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Prevention of pertussis: from clinical trials to Real World Evidence
1Pediatric Clinic, Department of Medical and Surgical Sciences, Università degli Studi di Perugia, Italy.
Insights
Strengthening pertussis (whooping cough) vaccination coverage in all age groups, including maternal vaccination during pregnancy, is crucial for preventing this widespread infectious disease. This approach protects newborns before they can be vaccinated.
Area of Science:
- Immunology
- Infectious Diseases
- Vaccinology
Background:
- Pertussis, caused by Bordetella pertussis, historically posed significant health and economic burdens, particularly for infants.
- While whole-cell and acellular pertussis vaccines have reduced disease incidence, pertussis remains a prevalent vaccine-preventable illness.
- Recent years have seen an increase in pertussis cases, highlighting ongoing challenges in disease control.
Purpose of the Study:
- To review the current understanding of pertussis epidemiology and vaccine effectiveness.
- To emphasize the necessity of updated vaccination strategies for comprehensive pertussis prevention.
- To highlight the critical role of maternal immunization in protecting newborns.
Main Methods:
- Review of existing literature on pertussis epidemiology, vaccine efficacy, and public health recommendations.
- Analysis of trends in pertussis incidence and vaccine coverage.
- Evaluation of the impact of different vaccination schedules and strategies.
Main Results:
- Acellular pertussis vaccines demonstrate good immunogenicity and real-world effectiveness.
- Despite vaccination efforts, pertussis incidence is increasing in some populations.
- Maternal vaccination during the third trimester is highly effective in protecting infants.
Conclusions:
- Enhanced and consistent vaccination coverage across all age groups is essential for controlling pertussis.
- Booster vaccinations every 10 years are recommended for sustained immunity in adults.
- Maternal vaccination is a key strategy to provide immediate protection to newborns against pertussis.
Abstract:
Pertussis, a highly contagious infective disease caused by Bordetella pertussis, was in the past very common among newborns and children, causing significant medical, social and economic issues burden, also due to frequent need of hospitalization and high mortality. Following the introduction of vaccines against pertussis, the burden of the disease dramatically decreased, although nowadays, this disease it is still the most widespread among the vaccine preventable ones. First vaccine formulations were composed with whole cell antigen of Bordetella pertussis and were followed by formulations with acellular antigens (PT, FHA, PRN, FIM), that showed to have similar efficacy and less reactogenicity. In particular, all the acellular vaccines, regardless the number of antigenic component included, demonstrated good immunogenicity in clinical trials and high effectiveness in real world evidence studies. Nevertheless, in the recent years it has been notified an increasing number of cases of pertussis. The most recent evidence demonstrated that for an effective control and prevention of pertussis it is necessary to strengthen vaccination coverage among the whole population, providing primary vaccination to newborns and booster in infancy, adolescence and adulthood every 10 years. Finally, vaccination of women at the third trimester of every pregnancy is the most effective intervention to protect the newborn from pertussis in his first months of life, before developing a protective response after the primary vaccination.
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