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Recommendations are needed for adolescent and adult pertussis immunisation: rationale and strategies for
M Campins-Martí1, H K Cheng, K Forsyth
1Department of Preventive Medicine and Epidemiology, Vall d'Hebron Hospital, Barcelona, Spain.
Insights
Pertussis vaccination protects infants, but adults spread the disease to vulnerable babies. Adult acellular pertussis vaccines offer protection and can reduce transmission.
Area of Science:
- Immunology
- Public Health
- Vaccinology
Background:
- Infant pertussis vaccination significantly reduced childhood disease and mortality.
- A substantial public health challenge remains: addressing pertussis (whooping cough) morbidity and economic burden in older populations.
- Adolescents and adults are key reservoirs for pertussis transmission to unvaccinated or partially vaccinated infants, who are at high risk for severe complications.
Purpose of the Study:
- To review strategies for extending pertussis (whooping cough) vaccination to older age groups.
- To evaluate the role of adult-type acellular pertussis vaccines in disease control.
- To identify optimal immunization programs for adolescents and adults to protect both individuals and vulnerable infants.
Main Methods:
- Review of existing literature on pertussis epidemiology and vaccination strategies.
- Analysis of the effectiveness and safety of adult acellular pertussis vaccines.
- Discussion of various immunization program models, including universal and targeted approaches.
Main Results:
- Adult-type acellular pertussis vaccines are safe and effective in preventing pertussis.
- Universal vaccination across all age groups offers the most comprehensive protection but faces logistical and economic challenges.
- Targeted strategies, such as adolescent boosters and vaccinating adults in close contact with infants, are feasible first steps.
Conclusions:
- Expanding pertussis vaccination to adolescents and adults is crucial for controlling the disease and protecting infants.
- A phased approach, starting with adolescent boosters and targeted adult vaccination, is recommended.
- Country-specific implementation details for pertussis immunization programs are necessary, considering local circumstances.
Abstract:
Pertussis vaccination of infants has dramatically reduced disease, complications and deaths in infancy and early childhood. But there is still a major public health challenge--to deal with the morbidity and economic burden of illness in older children, adolescents and adults. Furthermore, it is these groups that form a major source of infection for non-immunised and partially immunised infants who are at high risk of severe complications. Adult-type acellular pertussis vaccine confers safe and effective protection against pertussis. There are several strategies to consider for immunising older individuals. Universal vaccination of all age groups would be the best available strategy for protecting individuals. It would also reduce the potential for transmitting the disease to other susceptibles, particularly infants. However, such a policy may be difficult both logistically and economically at this time. More easily achievable as a first step would be a strategy of universal adolescent booster vaccination combined with a programme targeted at adults most likely to have contact with very young babies including healthcare and childcare workers, parents and close family contacts. There is also potential for offering vaccination to adults (and their carers and close contacts) whose medical conditions or advanced age may place them at increased risk of more severe pertussis disease. Specific details of immunisation programmes must be made on a country by country basis depending on local circumstances.
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