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pertussis vaccine is toxic with measurable risk of damage to the central nervous system, though the incidence of risk from vaccination does not exceed that from infection. Considerable effort is underway to develop a safer useful recombinant pertussis vaccine.

Inactivated toxins and toxoids as vaccines

The most successful bacterial vaccines (for tetanus and diphtheria) use the inactivated exotoxins, in the case of tetanus, given in an alum precipitate. Their efficacy is evident from the decline in reported cases of diphtheria following introduction of this vaccine in the United Kingdom (from 70,000 cases annually in 1935 to less than 1,000 by 1950). Now tetanus toxoid is used as a "carrier" molecule for trial vaccination with other peptides (e.g., of malaria organisms etc.) which are otherwise nonimmunogenic. The tetanus toxin provides carrier determinants recognized by memory T cells (most individuals have high levels of T-cell memory to tetanus toxin following vaccination) while the novel hapten antigen linked to it stimulates B cells for antibody production.

Recombinant vaccines

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