Controlling pertussis: how can we do it? A focus on immunization

ABSTRACT

Introduction: Pertussis is a highly contagious disease of the respiratory tract which is caused by the bacterium Bordetella pertussis and is most severe in those <1 year of age. A vaccine against pertussis, introduced in the 1950’s, led to a significant decrease in incidence of the disease, but recent increases in outbreaks have been attributed to insufficient vaccine uptake, suboptimal protection conferred by vaccines, and waning immunity after immunization.

Areas covered: In this review we discuss the major challenges for controlling pertussis, and what we believe the best strategies are to overcome these challenges, focusing on immunization against pertussis in Europe, but with recommendations that are relevant worldwide.

Expert commentary: To provide maximum vaccine coverage we propose a schedule that incorporates immunization of infants, preschoolers, adolescents, adults, and pregnant women. Uptake of vaccines may also vary between populations due to a variety of causes, including hesitancy to vaccinate, so any national strategy to control pertussis should also include sustaining public and healthcare provider confidence in vaccination. Addressing and improving regional variations in surveillance will also help better monitor annual incidence and outbreaks. Looking towards the future, the development of new pertussis vaccines with longer duration of protection would be advantageous.

KEYWORDS:

• Acellular pertussis vaccine
• Bordetella pertussis
• vaccine hesitancy
• vaccine schedule
• whole-cell pertussis vaccine

Acknowledgments

Editorial assistance with the preparation of the manuscript was provided by a professional medical writer, Nicola Truss PhD of inScience Communications, Springer Healthcare, and was funded by Sanofi Pasteur.

Declaration of interest

F Martinon-Torres’s institution received clinical trial fees and/or research grants from Sanofi Pasteur, GSK, Novartis, Pfizer, SPMSD, and Merck; FMT has received in the last 12 months speaker fees from all major European vaccine manufacturers. U Heininger is a member of The Global Pertussis Initiative (GPI) which is supported by Sanofi Pasteur; UH has received speaker fees for product independent scientific presentations from Pfizer, Sanofi Pasteur, and Baxter. A Thompson is employed by Sanofi Pasteur. C.H.W von König reports personal fees from the Global Pertussis Initiative, which is supported by Sanofi Pasteur and personal fees from GSK Biologicals SA, and Rixensart. The views and opinions expressed in this comment are solely those of the authors independent of the GPI, Sanofi Pasteur, or any other vaccine manufacture. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Editorial assistance with the preparation of the manuscript was provided by a professional medical writer and was funded by Sanofi Pasteur.