Whooping cough, twenty years from acellular vaccines introduction

Area of Science:

• Immunology
• Vaccinology
• Public Health

Background:

• Pertussis (whooping cough) remains a significant public health issue despite widespread vaccination.
• Whole-cell pertussis vaccines faced limitations due to side effects and combination vaccine challenges.
• Acellular pertussis vaccines (aP) were introduced, offering improved safety and efficacy, largely replacing whole-cell vaccines in Western countries.

Purpose of the Study:

• To review the evolution of pertussis vaccines and their impact on disease control.
• To assess the effectiveness and limitations of current acellular pertussis vaccines.
• To discuss current and future strategies for enhancing pertussis disease control.

Main Methods:

• Review of historical vaccine data and clinical trial outcomes.
• Analysis of recent epidemiological evidence on vaccine effectiveness and duration of protection.
• Examination of public health recommendations and ongoing vaccine development.

Main Results:

• Acellular pertussis vaccines provide approximately 80% protection, which wanes over time, leaving vaccinated individuals susceptible.
• High vaccination coverage (e.g., 95%) does not fully eliminate disease incidence due to vaccine limitations.
• Protection wanes, leading to unprotected adolescents and adults, highlighting the need for boosters.

Conclusions:

• Current pertussis control strategies require enhancement beyond infant vaccination.
• Booster doses for infants, adolescents, young adults, healthcare personnel, and potentially pregnant women/infant contacts are recommended.
• Development of improved pertussis vaccines, particularly multi-component acellular formulations, is crucial for long-term disease control.