Vaccines containing formalin-inactivated whole-cell Bordetella pertussis strains were first developed in the USA in the 1930s, and manufacturing processes were standardised in 1947. From the mid-1950s, whole-cell vaccines were combined with diphtheria and tetanus toxoids, but frequent systemic and local reactions and variability in effectiveness led to declining uptake in Europe and Japan. In the USA, litigation was brought against manufacturers, leading to development of more purified acellular vaccines in the 1980s.

Pertussis toxin was included in all acellular vaccines, generally with filamentous haemagglutinin (FHA), pertactin, or fimbriae. 1 Pertussis toxin is a two-component bacterial toxin responsible for many of the organism’s biological effects, including lymphocytosis, and must be modified to reduce toxicity for use in vaccines. Typically, pertussis toxin is chemically detoxified with formaldehyde, glutaraldehyde, or hydrogen peroxide.

A vaccine containing a genetically modified pertussis toxin (PTgen) combined with diphtheria and tetanus toxoids, FHA, and pertactin, showed significantly greater immunogenicity than a vaccine containing detoxified pertussis toxin (PTchem) in infants, but, despite being licensed in Europe, has not been commercially available for over a decade.

Source : https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30426-2/fulltext