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his 1933 account reports two deaths within 48 hours of immunization, the first published report of serious adverse effects after pertussis vaccination. In the same year, Louis Sauer of Northwestern University Medical School, Chicago, describes minor reactions to a whole-cell pertussis vaccine being used in the United States (Sauer, 1933a,b).


Pearl Kendrick of the State of Michigan Health Department further refines and uses whole-cell pertussis vaccines in children (Kendrick, 1942, 1943; Kendrick and Eldering, 1936, 1939). In 1942, she and colleagues combine her improved killed vaccine with diphtheria and tetanus toxoids to produce the diphtheria-tetanus-pertussis (DTP, also known as DPT) combination vaccine. In 1944, the Committee on Infectious Diseases of the American Academy of Pediatrics suggests routine use of pertussis vaccine and, in 1947, recommends its use in the form of the DPT combination (American Academy of Pediatrics, 1944; Cherry, 1984). In the United States, vaccination of children against pertussis becomes a routine procedure and is made compulsory in some states.


The first published reports appear of irreversible brain damage after whole-cell pertussis vaccine (Brody and Sorley, 1947; Byers and Moll, 1948). Although the Brody and Sorley report describes one case only, it leads to the first warnings that pertussis vaccine should not be administered to those with a known neurologic disorder.


Approximately a dozen companies are manufacturing DPT vaccine (Coulter and Fisher, 1985).


The Parke-Davis Quadrigen vaccine (DPT combined with the Salk polio vaccine) is licensed. The vaccine is alleged to be particularly reactive because of the effect of the preservative on the pertussis component. Several lawsuits ensue. The vaccine is withdrawn from the market in 1968 (Coulter and Fisher, 1985).


By the mid-1960s, many states have passed laws requiring that all children be immunized with DPT vaccine prior to entering school (Coulter and Fisher, 1985).


In Great Britain, questions about the safety of whole-cell pertussis vaccines are widely publicized in the popular press after news-

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