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New pertussis vaccination approaches: en route to protect newborns?
Camille Locht1, Nathalie Mielcarek
1Center for Infection and Immunity of Lille, Institut Pasteur de Lille, Lille, France. camille.locht@pasteur-lille.fr
Insights
Pertussis (whooping cough) remains a global threat despite vaccination. New strategies, including maternal and neonatal immunization and improved vaccines, are crucial for infant protection.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Pertussis (whooping cough) is a severe, life-threatening childhood illness, especially in infants.
- Current vaccination strategies have reduced incidence but not eradicated pertussis, highlighting its status as a poorly controlled vaccine-preventable disease.
- Adolescent and adult pertussis cases are increasingly recognized, contributing to disease transmission.
Purpose of the Study:
- To explore novel vaccination strategies for pertussis control.
- To address the limitations of existing vaccines and identify needs for improved pertussis immunizations.
- To evaluate emerging vaccine approaches for comprehensive infant protection.
Main Methods:
- Review of current and emerging pertussis vaccination strategies.
- Discussion of whole-cell and acellular vaccine types and their limitations.
- Consideration of novel approaches like maternal vaccination, cocooning, neonatal vaccination, and live attenuated nasal vaccines.
Main Results:
- Existing vaccines, while effective, have not eliminated pertussis.
- New strategies such as maternal immunization, cocooning, and neonatal vaccination show promise but have limitations.
- Development of improved acellular vaccines and novel approaches like live attenuated nasal vaccines are underway.
Conclusions:
- No single strategy may be sufficient to protect infants from severe pertussis.
- A combination of multiple vaccination strategies may be necessary for effective disease control.
- Continued research and development of improved pertussis vaccines are urgently needed.
Abstract:
Pertussis or whooping cough is a life-threatening childhood disease, particularly severe during the first months of life, although adolescent and adult pertussis is increasingly more noted. General vaccination has tremendously reduced its incidence but has failed to bring it completely under control. In fact, it remains one of the most poorly controlled vaccine-preventable diseases in the world. New vaccination strategies are thus being explored. These include vaccination of pregnant mothers to transmit protective antibodies to the offspring, a cocooning strategy to prevent the transmission of the disease from family members to the newborn and neonatal vaccination. All have their inherent limitations, and improved vaccines are urgently needed. Two types of pertussis vaccines are currently available, whole-cell, first-generation and second-generation, acellular vaccines, with an improved safety profile. Attempts have been made to discover additional protective antigens to the 1-5 currently included in the acellular vaccines or to include new adjuvants. Recently, a live attenuated nasal Bordetella pertussis vaccine has been developed and undergone first-in-man clinical trials. However, as promising as it may be, in order to protect infants against severe disease, a single approach may not be sufficient, and multiple strategies applied in a concerted fashion may ultimately be required.
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