Pertussis before, during and after Covid-19.

Area of Science:

• Immunology
• Infectious Diseases
• Vaccinology

Background:

• Pertussis (whooping cough) has seen a significant resurgence globally post-COVID-19 pandemic, reversing a trend of decline observed during pandemic-related social distancing.
• Pre-pandemic, pertussis incidence was already increasing in many regions, particularly in countries utilizing acellular pertussis vaccines (aP) over whole-cell vaccines (wP).
• Contributing factors to the pertussis upsurge include Bordetella pertussis strain adaptation to evade vaccine-induced immunity, rapid waning of immunity post-vaccination, and the inability of current vaccines to prevent infection and transmission.

Purpose of the Study:

• To review the current challenges in pertussis control, including the limitations of existing vaccines.
• To highlight the potential of novel vaccine strategies for more comprehensive pertussis prevention.
• To introduce the live attenuated BPZE1 vaccine as a promising candidate for future pertussis control.

Main Methods:

• Review of epidemiological data on pertussis incidence trends.
• Analysis of factors contributing to vaccine ineffectiveness and disease resurgence.
• Evaluation of current and emerging pertussis control strategies, including maternal vaccination and novel vaccine candidates.

Main Results:

• Acellular pertussis vaccines (aP) show reduced efficacy in preventing infection and transmission compared to whole-cell vaccines (wP).
• Waning immunity and bacterial adaptation are key drivers of pertussis resurgence.
• Maternal vaccination is effective in protecting newborns from severe pertussis but does not prevent infection or transmission.

Conclusions:

• Current pertussis vaccines are insufficient to halt disease transmission.
• Novel vaccines capable of preventing infection and transmission are crucial for ultimate pertussis control.
• The live attenuated BPZE1 vaccine demonstrates potential as a game-changer in pertussis prevention, offering promise beyond disease prevention to include infection and transmission blockade.