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Pertussis after end of a mass vaccination project--end of the "vaccination honey-moon"

Birger Trollfors1, Leif Dotevall, Valter Sundh

  • 1Department of Pediatrics, Sahlgrenska University Hospital-East, 41685 Gothenburg, Sweden. birger.trollfors@vgregion.se

Vaccine
|February 5, 2011
PubMed

Insights

Mass pertussis vaccination in Sweden temporarily eliminated the disease, but it reemerged. Booster doses are needed to control pertussis, especially in infants, though optimal timing remains unknown.

Area of Science:

  • Epidemiology
  • Vaccinology
  • Public Health

Background:

  • Sweden experienced a 16-year period without pertussis vaccination.
  • A mass vaccination campaign using a monocomponent pertussis toxoid vaccine was conducted in Greater Gothenburg from 1995-1999.
  • The campaign achieved 56% coverage in 10-year-olds, leading to temporary pertussis elimination.

Purpose of the Study:

  • To monitor the incidence of pertussis following the cessation of the mass vaccination project (1999-2009).
  • To analyze laboratory-verified cases and hospitalizations to understand disease trends.
  • To evaluate the long-term effectiveness of the pertussis toxoid vaccine.

Main Methods:

  • Surveillance of laboratory-verified pertussis cases (culture and/or PCR) from July 1999 to December 2009.
  • Analysis of pertussis-related hospitalizations during the study period.
  • Examination of vaccination status in confirmed pertussis cases, including time since last vaccination.

Main Results:

  • Pertussis reemerged from late 1999, peaking in 2004, with a subsequent decrease after booster doses were introduced in 2005-2006.
  • A total of 1973 cases were diagnosed; the disease affected all age groups, with the highest incidence in infants (<12 months).
  • Of 450 vaccinated individuals with pertussis, the mean time to diagnosis was 5 years post-vaccination. 128 hospitalizations occurred, 106 in infants.

Conclusions:

  • Pertussis remains a significant public health concern in the Greater Gothenburg area.
  • Booster vaccinations are necessary to maintain immunity and control pertussis.
  • Further research is needed to determine the optimal timing and dosage for booster vaccinations.

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