Clinical Report: Review of Notable Adverse Events Associated with Acellular Pertussis Vaccination

Overview

This narrative review updates the evidence on adverse events following immunization (AEFI) associated with acellular pertussis vaccines. It highlights the frequency and types of mild to moderate adverse events.

Background

Acellular pertussis vaccines were developed to reduce reactogenicity compared to whole-cell vaccines. Understanding the adverse events associated with these vaccines is crucial for maintaining vaccination coverage.

Data Highlights

Key Findings

• Mild adverse events are transient and include local reactions and low-grade fever.
• Moderate adverse events include fever, hypotonic hyporesponsive episodes, and persistent crying.
• Severe adverse events such as Guillain–Barré syndrome and acute disseminated encephalomyelitis have uncertain causal relationships with vaccination.
• Acellular pertussis vaccines have lower rates of mild adverse events compared to whole-cell vaccines.
• Systematic surveillance for AEFIs has been implemented globally since the introduction of acellular vaccines.

Clinical Implications

Healthcare providers should be aware of the common mild and moderate adverse events associated with acellular pertussis vaccines.

Conclusion

The review emphasizes the importance of understanding the safety profile of acellular pertussis vaccines.

Related Resources & Content

1. Open Forum Infectious Diseases, 2023 -- Assessment of the Effectiveness of Three Acellular Pertussis Vaccines in Children Aged 3 Months to 16 Years in Lu’an, China: A Matched Case-Control Analysis
2. Frontiers in Immunology, 2026 -- Preclinical Study on an Adsorbed Acellular Diphtheria-Tetanus-Pertussis (Reduced-Dose) Combined Vaccine: Evaluation of Reproductive safety and Immunogenicity
3. Drug Safety, 2018 -- Response to 'An Updated Review on the Safety of Human Papillomavirus Vaccines'
4. International Journal of Infectious Diseases, 2026 -- Timeliness and dose-dependent protection of pertussis vaccination in children under 5 years: Evidence from a population-based cohort in Zhejiang Province, China
5. Advisory Committee on Immunization Practices, 2025 -- Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger
6. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States, 2018 -- Recommendations of the Advisory Committee on Immunization Practices (ACIP)
7. Nature Communications, 2025 -- Immunogenicity and safety of co-purified diphtheria, tetanus and acellular pertussis vaccine in 6-year-old Chinese children
8. CDC Vaccine Safety Summary
9. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2025 | MMWR
10. Immunogenicity and safety of co-purified diphtheria, tetanus and acellular pertussis vaccine in 6-year-old Chinese children | Nature Communications