Laporan kasus berbasis bukti Perbandingan Efektivitas dan Keamanan Vaksin Pertusis Aselular dan Whole-cell

Background. Immunization is the best way to prevent various vaccine-preventable diseases. Diphtheria, tetanus and pertussis whole-cell vaccine (DTwP) may cause serious adverse events following immunization. Diphtheria, tetanus and acellular pertussis vaccine has milder adverse effect but presumed to be less effective. Objective. To compare effectiveness of DTwP and DTaP vaccine. Method. Literature search using PubMed and Cochrane electronic database with keywords “DTaP/acellular pertussis”, “DTwP/whole-cell pertussis”, “children”, “pertussis”, “vaccine” and “safety/efficacy/effectiveness” in the last 10 years (2006 – 2016). Result. There were two meta-analysis comparing DTwP and DTaP vaccine effectiveness and one case-control study comparing the long-term protection after DTwP and DTaP vaccine. Acellular pertussis vaccine was 74 % (95% CI, 51-86%) – 97% (95% CI, 91-99%) effectiveness (95% CI, 91-99%) and whole-cell pertussis vaccine was 94% effectiveness (95% CI, 88-97%). Effect size estimation of acellular pertussis vaccine to protect against pertussis disease according to WHO definition, was 84% (95% CI, 81-87%); for whole cell pertussis vaccine, the effect size was 94% (95% CI, 88-97%). DTaP had milder and less frequent adverse events than DTwP. Conclusion. DTaP and DTwP vaccine has comparable effectiveness. DTwP vaccine has better effect size for pertussis protection and long-term protection compared to DTaP vaccine. Vaccine DTaP has milder and less frequent adverse events.