Development of Vaccines for Whooping Cough

By Jaden Aland

In the early 20th century, whooping cough claimed the lives of five out of every one thousand children, most often before they had even celebrated their first birthday (Museum of Healthcare). However, by the middle of the century, the most powerful tool against the harmful effects of whooping cough came to light. The pertussis vaccine, commonly known today as the DTaP vaccine due to it being paired with immunization for diphtheria and tetanus, proved to be the most effective means of defense against whooping cough (CDC). In fact, pertussis vaccination was so effective that it is still common practice to administer it to children today. 

Developing the pertussis vaccine was an important achievement in the history of medicine, and an understanding of the disease’s cause was crucial to its creation. Although use of the whooping cough vaccine was not widespread until the 1930s and 40s, it was first developed in 1912 by bacteriologist Octave Gengou (Museum of Healthcare). Whooping cough is a respiratory infection caused by a bacteria called Bordetella pertussis. This bacterium releases toxins into the body that ultimately end up targeting respiratory cells. This leads to an inflamed respiratory system which produces the symptoms commonly observed with pertussis (History of Vaccines). Octave Gengou’s initial vaccine, and the more effective ones to follow, capitalized on this pathology by using inactivated samples of the Bordetella pertussis bacteria to introduce it to a patient’s body so that an immune response could be developed. This provided higher levels of immunity to whopping cough throughout the early and mid 20th century as compared to somebody who didn’t have the vaccine. 

Whooping cough “germs” under a microscope from Diseases of infancy and childhood by William Herbert Galland, 1920.

The whooping cough vaccine had specific methods of introduction that were needed to make it most effective. In Finsbury, a district in central London, the vaccine was beginning to see more use around 1937. During this time, the vaccine had been supplied to the district directly from a medical company, and was given to local healthcare providers to distribute to patients. In Finsbury, immunization for a patient was established through three age-dependent doses and was initially only given to a small portion of the population (Finsbury 1937). Similarly, in Leyton, another district in East London, the whooping cough vaccine was administered in 3 doses. However, around 1952, the Leyton district was recommending that the vaccination process start as early as possible, usually before a child was even two months old. This was due to the poor prognosis of whooping cough within the first six months of life (Leyton 1952). Although there were districts and boroughs in London that heavily used the pertussis vaccine, there were also ones that were less sure of its practicality. One of the Medical Officers of Health for the London County Council reported that many people believed that the vaccine provided little proven effects on whooping cough prevention and needed to be further studied. The report also stated that since whooping cough was considered a “mild disease” the three dose requirement was not justifiable (London County Council 1957). 

The number of people who received the whooping cough vaccine was fairly large throughout the mid 20th century. In a 1959 London County Council Health report, it was estimated that about two-thirds of all infants under the age of one had been given some kind of dose of the whooping cough vaccine (London County Council 1959). As compared to specific districts in London, such as Paddington in 1947, almost 60% of the population had received a full course of the vaccine, primarily through a joint dose with added protection against diphtheria (Paddington 1947). Additionally, in the Harrow district, almost 3000 doses had been given in 1963, as it was believed that the current vaccine provided over 80% immunity to the bacteria (Harrow 1963). 

The whooping cough vaccine had a dramatic impact on public health. The high level of immunization received from the vaccine encouraged parents to emphasize vaccinating their children. So much so, that many regions, such as the district of Willesden, held mass immunization sessions to maximize the vaccines accessibility (Willesden 1947). 

File:StateLibQld 2 163363 Mothers waiting with their small children ready to be vaccinated, Brisbane, 1947.jpg
Mothers waiting to vaccinate their children against whooping cough in 1947, Brisbane.
WIKIMEDIA

The health impact that the vaccine had on specific cases however is very apparent by district. For example, in Tottenham, in the approximately 509 confirmed cases of whooping cough in 1950, death only occurred in one of them (Tottenham 1950). Compared to the earlier five out of every one thousand, this is significantly better (Museum of Healthcare). Only four years later the number of confirmed whooping cough cases in Tottenham was only 144 (Tottenham 1954). Looking at the district of Leyton, the number of confirmed whooping cough cases also dropped significantly over the period of time where the pertussis vaccine began to become more effective (Leyton 1951). 

Number of confirmed cases and deaths from whooping cough from 1942-1952 in Leyton 1951

The whooping cough vaccine proved to be the most powerful tool available in the 20th century in terms of combating the disease. In fact, the vaccine was so effective that its use continued throughout the late 20th century and into the early 21stcentury. Vaccination is commonly referred to as the greatest discovery in the history of modern medicine. The whooping cough vaccine is a fantastic example of this statement and how human ingenuity can save lives. 

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