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Vaccination status and severity of pertussis among hospitalized pediatric patients at a tertiary center in Riyadh: an

Fatimah Mohammed Zabbani1, Omar Alzomor2, Hamad Sultan AlMasary3

  • 1Pediatric Infectious Diseases, King Saud Medical City, Riyadh, Saudi Arabia. f.zabbani@rfhc.gov.sa.

BMC Pediatrics
|July 6, 2026
PubMed

Insights

Pertussis hospitalization in infants is severe, with high ICU admission and mortality rates. Unvaccinated infants showed higher severe pertussis rates, warranting further study on vaccination impact.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Vaccinology

Background:

  • Pertussis (whooping cough) is a significant vaccine-preventable respiratory illness.
  • Young infants, ineligible for vaccination, bear the highest burden of pertussis morbidity.
  • Local data on clinical severity and healthcare needs for hospitalized children are crucial.

Purpose of the Study:

  • To characterize clinical features, management, and outcomes of children hospitalized with pertussis.
  • To explore associations between vaccination status and pertussis severity in hospitalized children.
  • To provide local evidence from King Saud Medical City (KSMC), Riyadh.

Main Methods:

  • Retrospective chart review of children (0-14 years) with PCR-confirmed pertussis (2023-2025).
  • Disease severity assessed using Pertussis Severity Score (PSS); PSS > 5 defined severe disease.
  • Unadjusted exploratory analyses examined vaccination status and severity outcomes.

Main Results:

  • Fifty children hospitalized; median age 2.0 months. Common symptoms: cough, cyanosis, apnea, vomiting, hypoxemia, pneumonia.
  • 86% lacked documented pertussis vaccination. 52% had severe pertussis (PSS > 5).
  • 58% required oxygen, 54% ICU admission, and 20% in-hospital mortality. Unvaccinated children had higher severe pertussis rates (58.1% vs 14.3%).

Conclusions:

  • Hospitalized pertussis in this cohort primarily affected very young infants, showing high severity and mortality.
  • Unvaccinated children were over-represented in severe cases, though this requires cautious interpretation due to age and eligibility factors.
  • Further prospective studies are needed to clarify vaccination's role in pertussis severity, controlling for confounders.
Abstract

Keywords:
Disease severityHospitalized childrenPertussisPertussis-containing vaccineSaudi ArabiaVaccination status

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