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Global patterns of pertussis incidence and vaccination strategies: implications of divergent surveillance data

Kangguo Li1, Yulun Xie1, Jiadong Wu1

  • 1State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China.

NPJ Vaccines
|May 9, 2026
PubMed

Insights

Pertussis (whooping cough) control requires careful vaccine strategy. Comparing WHO and GBD data revealed significant differences in pertussis incidence, highlighting the need for harmonized surveillance data for accurate global health insights.

Area of Science:

  • Public Health
  • Epidemiology
  • Immunology

Background:

  • Pertussis (whooping cough) poses a significant global health risk to infants, with recent increases in cases prompting a reevaluation of vaccination strategies.
  • Maternal pertussis immunization offers benefits beyond passive antibody transfer, potentially involving complex maternal-infant immune interactions.

Purpose of the Study:

  • To compare pertussis incidence data from WHO notifications and GBD modeled estimates.
  • To assess how associations between vaccination policy indicators and pertussis incidence vary across different data sources and outcome definitions.

Main Methods:

  • Utilized Joinpoint regression to characterize incidence trends.
  • Employed Bayesian hierarchical models to estimate associations between vaccination policies and incidence, accounting for Universal Health Coverage.
  • Compared data from World Health Organization (WHO) routine notifications and Global Burden of Disease (GBD) modeled estimates.

Main Results:

  • Significant discrepancies were observed in pertussis incidence levels and trends between WHO and GBD datasets.
  • Unadjusted analyses indicated varied, sometimes contradictory, associations for maternal immunization and vaccination schedule timing.
  • After adjustment, DTP3 (diphtheria-tetanus-pertussis) vaccine coverage showed a strong inverse association with incidence in GBD data, but not in WHO data.

Conclusions:

  • WHO and GBD estimates for pertussis incidence are not interchangeable and should not be interpreted similarly.
  • Robust cross-country inferences necessitate harmonized data constructs and detailed metadata on surveillance implementation and ascertainment.

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