3, 5, and 12 months of age. This decision was made after acellular pertussis vaccines had replaced whole-cell pertussis vaccines in several industrialized countries due to their improved safety profile. The introduction of the DTPa vaccine in Sweden rapidly achieved coverage of more than 98%.
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Acellular pertussis vaccines were introduced in 1996
In 1979, Sweden stopped administering the whole-cell pertussis vaccine, which aimed to prevent whooping cough. This decision was influenced by concerns about the safety and effectiveness of the vaccine, with a strategy to wait for a new, improved version. As a result, Sweden experienced a resurgence of pertussis, with annual incidence rates exceeding global levels.
During the suspension period, Sweden witnessed an increase in the annual incidence of whooping cough among children aged 0-4 years, reaching 3370 per 100,000 between 1980 and 1983. Subsequently, Sweden reported over 10,000 cases annually, with incidence rates surpassing 100 per 100,000. This situation highlighted the urgent need for an effective vaccination program.
In 1996, acellular pertussis vaccines were introduced as an alternative to the whole-cell pertussis vaccine. Acellular vaccines contain purified components of Bordetella pertussis, such as inactivated pertussis toxin, filamentous haemagglutinin, fimbrial antigens, and pertactin. They are designed to prevent typical whooping cough cases and have an effectiveness range of 71-85%.
The acellular pertussis vaccines offer several advantages over their whole-cell counterparts. They cause fewer adverse effects, with reduced incidence of redness at the injection site, fever, febrile seizures, and prolonged crying. While the whole-cell vaccines should not be administered after seven years of age, the acellular vaccines can be used in combination with tetanus and diphtheria vaccines for adolescents and adults, providing continued protection against whooping cough.
The introduction of acellular pertussis vaccines in 1996 marked a significant step forward in addressing the shortcomings of the whole-cell pertussis vaccine. By offering improved safety, effectiveness, and reduced side effects, the acellular vaccines played a crucial role in controlling the spread of whooping cough and protecting individuals of all ages.
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The new vaccine led to a rapid decline in pertussis cases
In 1979, Sweden abandoned the whole-cell pertussis vaccine due to concerns about its safety and efficacy. This decision led to a rapid increase in pertussis cases, with the annual incidence for children aged 0-4 years surging to 3370 per 100,000 during 1980-1983. Sweden reported more than 10,000 cases annually, with an incidence rate exceeding 100 per 100,000 in subsequent years.
In January 1996, after 17 years of suspension, Sweden reintroduced diphtheria-tetanus-acellular pertussis vaccines (DTPa) into its national vaccination program. The coverage rapidly surpassed 98% as it only required switching from the diphtheria-tetanus vaccine (DT) to DTPa.
The introduction of acellular vaccines led to a swift and widespread decline in pertussis cases across Sweden. The reported incidence of culture-confirmed pertussis decreased by 80-90% compared to pre-acellular vaccine introduction levels. The annual incidence of culture-confirmed Bordetella pertussis dropped significantly, from 89-150 per 100,000 to 17-26 per 100,000.
The data suggests that even unimmunized infants and children who received only one dose of the pertussis vaccine gained some protection. The decline in cases became more pronounced after the second dose and remained stable for 4-5 years without the need for a booster dose.
Currently, Sweden offers voluntary and free-of-charge vaccinations against eleven diseases, including whooping cough, to all children as part of its national vaccination program.
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Frequently asked questions
Yes, in 1979, the Swedish government abandoned the whole-cell pertussis vaccine due to concerns about safety and efficacy.
The Swedish-made vaccine had become ineffective, and there were concerns about the safety of the DPT vaccine.
The annual incidence of pertussis in children aged 0-4 years increased to 3370 per 100,000, with rates of serious complications approaching global rates. Sweden reported more than 10,000 cases annually, with an incidence exceeding 100 per 100,000.
Yes, in 1996, 17 years after withdrawing the whole-cell pertussis vaccine, Sweden introduced the diphtheria-tetanus-acellular pertussis vaccine (DTPa) as part of its national vaccination program.
