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Real-world effectiveness of maternal genetically inactivated acellular pertussis vaccination in protecting infants

Farooq Phiriyasart1, Virasakdi Chongsuvivatwong2, Ponlagrit Kumwichar3

  • 1Su-ngai Kolok Hospital, Narathiwat Provincial Public Health Office, Su- ngai Kolok, Narathiwat, Thailand.

Infection
|July 27, 2026
PubMed

Insights

Maternal vaccination with recombinant acellular pertussis (aPgen) vaccine during pregnancy demonstrated high effectiveness in protecting infants under three months against pertussis. This strategy offers robust protection for vulnerable newborns in Thailand.

Area of Science:

  • * Public Health
  • * Vaccinology
  • * Pediatric Infectious Diseases

Background:

  • * Infants under three months are highly susceptible to severe pertussis and mortality.
  • * Maternal vaccination is a key strategy for protecting young infants, but real-world effectiveness of acellular pertussis (aP) vaccines in Thailand is not well-established.
  • * Recombinant aP (aPgen) vaccines are increasingly used, necessitating evaluation of their effectiveness.

Purpose of the Study:

  • * To assess the vaccine effectiveness (VE) of maternal aP vaccination during pregnancy in preventing symptomatic pertussis in infants younger than three months.
  • * To evaluate the specific VE of recombinant aP (aPgen) vaccines in the Thai context.

Main Methods:

  • * A case-control study conducted in Narathiwat Province, Thailand, during a pertussis outbreak (September 2023–October 2024).
  • * Included PCR-confirmed pertussis cases (n=33) and community-matched asymptomatic controls (n=330).
  • * Maternal vaccination status (aP vaccine during pregnancy) was compared to no vaccination; VE was estimated using weighted logistic regression.

Main Results:

  • * All mothers who received the aP vaccine (98/404) were vaccinated with aPgen (94% standalone aPgen).
  • * Maternal aPgen vaccination showed a high VE of 95.3% (95% CI: 64.7%, 99.4%) against symptomatic, PCR-confirmed infant pertussis.
  • * Sensitivity analyses confirmed the robustness of the observed VE, indicating it was unlikely to be explained by unmeasured confounders.

Conclusions:

  • * Maternal aPgen vaccination during pregnancy provides highly probable and robust VE against pertussis in infants during their first three months of life.
  • * Findings support the use of recombinant aP vaccines for maternal pertussis immunization programs in Thailand.
  • * This effective strategy could be considered for implementation in other regions facing similar public health challenges.
Abstract

Keywords:
Genetically inactivated pertussis vaccineInfantMaternal immunizationPertussisReal-world evidenceRecombinant pertussis vaccineVaccine effectivenessaPgen

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