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Pertussis vaccination in adults in France: Overview and suggestions for improvement
E Blanchard1, D Chavade2, B de Wazières3
1Respiratory Department, Bordeaux University Hospital, 33604 Pessac, France.
Insights
France
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Pertussis (whooping cough) vaccination in France primarily targets newborns and infants.
- Current strategies include infant vaccination, adolescent boosters, and vaccination of pregnant women.
- A cocooning strategy is reserved for infants born to unvaccinated mothers.
Purpose of the Study:
- To evaluate the effectiveness of the current pertussis vaccination program in France.
- To identify challenges and propose improvements for pertussis vaccination coverage and strategy.
- To enhance pertussis diagnosis and surveillance in adults and seniors.
Main Methods:
- Analysis of real-world pertussis vaccination data in France.
- Review of vaccination coverage rates among different age groups.
- Assessment of the appropriateness of tetanus, diphtheria, and polio (Td/IPV) vaccine usage.
- Evaluation of pertussis diagnosis and surveillance in adult populations.
Main Results:
- Inadequate pertussis vaccination coverage observed in adolescents and adults under 25.
- Improper use of the Td/IPV vaccine noted in young children, adolescents, and young adults.
- Underdiagnosis of pertussis is prevalent in the adult population.
- Adults and seniors with chronic conditions are at higher risk for severe pertussis disease.
Conclusions:
- Improving adult and senior pertussis diagnosis and surveillance is crucial.
- Aligning adult pertussis boosters with the Td/IPV schedule (e.g., at 45, 65 years, then every 10 years) would simplify implementation.
- Large-scale awareness campaigns are recommended to increase adult vaccination coverage and program effectiveness.
Abstract:
In France, the goal of the pertussis vaccination program is to protect newborns. All infants are vaccinated under the program and then given booster shots up to the age of 25 years. Pregnant women are likewise vaccinated, with the cocooning strategy reserved for infants born to unvaccinated mothers. Real-world data shows (i) inadequate coverage among adolescents and adults under 25; (ii) improper use of the tetanus, diphtheria, and polio (Td/IPV) vaccine in children under six years, adolescents, and young adults; and (iii) underdiagnosis of pertussis in adults. Older patients or those with specific chronic medical conditions are at risk of developing severe disease. Improving the diagnosis and surveillance of pertussis in adults and seniors would be one of the first steps in the right direction. Aligning pertussis vaccination in adults with the Td/IPV program (boosters at 45, 65 years of age, and then every 10 years) would make the vaccination schedule simpler, easier to understand, and easier to implement. Large-scale awareness campaigns targeting this population would increase coverage, thereby boosting the effectiveness of the other measures.
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