Journal articles: 'Epidemiology;Pertussis;Vaccine effectiveness'

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OKADA, K., Y. OHASHI, F. MATSUO, S. UNO, M. SOH, and S. NISHIMA. "Effectiveness of an acellular pertussis vaccine in Japanese children during a non-epidemic period: a matched case-control study." Epidemiology and Infection 137, no. 1 (May 12, 2008): 124–30. http://dx.doi.org/10.1017/s0950268808000708.

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SUMMARYThe number of pertussis cases in Japan has decreased dramatically following the nationwide use of an acellular pertussis vaccine combined with diphtheria-tetanus toxoids (DTaP vaccines) which began in 1981. However, the effectiveness of the DTaP vaccine has not been systematically evaluated using appropriate epidemiological methods during a non-epidemic period in Japan. We evaluated the vaccine effectiveness (VE) of the Kaketsuken DTaP vaccine which contains two-component pertussis antigens in Japanese children from 1999 to 2001 using a matched case-control design and data from the Basic Resident Registration and Maternal and Child Health Handbooks. The DTaP vaccination history of 15 children with pertussis and 59 controls was obtained. The VE of 3 or 4 pertussis vaccinations compared with non-vaccination (baseline) was 96·9% for coughing attacks that lasted ⩾7 days, 96·4% for those lasting ⩾14 days, and 95·9% for those lasting ⩾21 days. These findings suggest that DTaP vaccination effectively prevented pertussis during a non-epidemic period in Japan.

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Muller, A. S., J. Leeuwenburg, and David S. Pratt. "Epidemiology and Control of Pertussis." Tropical Doctor 17, no. 4 (October 1987): 182–90. http://dx.doi.org/10.1177/004947558701700411.

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An estimated 60 million children suffer from whooping cough annually, causing half a million deaths. The gradual decline in incidence rates observed in Europe and North America even before the introduction of pertussis immunization is not likely to occur within the near future in developing countries short of widespread immunization efforts. The present pertussis vaccine is effective, and serious adverse effects are rare in comparison with the consequences of the disease itself. A new, acel-lular vaccine is under trial and holds promise for the future. Epidemiological studies and surveillance for pertussis activity are hampered by the fact that the clinical diagnosis is difficult to make under field conditions. New serological techniques may bring improvement in this respect. Immunization does not play a significant role in outbreak control. Outbreak investigations are, however, extremely valuable for assessment of the effectiveness of immunization programmes; they provide valuable information, not easily obtained by other means, on age-specific attack rates and vaccine efficacy if the immunization status of the population is known.

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Riolo, Maria A., and Pejman Rohani. "Combating pertussis resurgence: One booster vaccination schedule does not fit all." Proceedings of the National Academy of Sciences 112, no. 5 (January 20, 2015): E472—E477. http://dx.doi.org/10.1073/pnas.1415573112.

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Pertussis has reemerged as a major public health concern in many countries where it was once considered well controlled. Although the mechanisms responsible for continued pertussis circulation and resurgence remain elusive and contentious, many countries have nevertheless recommended booster vaccinations, the timing and number of which vary widely. Here, using a stochastic, age-stratified transmission model, we searched for cost-effective booster vaccination strategies using a genetic algorithm. We did so assuming four hypothesized mechanisms underpinning contemporary pertussis epidemiology: (I) insufficient coverage, (II) frequent primary vaccine failure, (III) waning of vaccine-derived protection, and (IV) vaccine “leakiness.” For scenarios I–IV, successful booster strategies were identified and varied considerably by mechanism. Especially notable is the inability of booster schedules to alleviate resurgence when vaccines are leaky. Critically, our findings argue that the ultimate effectiveness of vaccine booster schedules will likely depend on correctly pinpointing the causes of resurgence, with misdiagnosis of the problem epidemiologically ineffective and economically costly.

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O’Leary, Sean T., Yvonne A. Maldonado, and David W. Kimberlin. "Update from the Advisory Committee on Immunization Practices." Journal of the Pediatric Infectious Diseases Society 9, no. 1 (February 4, 2020): 3–5. http://dx.doi.org/10.1093/jpids/piaa008.

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Abstract The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, meets 3 times per year to develop recommendations for vaccine use in the United States. There are usually 15 voting members; members’ terms are for 4 years. ACIP members and Centers for Disease Control and Prevention staff discuss the epidemiology of vaccine-preventable diseases and vaccine research, effectiveness, safety data, and results from clinical trials. Representatives from the American Academy of Pediatrics (Y. A. M., D. W. K.) and the Pediatric Infectious Diseases Society (S. T. O.) are present as liaisons to the ACIP. The ACIP met on 23–24 October 2019 to discuss pertussis vaccines, the child/adolescent and adult immunization schedule, influenza vaccine effectiveness and safety, Ebola vaccine, orthopoxvirus vaccines, Dengue vaccine, rabies vaccine, measles, and vaccine safety update.

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Luna, Carlos M. "Impact of vaccination on the epidemiology and prognosis of pneumonia." Revista Española de Quimioterapia 35, Suppl1 (April 22, 2022): 104–10. http://dx.doi.org/10.37201/req/s01.22.2022.

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Adults with lung diseases, comorbidities, smokers, and elderly are at risk of lung infections and their consequences. Community-acquired pneumonia happen in more than 1% of people each year. Possible pathogens of community-acquired pneumonia include viruses, pneumococcus and atypicals. The CDC recommend vaccination throughout life to provide immunity, but vaccination rates in adults are poor. Tetravalent and trivalent influenza vaccine is designed annually during the previous summer for the next season. The available vaccines include inactivated, adjuvant, double dose, and attenuated vaccines. Their efficacy depends on the variant of viruses effectively responsible for the outbreak each year, and other reasons. Regarding the pneumococcal vaccine, there coexist the old polysaccharide 23-valent vaccine with the new conjugate 10-valent and 13-valent conjugate vaccines. Conjugate vaccines demonstrate their usefulness to reduce the incidence of pneumococcal pneumonia due to the serotypes present in the vaccine. Whooping cough is still present, with high morbidity and mortality rates in young infants. Adult’s pertussis vaccine is available, it could contribute to the control of whooping cough in the most susceptible, but it is not present yet in the calendar of adults around the world. About 10 vaccines against SARS-CoV-2 have been developed in a short time, requiring emergency use authorization. A high rate of vaccination was observed in most of the countries. Booster doses became frequent after the loss of effectiveness against new variants. The future of this vaccine is yet to be written.

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Pal, Moneeta, Felicity Goodyear-Smith, and Daniel Exeter. "Systematic review of pertussis immunisation among Asians." International Journal of Human Rights in Healthcare 9, no. 2 (June 6, 2016): 135–46. http://dx.doi.org/10.1108/ijhrh-02-2016-0002.

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Purpose – The purpose of this paper is to provide a review of the literature on pertussis immunisations among the Asian population. Design/methodology/approach – A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review performed searches using the keywords: immun*, vaccine* AND whooping cough or Bordetella pertussis OR B pertussis AND Asia*. The search was conducted on four electronic databases, namely, Medline, CINAHL, Embase and Cochrane Database of Systematic Reviews. Findings – In total, 13 studies of relevance were included in the review after screening 206 articles. The studies were categorised into three literature sections which were: epidemiology of pertussis, vaccine effectiveness studies in Asia and strategies aimed to increase uptake of immunisations against pertussis. Research limitations/implications – Due to financial constraints, the authors only had access to articles published in the English language and full text articles which may limit the generalisability of the review. Originality/value – The review is useful in providing insight into the general trends of pertussis immunisations among Asians and in aiding future research in this area.

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Tam, Pui-Ying Iroh, Paul Visintainer, and Donna Fisher. "Response to an Education Program for Parents About Adult Pertussis Vaccination." Infection Control & Hospital Epidemiology 30, no. 6 (June 2009): 589–92. http://dx.doi.org/10.1086/597510.

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We designed a prospective study to evaluate the effectiveness of an educational intervention designed to increase awareness and knowledge of pertussis among parents and grandparents of newborns. We also evaluated its effect on their willingness to receive the tetanus toxoid-diphtheria toxoid-acellular pertussis vaccine. There was a statistically significant (P < .05) increase in participants' knowledge about pertussis and in their willingness to receive vaccination after our education program. However, follow-up several months after participants underwent the intervention revealed that only 12 (8%) of 150 participants had been vaccinated.

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Medkova, A. Yu, A. A. Lidzhiyeva, E. G. Semin, L. N. Sinyashina, R. A. Syundyukova, N. A. Snegireva, I. N. Chernyshova, et al. "Immunogenicity of the drug "Live intranasal vaccine for the prevention of pertussis" (GamLPV) with a single use in healthy volunteers." Journal of microbiology, epidemiology and immunobiology 98, no. 6 (January 10, 2022): 706–20. http://dx.doi.org/10.36233/0372-9311-194.

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Introduction. A significant increase in the incidence of pertussis in the world, including among adolescents and adults, the prevalence of mild forms of the disease and asymptomatic carrier of bacteria B. pertussis, and the resulting need for mass revaccination of different age groups determine the demand for new vaccines against B. pertussis. In N.F. Gamaleya Federal Research Center for Epidemiology and Microbiology, a live intranasal pertussis vaccine for the prevention of pertussis (GamLPV) has been developed. The GamLPV vaccine underwent preclinical studies that proved its safety and effectiveness in experiments on small laboratory animals and nonhuman monkeys. Safety of vaccine is shown in clinical studies on healthy volunteers.The aim of the study is to assess the immunogenicity of different doses of the drug GamLPV when first used in healthy volunteers.Materials and methods. The study was conducted as randomized placebo-controlled, blind trial with consistent volunteer inclusion and dose escalation. Study ID in clinicaltrials.gov database: NCT03137927 (A Phase I Clinical Study of a GamLPV, a Live Intranasal Bordetella Pertussis Vaccine). The following parameters of humoral and cellular immune responses were assessed in dynamics: levels of specific IgM, IgG and IgA antibodies in blood serum of volunteers and the number of cytokines interleukin-17, tumor necrosis factor-α, interferon-γ produced after specific induction in vitro of blood mononuclears of vaccinated volunteers. Dynamics of attenuated bacteria persistence in nasopharynx of vaccinated volunteers was evaluated.Results. Intranasal vaccination of volunteers with the drug Gam LPV resulted in the formation of a specific humoral (IgG and IgA) and cellular immune response. The dose-dependent nature of immunoglobulin and cytokine production was shown. Attenuated bacteria persisted for a long time in the nose/oropharynx of vaccinated volunteers.Discussion. Good tolerability of all tested doses of the drug justifies the choice for further investigation of a vaccine dose equal to 4 × 109 CFU. At the next stage, the safety and immunogenicity of two-time vaccination of volunteers will be studied.

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Pesco, P., P. Bergero, G. Fabricius, and D. Hozbor. "Modelling the effect of changes in vaccine effectiveness and transmission contact rates on pertussis epidemiology." Epidemics 7 (June 2014): 13–21. http://dx.doi.org/10.1016/j.epidem.2014.04.001.

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Goudsmit, Jaap, Anita Huiberdina Johanna van den Biggelaar, Wouter Koudstaal, Albert Hofman, Wayne Chester Koff, Theodore Schenkelberg, Galit Alter, Michael Joseph Mina, and Julia Wei Wu. "Immune age and biological age as determinants of vaccine responsiveness among elderly populations: the Human Immunomics Initiative research program." European Journal of Epidemiology 36, no. 7 (June 12, 2021): 753–62. http://dx.doi.org/10.1007/s10654-021-00767-z.

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AbstractThe Human Immunomics Initiative (HII), a joint project between the Harvard T.H. Chan School of Public Health and the Human Vaccines Project (HVP), focuses on studying immunity and the predictability of immuneresponsiveness to vaccines in aging populations. This paper describes the hypotheses and methodological approaches of this new collaborative initiative. Central to our thinking is the idea that predictors of age-related non-communicable diseases are the same as predictors for infectious diseases like COVID-19 and influenza. Fundamental to our approach is to differentiate between chronological, biological and immune age, and to use existing large-scale population cohorts. The latter provide well-typed phenotypic data on individuals’ health status over time, readouts of routine clinical biochemical biomarkers to determine biological age, and bio-banked plasma samples to deep phenotype humoral immune responses as biomarkers of immune age. The first phase of the program involves 1. the exploration of biological age, humoral biomarkers of immune age, and genetics in a large multigenerational cohort, and 2. the subsequent development of models of immunity in relation to health status in a second, prospective cohort of an aging population. In the second phase, vaccine responses and efficacy of licensed COVID-19 vaccines in the presence and absence of influenza-, pneumococcal- and pertussis vaccines routinely offered to elderly, will be studied in older aged participants of prospective population-based cohorts in different geographical locations who will be selected for representing distinct biological and immune ages. The HII research program is aimed at relating vaccine responsiveness to biological and immune age, and identifying aging-related pathways crucial to enhance vaccine effectiveness in aging populations.

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Yerdessov, Sauran, Anara Abbay, Zhalaliddin Makhammajanov, Aygerim Zhuzzhasarova, Arnur Gusmanov, Yesbolat Sakko, Gulnur Zhakhina, et al. "Epidemiological characteristics and seasonal variation of measles, pertussis, and influenza in Kazakhstan between 2010-2020 years." Electronic Journal of General Medicine 20, no. 1 (January 1, 2023): em429. http://dx.doi.org/10.29333/ejgm/12621.

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Background: Vaccine-preventable diseases such as pertussis, measles, and influenza remain among the most significant medical and socioeconomic issues in Kazakhstan, despite significant vaccination achievements. Thus, here we aimed to analyze the long-term dynamics and provide information on the current epidemiology of pertussis, measles, and influenza in Kazakhstan. Methods: A retrospective analysis of the long-term dynamics of infectious diseases was carried out using the data from the statistical collections for 2010-2020 and the Unified Payment System from 2014 to 2020. Results: During the 2010-2020 years, the long-term dynamics show an unequal distribution of pertussis, measles, and influenza-related morbidity. In comparison with earlier years, registration of infectious disease was the highest in 2019 and 2020. The incidence cases among registered infectious diseases in 2019 were: pertussis-147, measles-13,326, and in 2020: influenza-2,678. High incidence rates have been documented in Pavlodar, North Kazakhstan, Mangystau regions, and the cities of Shymkent and Nur-Sultan. The incidence varies depending on the seasonality: pertussis (summer-autumn), measles (winter-spring), and influenza (mostly in winter). Conclusion: The findings highlight the importance of focusing more on the characteristics of the epidemic process of vaccine-preventable diseases in order to assess the effectiveness of implemented measures and verify new routes in strengthening the epidemiological surveillance system.

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Buck, Philip. "The Value of Vaccination in Older Adults: The Why." Innovation in Aging 4, Supplement_1 (December 1, 2020): 806–7. http://dx.doi.org/10.1093/geroni/igaa057.2929.

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Abstract The incidence of vaccine-preventable diseases remains high among older adults in the US, despite longstanding immunization recommendations, and is projected to increase as the population ages. The impact of US population aging on the burden of four vaccine-preventable diseases (influenza, pneumococcal disease, shingles, and pertussis) was modeled over a 30-year time horizon, with cumulative direct and indirect costs increasing from $378 billion over 10 years to $1.28 trillion over 30 years. Compared to current levels of vaccination coverage, increasing coverage was predicted to avert over 33 million cases of disease and greater than $96 billion in disease-associated costs, with a corresponding increase in vaccination costs of approximately $83 billion over the entire 30-year time period. Specific examples of cost-effectiveness analyses that assess the epidemiologic and economic impact of vaccination against shingles and pertussis in older adults will be discussed. Part of a symposium sponsored by the Health Behavior Change Interest Group.

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Cho, Bo-Hyun, Anna M. Acosta, Andrew J. Leidner, Amanda E. Faulkner, and Fangjun Zhou. "Tetanus, diphtheria and acellular pertussis (Tdap) vaccine for prevention of pertussis among adults aged 19 years and older in the United States: A cost-effectiveness analysis." Preventive Medicine 134 (May 2020): 106066. http://dx.doi.org/10.1016/j.ypmed.2020.106066.

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Liew, Fereen, Li Wei Ang, Jeffery Cutter, Lyn James, and Kee Tai Goh. "Evaluation on the Effectiveness of the National Childhood Immunisation Programme in Singapore, 1982-2007." Annals of the Academy of Medicine, Singapore 39, no. 7 (July 15, 2010): 532–41. http://dx.doi.org/10.47102/annals-acadmedsg.v39n7p532.

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Introduction: We undertook a study to evaluate the effectiveness of the National Childhood Immunisation Programme (NCIP) over the past 26 years by reviewing the epidemiological trends of the diseases protected, the immunisation coverage and the changing herd immunity of the population during the period of 1982 to 2007. Materials and Methods: The epidemiological data of all cases of diphtheria, pertussis, poliomyelitis, measles, mumps, rubella and acute hepatitis B notified to the Communicable Diseases Division, Ministry of Health (MOH) from 1982 to 2007 were collated and analysed. Data on tuberculosis (TB) cases were obtained from the TB Control Unit, Tan Tock Seng Hospital. Cases of neonatal tetanus and congenital rubella syndrome (CRS) among infants born in Singapore were identified from the Central Claims Processing System. The number of therapeutic abortions performed for rubella infections was retrieved from the national abortion registry. Coverage of the childhood immunisation programme was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against the various vaccine-preventable diseases protected, the findings of several serological surveys conducted from 1982 to 2005 were reviewed. Results: The incidence of vaccine-preventable diseases covered under the NCIP had declined over the last 26 years with diphtheria, neonatal tetanus, poliomyelitis and congenital rubella virtually eliminated. The last case of childhood TB meningitis and the last case of acute hepatitis B in children below 15 years were reported in 2002 and 1996, respectively. Conclusion: The NCIP has been successfully implemented as evidenced by the disappearance of most childhood diseases, excellent immunisation coverage rate in infants, preschool and school children, and high level of herd immunity of the childhood population protected. Key words: Epidemiology, Herd immunity, Vaccine-preventable diseases

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Hodder, Sally L., and Edward A. Mortimer. "Epidemiology of Pertussis and Reactions to Pertussis Vaccine." Epidemiologic Reviews 14, no. 1 (1992): 243–67. http://dx.doi.org/10.1093/oxfordjournals.epirev.a036089.

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Briko, N. I., A. Ya Mindlina, I. V. Mikheeva, L. D. Popovich, and A. V. Lomonosova. "Modeling of the Potential Effect of Revaccination against Whooping Cough in Children Aged 6–7 and 14 years within the Framework of the National of preventive vaccinations." Epidemiology and Vaccinal Prevention 20, no. 5 (November 5, 2021): 4–20. http://dx.doi.org/10.31631/2073-3046-2021-20-5-4-20.

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Relevance. Currently, the national calendar of preventive vaccinations does not provide for revaccination against whooping cough in children over the age of 18 months. At the same time, the epidemiological and economic feasibility of revaccination against whooping cough in children aged 6–7 years, as well as adolescents, has been demonstrated in world practice. Aim. Based on a mathematical model, develop a forecast of pertussis morbidity dynamics and assess the potential socio-economic damage under the current and expanded vaccine prophylaxis algorithms.Methods. Mathematical modeling of the potential effect of revaccination against whooping cough in children aged 6–7 years (scenario 1) and at 6–7 years and 14 years (scenario 2) was carried out within the framework of the national calendar of preventive vaccinations. A simulation dynamic mathematical model is constructed that allows predicting the development of the epidemiological process of whooping cough on the basis of the dynamics of the main indicators of its prevalence in the population that developed in previous years. The model took into account dynamic changes in the preventive effectiveness of vaccinations and the potential level of underestimation of morbidity. The obtained arrays of indicators served as the basis for extrapolating trends in morbidity and mortality until 2034.The calculation of epidemiological benefits was carried out in the metrics of prevented loss of years of life under the two scenarios under consideration in comparison with the current vaccination algorithm. The calculation of the economic effect was carried out on the basis of the obtained indicators of epidemiological benefits in the metrics of the monetary equivalent of the average cost of a year of life, taking into account the projected inflation coefficients until 2034.Results. The projected decrease in the number of years of life lived in a state of illness, in comparison with the current situation, will total 44.5 thousand years for the period 2019–2034 under scenario 1 and 66.7 thousand years under scenario 2. The socio-economic damage from prevented cases of the disease, expressed in the monetary equivalent of the average cost of living, will decrease by 28.6% (scenario 1) or 42.0% (scenario 2).Conclusions. A comparison of the received public benefits with the costs of vaccination shows that the expansion of the NCPP with additional revaccinations against whooping cough (at 6–7 years or at 6–7 and at 14 years) is advisable both in epidemiological and economic aspects.

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Zerbo, Ousseny, Joan Bartlett, Kristin Goddard, Bruce Fireman, Edwin Lewis, and Nicola P. Klein. "Acellular Pertussis Vaccine Effectiveness Over Time." Pediatrics 144, no. 1 (June 10, 2019): e20183466. http://dx.doi.org/10.1542/peds.2018-3466.

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Breakwell, L., P. Kelso, C. Finley, S. Schoenfeld, B. Goode, L. K. Misegades, S. W. Martin, and A. M. Acosta. "Pertussis Vaccine Effectiveness in the Setting of Pertactin-Deficient Pertussis." PEDIATRICS 137, no. 5 (April 12, 2016): e20153973-e20153973. http://dx.doi.org/10.1542/peds.2015-3973.

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&NA;. "Effectiveness of whole-cell pertussis vaccine low." Inpharma Weekly &NA;, no. 1046 (July 1996): 14. http://dx.doi.org/10.2165/00128413-199610460-00024.

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Brady, R. C. "Pertactin-Negative B pertussis and Vaccine Effectiveness." AAP Grand Rounds 33, no. 4 (April 1, 2015): 37. http://dx.doi.org/10.1542/gr.33-4-37.

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Taye, Solomon, Belay Tessema, Baye Gelaw, and Feleke Moges. "Assessment of Pertussis Vaccine Protective Effectiveness in Children in the Amhara Regional State, Ethiopia." International Journal of Microbiology 2020 (October 13, 2020): 1–8. http://dx.doi.org/10.1155/2020/8845835.

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Background. Bordetella pertussis is a human pathogen which causes pertussis, or whooping cough. The diphtheria-tetanus-pertussis immunization has significantly reduced the morbidity and mortality of pertussis globally. However, higher prevalence and resurgence of pertussis cases among both vaccinated and unvaccinated people has raised questions on the effectiveness of pertussis vaccine over time. Therefore, the objective of this study was to assess the protective effectiveness of pertussis vaccine in the Amhara Regional State, Ethiopia. Methods. A nested matched case-control study design approach was used with vaccinated individuals as cases and unvaccinated individuals as controls. The study was conducted from July 2018 to February 2019. Real-time (RT-) PCR assay was done to ascertain the presence of pertussis among clinically suspected patients. Bivariable and multivariable logistic regression analyses were computed to estimate the crude and adjusted odds ratios (ORs), respectively. Vaccine effectiveness was calculated as (1 − OR) × 100. Adjusted OR with 95% CI and a P value <0.05 were used to assess statistical significance. Results. A total of 112 vaccinated and 223 unvaccinated controls were enrolled for the study. Of the total participants, 173/335 (51.6%) were males. The prevalence of pertussis among vaccinated was 35/112 (31.3%), whereas it was 84/223 (37.7%) among the control group. The adjusted matched vaccine protective effectiveness against B. pertussis infection following three doses of whole-cell vaccine was 25% among children aged between 6 and 9 years. Adjusted estimates of vaccine protective effectiveness for participants who had complete vaccination, stratified by time since last vaccination, were 50% at 6 years, 34% at 7 years, and 2% at 8–9 years since last vaccination. Conclusion. Despite the availability and good coverage of childhood vaccination, the effectiveness of pertussis vaccine was found to be low in the Amhara region, Ethiopia. Moreover, we observed declining trends in the protective effectiveness of the vaccine after 6 years of vaccination. Thus, by considering the waning nature of immune response which is induced by whole-cell vaccine during early life, booster dose is highly recommended to optimize pertussis prevention and control strategies.

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Sheridan, Sarah, Peter McIntyre, Bette Liu, Parveen Fathima, Thomas Snelling, Christopher Blyth, Nicholas de Klerk, Hannah Moore, and Heather Gidding. "Pertussis burden and acellular pertussis vaccine effectiveness in high risk children." Vaccine 40, no. 9 (February 2022): 1376–82. http://dx.doi.org/10.1016/j.vaccine.2021.10.013.

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Dewan, Kalyan K., Bodo Linz, Susan E. DeRocco, and Eric T. Harvill. "Acellular Pertussis Vaccine Components: Today and Tomorrow." Vaccines 8, no. 2 (May 13, 2020): 217. http://dx.doi.org/10.3390/vaccines8020217.

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Pertussis is a highly communicable acute respiratory infection caused by Bordetella pertussis. Immunity is not lifelong after natural infection or vaccination. Pertussis outbreaks occur cyclically worldwide and effective vaccination strategies are needed to control disease. Whole-cell pertussis (wP) vaccines became available in the 1940s but have been replaced in many countries with acellular pertussis (aP) vaccines. This review summarizes disease epidemiology before and after the introduction of wP and aP vaccines, discusses the rationale and clinical implications for antigen inclusion in aP vaccines, and provides an overview of novel vaccine strategies aimed at better combating pertussis in the future.

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Xu, Han, Jing Huang, Zhaolu Liu, Xin Li, Kangfeng Wang, Erling Feng, Jun Wu, et al. "Expression of Bordetella pertussis Antigens Fused to Different Vectors and Their Effectiveness as Vaccines." Vaccines 9, no. 6 (May 21, 2021): 542. http://dx.doi.org/10.3390/vaccines9060542.

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Pertussis is an acute respiratory tract infection caused by Bordetella pertussis. Even though its current vaccine coverage is relatively broad, they still have some shortcomings such as short protection time and might be incapable of blocking the spread of the disease. In this study, we developed new pertussis vaccine candidates by separately fusing three pertussis antigens (B. pertussis fimbriae 2 “Fim2”, pertussis toxin S1 subunit “PtxS1”, and filamentous hemagglutinin “FHA1877–2250”) to each of two immune-boosting carrier proteins (B subunits of AB5 toxin family: cholera toxin B subunit “CTB” and shiga toxin B subunit “StxB”). We then immunized mice with these fusion antigens and found that they significantly increased the serum antibody titers and elicited high bactericidal activity against B. pertussis. After CTB-or StxB-fused antigen-immunized mice were challenged with a non-lethal dose of B. pertussis, the bacterial loads in different tissues of these mice were significantly reduced, and their lung damage was nearly invisible. Furthermore, we also demonstrated that these candidate vaccines could provide strong prophylactic effects against a lethal challenge with B. pertussis. Overall, our candidate vaccines conferred better immune protection to mice compared with pertussis antigen alone. This B5 subunit-based vaccine strategy provides a promising option for vaccine design.

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POYNTEN, M., P. B. McINTYRE, F. R. MOOI, K. J. HEUVELMAN, and G. L. GILBERT. "Temporal trends in circulating Bordetella pertussis strains in Australia." Epidemiology and Infection 132, no. 2 (February 26, 2004): 185–93. http://dx.doi.org/10.1017/s095026880300164x.

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Australia experienced a resurgence of pertussis in the 1990s despite improved vaccine coverage. Although much of the increase was attributable to increased detection of cases in older persons with waning immunity by serology, vaccine changes or alterations in circulating Bordetella pertussis strains may also have contributed. We determined the frequency of variants of B. pertussis pertactin (prn), and pertussis toxin subunit 1 (ptxS1) genes, restriction fragment length polymorphism (RFLP) types and fimbrial serotypes prevalent in Australia prior to, and during the 1990s. Ampoules of the whole-cell vaccine in use prior to 1999 and 84 B. pertussis isolates stored between 1967 and 1998 by laboratories around Australia were analysed. One pertactin allele, Prn3, not detected before 1985, was found in 24 out of 57 (42%) isolates between 1989 and 1998 (P<0·0001). PtxS1A was found in all isolates. IS1002 type 29, found in 17 out of 31 (55%) isolates tested, was the predominant RFLP type. The only difference in fimbrial serotype distribution between the time-periods was an increase in serotype 3 (P=0·054). The whole-cell vaccine contained only the alleles prn1 and ptxS1A. Antigenic shift in B. pertussis may have contributed to the re-emergence of pertussis in Australia. Monitoring these trends will be important as acellular vaccines are introduced and changes are made to pertussis vaccine schedules.

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Tolan, R. W. "Acellular Pertussis Vaccine Effectiveness Wanes After 5 Doses." AAP Grand Rounds 29, no. 2 (February 1, 2013): 13. http://dx.doi.org/10.1542/gr.29-2-13.

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Bannatyne, Robert M., and Jerry Jackowski. "Protective effectiveness of an endotoxin-depleted pertussis vaccine." Vaccine 5, no. 4 (December 1987): 268–69. http://dx.doi.org/10.1016/0264-410x(87)90149-6.

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De Serres, Gaston, Ramak Shadmani, Nicole Boulianne, Bernard Duval, Louis Rochette, Monique Douville Fradet, and Scott A. Halperin. "Effectiveness of a single dose of acellular pertussis vaccine to prevent pertussis in children primed with pertussis whole cell vaccine." Vaccine 19, no. 20-22 (April 2001): 3004–8. http://dx.doi.org/10.1016/s0264-410x(00)00545-4.

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Mooi, Frits R., Qiushui He, Hans van Oirschot, and Jussi Mertsola. "Variation in the Bordetella pertussis Virulence Factors Pertussis Toxin and Pertactin in Vaccine Strains and Clinical Isolates in Finland." Infection and Immunity 67, no. 6 (June 1, 1999): 3133–34. http://dx.doi.org/10.1128/iai.67.6.3133-3134.1999.

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ABSTRACT There is evidence that pertussis is reemerging in vaccinated populations. We have proposed, and provided evidence for, one explanation for this phenomenon in The Netherlands: antigenic divergence between vaccine strains and circulating strains. Finland has a pertussis vaccination history very similar to that of The Netherlands, and yet there is no evidence for an increase in the incidence of pertussis to the extent that it was observed in The Netherlands. A comparison of the Bordetella pertussisstrains circulating in the two countries may shed light on the differences in pertussis epidemiology. Here we investigated whether temporal changes had occurred in pertussis toxin and pertactin types produced by the Finnish B. pertussis population. We show that strains isolated before 1964 produced the same pertussis toxin and pertactin variants as the vaccine strains. However, these vaccine types were replaced in later years, and in the 1990s most strains were distinct from the vaccine strains with respect to the two proteins. These trends are similar to those found in the Dutch B. pertussis population. An interesting difference between the contemporary Finnish and Dutch B. pertussis populations was found in the frequencies of pertactin variants, possibly explaining the distinct epidemiology of pertussis in the two countries.

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Ma, Longhuan, Amanda Caulfield, Kalyan K. Dewan, and Eric T. Harvill. "Pertactin-Deficient Bordetella pertussis, Vaccine-Driven Evolution, and Reemergence of Pertussis." Emerging Infectious Diseases 27, no. 6 (June 2021): 1561–66. http://dx.doi.org/10.3201/eid2706.203850.

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MOSSONG, J., L. PUTZ, Z. SHKEDY, and F. SCHNEIDER. "Seroepidemiology of diphtheria and pertussis in Luxembourg in 2000." Epidemiology and Infection 134, no. 3 (November 29, 2005): 573–78. http://dx.doi.org/10.1017/s0950268805005662.

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A large serosurvey was carried out in Luxembourg in 2000–2001, to determine the population immunity against a number of vaccine-preventable infections including diphtheria and pertussis. Immunity to diphtheria and pertussis was assessed using an in-house neutralization assay and a commercial ELISA test respectively. Mean pertussis antibody activity decreased from 4 to 8 years of age, reflecting the effects of waning of vaccine-induced immunity. Mean pertussis antibody activity increased during adolescence due to infection in previously vaccinated individuals and levelled out after approximately 20 years of age. For adults >25 years age, a statistically significant 30% difference in mean antibody activity between men and women was observed. The proportion of seronegatives for diphtheria among children and adolescents aged <20 years was 2·5% reflecting the high vaccination coverage. The proportion seronegative for diphtheria tended to increase with age such that 42% of individuals aged >40 years were seronegative. Our study supports the recently introduced acellular pertussis vaccine booster at 6 years to reduce pertussis transmission in school-aged children and adolescents.

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Lugauer, Siegfried, Ulrich Heininger, James D. Cherry, and Klemens Stehr. "Long-term clinical effectiveness of an acellular pertussis component vaccine and a whole cell pertussis component vaccine." European Journal of Pediatrics 161, no. 3 (January 24, 2002): 142–46. http://dx.doi.org/10.1007/s00431-001-0893-5.

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MAGPANTAY, F. M. G., M. DOMENECH DE CELLÈS, P. ROHANI, and A. A. KING. "Pertussis immunity and epidemiology: mode and duration of vaccine-induced immunity." Parasitology 143, no. 7 (September 4, 2015): 835–49. http://dx.doi.org/10.1017/s0031182015000979.

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SUMMARYThe resurgence of pertussis in some countries that maintain high vaccination coverage has drawn attention to gaps in our understanding of the epidemiological effects of pertussis vaccines. In particular, major questions surround the nature, degree and durability of vaccine protection. To address these questions, we used mechanistic transmission models to examine regional time series incidence data from Italy in the period immediately following the introduction of acellular pertussis (aP) vaccine. Our results concur with recent animal-challenge experiments wherein infections in aP-vaccinated individuals proved as transmissible as those in naive individuals but much less symptomatic. On the other hand, the data provide evidence for vaccine-driven reduction in susceptibility, which we quantify via a synthetic measure of vaccine impact. As to the precise nature of vaccine failure, the data do not allow us to distinguish between leakiness and waning of vaccine immunity, or some combination of these. Across the range of well-supported models, the nature and duration of vaccine protection, the age profile of incidence and the range of projected epidemiological futures differ substantially, underscoring the importance of the remaining unknowns. We identify key data gaps: sources of data that can supply the information needed to eliminate these remaining uncertainties.

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Quinn, Helen E., Jeannette L. Comeau, Helen S. Marshall, Elizabeth J. Elliott, Nigel W. Crawford, Christopher C. Blyth, Jennifer A. Kynaston, et al. "Pertussis Disease and Antenatal Vaccine Effectiveness in Australian Children." Pediatric Infectious Disease Journal 41, no. 3 (October 26, 2021): 180–85. http://dx.doi.org/10.1097/inf.0000000000003367.

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Decker, Michael D., Phillip Hosbach, David R. Johnson, Vitali Pool, and David P. Greenberg. "Estimating the Effectiveness of Tetanus-Diphtheria-Acellular Pertussis Vaccine." Journal of Infectious Diseases 211, no. 3 (August 25, 2014): 497–98. http://dx.doi.org/10.1093/infdis/jiu477.

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Terranella, Andrew, Vicki Rea, Matthew Griffith, Susan Manning, Steven Sears, Ann Farmer, Stacey Martin, and Manisha Patel. "Vaccine effectiveness of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine during a pertussis outbreak in Maine." Vaccine 34, no. 22 (May 2016): 2496–500. http://dx.doi.org/10.1016/j.vaccine.2016.03.083.

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Hekimoğlu, Can Hüseyin. "Vaccine Epidemiology: Epidemiologic Study Designs for Vaccine Effectiveness." Turkish Bulletin of Hygiene and Experimental Biology 73, no. 2 (2016): 161–74. http://dx.doi.org/10.5505/turkhijyen.2016.28482.

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Sheridan, Sarah L., Bradley J. McCall, Craig A. Davis, Jennifer M. B. Robson, Brynley P. Hull, Christine E. Selvey, Robert S. Ware, Keith Grimwood, and Stephen B. Lambert. "Acellular pertussis vaccine effectiveness for children during the 2009–2010 pertussis epidemic in Queensland." Medical Journal of Australia 200, no. 6 (April 2014): 334–38. http://dx.doi.org/10.5694/mja13.11069.

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Mungall, Bruce, Hyungwoo Kim, and Kyu-Bin Oh. "1422. Burden of Pertussis in South Korea: Implications for adults." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S718. http://dx.doi.org/10.1093/ofid/ofaa439.1604.

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Abstract Background There are a limited number of published studies on pertussis disease burden and epidemiology in South Korea, particularly those evaluating the impact in adults. Methods We conducted a systematic literature review on pertussis epidemiology and burden of disease in South Korea. The objective was to highlight evidence gaps which could help improve awareness about pertussis disease in adults in South Korea. Results Of 940 articles published between January 2000 to December 2019, 19 articles provided data for pertussis epidemiology and 9 provided data in adults. Laboratory confirmation rates in adults varied according to methodology, likely influenced by study/sampling variations. Three studies reported serological evidence of infection in adolescents and adults (33-57%). Among cases, the average cough duration was 16.5 days (range 7-30 days) and over 85% of cases presented with paroxysmal cough, while only 25% of cases or less presented with a characteristic whoop or post-tussive vomiting. Importantly, in 4 studies reporting vaccination status, almost all adult cases had no history of pertussis vaccination since childhood. Conclusion Primary childhood vaccination rates in South Korea are among the highest globally, while adult pertussis vaccine uptake appears to be quite low. Our literature review suggests that pertussis is underreported in adults, as evidenced by serology data demonstrating that tetanus antibody levels are low while pertussis toxin antibody levels are relatively high, suggesting continued circulation of community pertussis. These findings highlight the need for strategies such as maternal immunization and decennial revaccination of adults to address the changing epidemiology and waning immunity. Active pertussis testing/reporting and better utilization of adult vaccine registries is required to help provide robust data for vaccine decision-making at the national level. In the current COVID-19 environment, strategies that can reduce clinic or hospital visits will have substantial benefits to authorities managing rapid increases in health care resource utilization, and vaccine preventable diseases provide an easy and immediate target for achieving that goal. Disclosures Bruce Mungall, PhD, the GSK group of companies (Employee, Shareholder) Hyungwoo Kim, MD, MPH, the GSK group of companies (Employee) Kyu-Bin Oh, MD, the GSK group of companies (Employee, Shareholder)

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MOOI, F. R., N. A. T. VAN DER MAAS, and H. E. De MELKER. "Pertussis resurgence: waning immunity and pathogen adaptation – two sides of the same coin." Epidemiology and Infection 142, no. 4 (February 13, 2013): 685–94. http://dx.doi.org/10.1017/s0950268813000071.

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SUMMARYPertussis or whooping cough has persisted and resurged in the face of vaccination and has become one of the most prevalent vaccine-preventable diseases in Western countries. The high circulation rate ofBordetella pertussisposes a threat to infants that have not been (completely) vaccinated and for whom pertussis is a severe, life-threatening, disease. The increase in pertussis is mainly found in age groups in which immunity has waned and this has resulted in the perception that waning immunity is the main or exclusive cause for the resurgence of pertussis. However, significant changes inB. pertussispopulations have been observed after the introduction of vaccinations, suggesting a role for pathogen adaptation in the persistence and resurgence of pertussis. These changes include antigenic divergence with vaccine strains and increased production of pertussis toxin. Antigenic divergence will affect both memory recall and the efficacy of antibodies, while higher levels of pertussis toxin may increase suppression of the innate and acquired immune system. We propose these adaptations ofB. pertussishave decreased the period in which pertussis vaccines are effective and thus enhanced the waning of immunity. We plead for a more integrated approach to the pertussis problem which includes the characteristics of the vaccines, theB. pertussispopulations and the interaction between the two.

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Moraes, José Cassio de, Telma Carvalhanas, and Lucia Ferro Bricks. "Should acellular pertussis vaccine be recommended to healthcare professionals?" Cadernos de Saúde Pública 29, no. 7 (July 2013): 1277–90. http://dx.doi.org/10.1590/s0102-311x2013000700003.

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The aim of this study was to describe recent changes in the epidemiology of pertussis and existing policies regarding recommended and mandatory occupational vaccinations for healthcare professionals (HCPs). The authors carried out an extensive review of references on the PubMed and SciELO databases and the official sites of the World Health Organization, Pan American Health Organization, Centers for Disease Control and Prevention, and Brazilian Ministry of Health, using the keywords pertussis, vaccines and healthcare professionals. Vaccination against pertussis is recommended for HCPs in the United States, Canada, nine European countries, Australia, Hong Kong, Singapore, Costa Rica, Argentina and Uruguay, and in some countries it is compulsory. In Brazil, only one publication discussing the risk of pertussis among HCPs was found. Considering the reemergence of pertussis and the great number of associated hospitalizations and deaths registered in 2011, it is necessary to review public policies regarding HCP pertussis vaccination, particularly among workers in frequent contact with young babies.

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Liu, Bette C., Wen-Qiang He, Anthony T. Newall, Helen E. Quinn, Mark Bartlett, Andrew Hayen, Vicky Sheppeard, Nectarios Rose, C. Raina Macintyre, and Peter Mcintyre. "Effectiveness of Acellular Pertussis Vaccine in Older Adults: Nested Matched Case-control Study." Clinical Infectious Diseases 71, no. 2 (August 26, 2019): 340–50. http://dx.doi.org/10.1093/cid/ciz821.

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Abstract Background Despite recommendations that older adults receive acellular pertussis vaccines, data on direct effectiveness in adults aged over 50 years are sparse. Methods A case-control study nested within an adult cohort. Cases were identified from linked pertussis notifications and each matched to 3 controls on age, sex, and cohort recruitment date. Cases and controls were invited to complete a questionnaire, with verification of vaccination status by their primary care provider. Vaccine effectiveness (VE) was estimated by conditional logistic regression, with adjustment for reported contact with children and area of residence. Results Of 1112 notified cases in the cohort, we had complete data for 333 cases and 506 controls. Among 172 PCR-diagnosed cases (mean age, 61 years), 11.2% versus 19.5% of controls had provider-verified pertussis vaccination, on average, 3.2 years earlier. Adjusted VE against PCR-diagnosed pertussis was 52% (95% CI, 15–73%), nonsignificantly higher if vaccinated within 2 years (63%; −5–87%). Adjusted VE was similar in adults born before 1950, presumed primed by natural infection (51%; −8–77%) versus those born 1950 or later who may have received whole-cell pertussis vaccine (53%; −11–80%) (P-heterogeneity = 0.9). Among 156 cases identified by single-point serology, adjusted VE was −55% (−177–13%). Conclusions We found modest protection against PCR-confirmed pertussis among older adults (mean age, 61 years; range, 46–81 years) within 5 years after acellular vaccine. The most likely explanation for the markedly divergent VE estimate from cases identified by single-titer serology is misclassification arising from limited diagnostic specificity in our setting.

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Broutin, H., C. Viboud, B. T. Grenfell, M. A. Miller, and P. Rohani. "Impact of vaccination and birth rate on the epidemiology of pertussis: a comparative study in 64 countries." Proceedings of the Royal Society B: Biological Sciences 277, no. 1698 (June 9, 2010): 3239–45. http://dx.doi.org/10.1098/rspb.2010.0994.

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Bordetella pertussis infection remains an important public health problem worldwide despite decades of routine vaccination. A key indicator of the impact of vaccination programmes is the inter-epidemic period, which is expected to increase with vaccine uptake if there is significant herd immunity. Based on empirical data from 64 countries across the five continents over the past 30–70 years, we document the observed relationship between the average inter-epidemic period, birth rate and vaccine coverage. We then use a mathematical model to explore the range of scenarios for duration of immunity and transmission resulting from repeat infections that are consistent with empirical evidence. Estimates of pertussis periodicity ranged between 2 and 4.6 years, with a strong association with susceptible recruitment rate, defined as birth rate × (1 − vaccine coverage). Periodicity increased by 1.27 years on average after the introduction of national vaccination programmes (95% CI: 1.13, 1.41 years), indicative of increased herd immunity. Mathematical models suggest that the observed patterns of pertussis periodicity are equally consistent with loss of immunity that is not as rapid as currently thought, or with negligible transmission generated by repeat infections. We conclude that both vaccine coverage and birth rate drive pertussis periodicity globally and that vaccination induces strong herd immunity effects. A better understanding of the role of repeat infections in pertussis transmission is critical to refine existing control strategies.

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QUINN, H. E., P. B. McINTYRE, J. L. BACKHOUSE, H. F. GIDDING, J. BROTHERTON, and G. L. GILBERT. "The utility of seroepidemiology for tracking trends in pertussis infection." Epidemiology and Infection 138, no. 3 (September 1, 2009): 426–33. http://dx.doi.org/10.1017/s0950268809990707.

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SUMMARYComparing pertussis epidemiology over time and between countries is confounded by differences in diagnostic and notification practices. Standardized serological methods applied to population-based samples enhance comparability. Population prevalence of different levels of pertussis toxin IgG (PT IgG) antibody, measured by standardized methods, were compared by age group and region of Australia between 1997/1998 and 2002. The proportion of 5- to 9-year-olds with presumptive recent pertussis infection (based on IgG levels ⩾62·5 ELISA units/ml) significantly decreased in 2002, consistent with notification data for the same period and improved uptake of booster vaccines following the schedule change from whole-cell to acellular vaccine. In contrast, recent presumptive infection significantly increased in adults aged 35–49 years. Population-based serosurveillance using standardized PT IgG antibody assays has the potential to aid interpretation of trends in pertussis incidence in relation to vaccine programmes and between countries.

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Lavine, Jennie S., and Pejman Rohani. "Resolving pertussis immunity and vaccine effectiveness using incidence time series." Expert Review of Vaccines 11, no. 11 (November 2012): 1319–29. http://dx.doi.org/10.1586/erv.12.109.

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Boulay, Brian R., Carolyn J. Murray, Judy Ptak, Kathryn B. Kirkland, Jose Montero, and Elizabeth A. Talbot. "An Outbreak of Pertussis in a Hematology-Oncology Care Unit: Implications for Adult Vaccination Policy." Infection Control & Hospital Epidemiology 27, no. 1 (January 2006): 92–95. http://dx.doi.org/10.1086/500420.

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A pertussis outbreak in a hematology-oncology care unit involved 10 (8.5%) of 117 employees. The source was an employee who contracted pertussis via a family contact. No screened patients contracted pertussis, likely because of isolation measures. Hospitals should consider employee immunization with acellular vaccine in healthcare settings where pertussis has high rates of morbidity and mortality.

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Wei, Stanley C., Kathleen Tatti, Kimberly Cushing, Jennifer Rosen, Kristin Brown, Pamela Cassiday, Thomas Clark, et al. "Effectiveness of Adolescent and Adult Tetanus, Reduced‐Dose Diphtheria, and Acellular Pertussis Vaccine against Pertussis." Clinical Infectious Diseases 51, no. 3 (August 2010): 315–21. http://dx.doi.org/10.1086/653938.

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Shapiro-Shapin, Carolyn G. "Pearl Kendrick, Grace Eldering, and the Pertussis Vaccine." Emerging Infectious Diseases 16, no. 8 (August 2010): 1273–78. http://dx.doi.org/10.3201/eid1608.100288.

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BYRNE, L., C. WARD, J. M. WHITE, G. AMIRTHALINGAM, and M. EDELSTEIN. "Predictors of coverage of the national maternal pertussis and infant rotavirus vaccination programmes in England." Epidemiology and Infection 146, no. 2 (December 14, 2017): 197–206. http://dx.doi.org/10.1017/s0950268817002497.

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SUMMARYThis study assessed variation in coverage of maternal pertussis vaccination, introduced in England in October 2012 in response to a national outbreak, and a new infant rotavirus vaccination programme, implemented in July 2013. Vaccine eligible patients were included from national vaccine coverage datasets and covered April 2014 to March 2015 for pertussis and January 2014 to June 2016 for rotavirus. Vaccine coverage (%) was calculated overall and by NHS England Local Team (LT), ethnicity and Index of Multiple Deprivation (IMD) quintile, and compared using binomial regression. Compared with white-British infants, the largest differences in rotavirus coverage were in ‘other’, white-Irish and black-Caribbean infants (−13·9%, −12·1% and −10·7%, respectively), after adjusting for IMD and LT. The largest differences in maternal pertussis coverage were in black-other and black-Caribbean women (−16·3% and −15·4%, respectively). Coverage was lowest in London LT for both programmes. Coverage decreased with increasing deprivation and was 14·0% lower in the most deprived quintile compared with the least deprived for the pertussis programme and 4·4% lower for rotavirus. Patients’ ethnicity and deprivation were therefore predictors of coverage which contributed to, but did not wholly account for, geographical variation in coverage in England.

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DURANOGLU, L., C. SÖNMEZ, S. VURUCU, D. KURTOGLU, V. KESIK, N. COPLU, V. KOSEOGLU, B. ESEN, and O. OZCAN. "Evaluation of pertussis immunity status in schoolchildren immunized with whole-cell vaccine." Epidemiology and Infection 138, no. 2 (July 7, 2009): 299–303. http://dx.doi.org/10.1017/s095026880999032x.

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SUMMARYIt has recently been reported that the worldwide increase in the number of pertussis cases is a result of the waning of whole-cell vaccine-induced immunity. Thus, in this study, we aimed to investigate the pertussis immunity status of primary and secondary school students in a district of Ankara, Turkey. A total of 997 healthy students, aged 9–17 years, who had been immunized with four doses of whole-cell pertussis vaccine were included in the study. The subjects were divided into two age groups: 9–14 and 15–17 years. To determine the immune status, serum levels of IgG anti-pertussis toxin (aPT) antibody were tested by in-house ELISA and arbitrarily evaluated as non-immune [<10 ELISA units (EU)/ml], immune (10–100 EU/ml), and recent infection (>100 EU/ml). Serum samples of 997 students (559 females, 438 males) aged between 9 and 17 years (mean 13·02±2·25, median 13 years) were tested. Non-immune, immune and recent infection levels of aPT were found in 27·3%, 59·3% and 13·4% of individuals, respectively. The immune group did not have statistically significant differences between males and females (P=0·68). In the 9–14 and 15–17 years age groups, serum aPT antibody levels ⩾10 EU/ml were 73·1% and 72·2%, respectively, which did not represent any statistical difference (P=0·81). Students aged 15–17 years had a higher immunity rate than the 9–14 years group, and the percentage of students with recent infection in the 9–14 years group was higher than the 15–17 years group (P<0·001). The peak age of non-immunized subjects was 9 years (47·0%), and decreased to a minimum at age 12–13 years, and began to increase again from age 13–14 years. In contrast, the ratio of recent infection was least at age 9–10 years, began to increase, and reached a peak at 12 years, and then decreased. On the other hand, it was observed that household size and monthly income were not associated with the immunity status (P=0·65,P=0·37, respectively). The results of the present study show that levels of antibody against pertussis decreased in the younger age groups and, as a result, there is an increase in the number of pertussis cases. Thus, in order to decrease the incidence of pertussis and protect infants, we recommend the application of booster doses at regular intervals.

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Journal articles on the topic 'Epidemiology;Pertussis;Vaccine effectiveness'

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