Global variations in immunisation strategies against pertussis in infancy

Area of Science:

• Immunology
• Vaccinology
• Public Health

Background:

• Pertussis (whooping cough) remains a significant public health concern globally, despite the World Health Organization's Expanded Programme on Immunisation (EPI) established in 1974.
• Vaccine-preventable diseases, including pertussis, continue to cause morbidity and mortality in both high-income and low- and middle-income countries.

Purpose of the Study:

• To review the clinical presentation of pertussis in vaccinated individuals and global disease burden estimates.
• To examine current pertussis vaccines, WHO-recommended immunization schedules, and the evidence supporting them.
• To synthesize current knowledge on immune responses to pertussis and regional variations in immunization practices.

Main Methods:

• Literature review of clinical heterogeneity and global pertussis burden.
• Analysis of existing pertussis vaccine types and immunization schedules.
• Examination of immunological data on protection against pertussis infection and colonization.

Main Results:

• Whole-cell pertussis vaccines offer sustained population control but are reactogenic.
• Acellular pertussis vaccines are less reactogenic but provide limited protection against transmission.
• Significant regional differences exist in current immunization schedules.

Conclusions:

• Heterogeneity in vaccines and schedules highlights uncertainty in optimal long-term pertussis control strategies.
• Further research into immune responses is crucial for developing novel pertussis vaccines and optimizing immunization schedules.