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[Recent epidemiology of pertussis: implications for vaccination]
Insights
Despite high infant immunization rates, pertussis (whooping cough) is circulating due to waning vaccine immunity. New strategies are needed to protect young infants from this persistent respiratory illness.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Acellular pertussis vaccines have been available for over a decade, enabling immunization beyond infancy.
- Despite high infant vaccination coverage, Bordetella pertussis continues to circulate, leading to outbreaks.
- Recent years have seen a significant rise in pertussis cases among infants, children, and adolescents in North America and Europe.
Purpose of the Study:
- To discuss the challenges in controlling pertussis (whooping cough) despite widespread vaccination.
- To explore the reasons behind the resurgence of pertussis, particularly in vulnerable young infants.
- To review novel vaccination strategies aimed at enhancing protection against pertussis.
Main Methods:
- Review of pertussis epidemiology and vaccine effectiveness data.
- Analysis of trends in Bordetella pertussis circulation.
- Discussion of current and proposed acellular pertussis vaccine usage.
Main Results:
- Pertussis remains a public health concern despite high infant immunization rates.
- Limited duration of vaccine-induced immunity is a key factor in disease resurgence.
- Outbreaks have been observed in populations with high vaccination coverage.
Conclusions:
- Current acellular pertussis vaccination schedules may not provide long-lasting protection.
- Effective control of pertussis requires addressing the waning immunity issue.
- New vaccination approaches are crucial for protecting young infants and the wider population.
Abstract:
The development of acellular pertussis vaccines allowed since more than a decade to continue beyond the 2 first years of life the immunization against this illness. This technological progress should have led to an improvement in the control of the disease. However, despite high immunisation rates in infancy, Bordetella pertussis is still circulating in the population. Since 2010 a marked increase in the number of cases of whooping cough in infants too young to be vaccinated, as well as in older children and in teenagers, has been reported in a number of north-American states and in the United-Kingdom. A similar observation has been made in Belgium in 2012 and 2013. The limited duration of the protection resulting from vaccination is probably responsible for the insufficient control of the disease. The new approaches for the use of these vaccines that are proposed to protect the most vulnerable young infants will be discussed.
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