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Rationale for pertussis booster vaccination throughout life in Europe
Fred Zepp1, Ulrich Heininger, Jussi Mertsola
1Department of Paediatrics and Adolescent Medicine, University Medical Centre, Johannes Gutenberg University, Mainz, Germany. zepp@kinder.klinik.uni-mainz.de
Insights
Pertussis (whooping cough) is rising in adolescents and adults due to waning immunity, posing a risk to infants. Booster vaccinations are proposed to reduce disease spread and enhance herd protection.
Area of Science:
- Epidemiology
- Immunology
- Public Health
Background:
- Universal infant pertussis immunization significantly reduced childhood cases.
- Recent years show increasing pertussis incidence in adolescents and adults.
- Waning immunity post-infection or vaccination is a primary driver of this trend.
Purpose of the Study:
- To review the pertussis epidemiological situation in Europe.
- To propose strategies for pertussis booster vaccinations in adolescents and adults.
- To reduce individual morbidity and transmission to infants, enhancing herd immunity.
Main Methods:
- Review of pertussis epidemiology across European countries.
- Analysis of factors contributing to the changing disease pattern.
- Consideration of European vaccination schedules.
Main Results:
- Pertussis incidence is increasing in adolescents and adults in Europe.
- Waning immunity is the main cause, alongside other contributing factors.
- Varied vaccination schedules across Europe impact disease control.
Conclusions:
- Adolescent and adult pertussis increases individual morbidity and transmission risk to infants.
- Booster vaccinations are recommended to mitigate disease spread.
- Strategic booster campaigns can improve individual protection and herd immunity.
Abstract:
Although the introduction of universal pertussis immunisation in infants has greatly reduced the number of reported cases in infants and young children, disease incidence has been increasing in adolescents and adults in recent years. This changing epidemiological pattern is probably largely attributable to waning immunity after natural infection or vaccination. Furthermore, improved diagnostic testing, active surveillance, changes in disease susceptibility, vaccine characteristics, and increased awareness of the disease might also be contributing factors. Susceptibility to pertussis in adolescents and adults results not only in direct morbidity in these age groups, but also poses a transmission risk to susceptible non-immune infants who are often too young to be vaccinated. Because vaccination schedules vary across Europe, we review the pertussis situation in this region and propose considerations for use of pertussis booster vaccinations at different ages to reduce individual morbidity and transmission from present rates and increase herd protection.
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