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Pathogens and Global Health Jun 2023is the causative agent of a respiratory infection called pertussis (whooping cough) that can be fatal in newborns and infants. The pathogen produces a variety of... (Review)
Review
is the causative agent of a respiratory infection called pertussis (whooping cough) that can be fatal in newborns and infants. The pathogen produces a variety of antigenic compounds which alone or simultaneously can damage various host cells. Despite the availability of pertussis vaccines and high vaccination coverage around the world, a resurgence of the disease has been observed in many countries. Reasons for the increase in pertussis cases may include increased awareness, improved diagnostic techniques, low vaccine efficacy, especially acellular vaccines, and waning immunity. Many efforts have been made to develop more effective strategies to fight against . and one of the strategies is the use of outer membrane vesicles (OMVs) in vaccine formulations. OMVs are attracting great interest as vaccine platforms since they can carry immunogenic structures such as toxins and LPS. Many studies have been carried out with OMVs from different . strains and they revealed promising results in the animal challenge and human preclinical model. However, the composition of OMVs differs in terms of isolation and purification methods, strains, culture, and stress conditions. Although the vesicles from . represent an attractive pertussis vaccine candidate, further studies are needed to advance clinical research for next-generation pertussis vaccines. This review summarizes general information about pertussis, the history of vaccines against the disease, and the immune response to these vaccines, with a focus on OMVs. We discuss progress in developing an OMV-based pertussis vaccine platform and highlight successful applications as well as potential challenges and gaps.
Topics: Infant, Newborn; Animals; Humans; Bordetella pertussis; Whooping Cough; Pertussis Vaccine; Respiratory Tract Infections; Vaccines, Acellular
PubMed: 36047634
DOI: 10.1080/20477724.2022.2117937 -
Vaccine Jan 2020Vaccines against pertussis have been used for more than a hundred years. This review describes the development of whole-cell (wP) and acellular pertussis (aP) vaccines,... (Review)
Review
Vaccines against pertussis have been used for more than a hundred years. This review describes the development of whole-cell (wP) and acellular pertussis (aP) vaccines, which, as DTP combination vaccines, have significantly reduced morbidity and mortality from pertussis, and which currently serve as the building blocks for a variety of vaccines used to immunize all infants worldwide. Two series of efficacy trials done in the 1950s for wP vaccines and in the 1990s for aP-vaccines have established standards for studying vaccine effectiveness. However, irrespective of their longtime use, critical aspects of pertussis vaccines remain unknown, including the exact mechanisms of protective immunity and a correlate of protection. Research to improve on the effectiveness and the duration of protection is ongoing, but although the vaccines are not perfect, only their continued use with a high coverage will ensure that infants and children are being protected from pertussis.
Topics: History, 20th Century; History, 21st Century; Humans; Infant; Pertussis Vaccine; Vaccines, Acellular; Vaccines, Combined; Whooping Cough
PubMed: 31780181
DOI: 10.1016/j.vaccine.2019.11.022 -
Emerging Infectious Diseases Jun 2021Recent reemergence of pertussis (whooping cough) in highly vaccinated populations and rapid expansion of Bordetella pertussis strains lacking pertactin (PRN), a common... (Review)
Review
Recent reemergence of pertussis (whooping cough) in highly vaccinated populations and rapid expansion of Bordetella pertussis strains lacking pertactin (PRN), a common acellular vaccine antigen, have raised the specter of vaccine-driven evolution and potential return of what was once the major killer of children. The discovery that most circulating B. pertussis strains in the United States have acquired new and independent disruptive mutations in PRN is compelling evidence of strong selective pressure. However, the other 4 antigens included in acellular vaccines do not appear to be selected against so rapidly. We consider 3 aspects of PRN that distinguish it from other vaccine antigens, which might, individually or collectively, explain why only this antigen is being precipitously eliminated. An understanding of the increase in PRN-deficient strains should provide useful information for the current search for new protective antigens and provide broader lessons for the design of improved subunit vaccines.
Topics: Bacterial Outer Membrane Proteins; Bordetella pertussis; Child; Humans; Pertussis Vaccine; Virulence Factors, Bordetella; Whooping Cough
PubMed: 34014152
DOI: 10.3201/eid2706.203850 -
Przeglad Epidemiologiczny 2021Pertussis is an endemic, highly contagious disease that can be prevented through vaccination. In Poland, since the second half of the nineties, changes in the...
INTRODUCTION
Pertussis is an endemic, highly contagious disease that can be prevented through vaccination. In Poland, since the second half of the nineties, changes in the epidemiology of pertussis have been observed - an increase in the number of cases, despite the high level of vaccination of the population. The highest percentage of registered cases of pertussis concerned people aged 15 and over. The causes of the increased incidence of pertussis are a complex problem. Immunity after pertussis vaccination is unstable, disappears within 4-12 years, and the risk of the disease increases with time after the last dose of the vaccine. Due to the loss of protection against pertussis in adults, it is important to repeat immunization with dTpa every 10 years.
OBJECTIVE
The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2018-2019 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis.
MATERIAL AND METHODS
The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH-NIH through the SRWE system and data from the bulletins "Infectious diseases and poisonings in Poland" for 2018 and 2019 and the bulletins "Vaccinations in Poland" for 2018 and 2019.
RESULTS
In 2018, 1 548 were registered, and in 2019 - 1 629 cases of pertussis. The incidence was respectively: 4.0 and 4.2 per 100 000 population and was lower compared to the incidence in 2017 (8.0). The highest incidence of pertussis was in the age group 0-4 years (20.6 and 23.6 respectively), and high in children and adolescents aged 5-9 (10.9 and 11.5 respectively) and 10-14 years (respectively: 12.2 and 11.2 - per 100 000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence among women was observed than in men, as well as a higher incidence in cities than in rural areas. In 2018, among people with pertussis, 434 people (i.e. 28%) and in 2019 - 482 people (i.e. 29.6%) were hospitalized. In 2019, one fatal case of the disease was reported to the epidemiological surveillance system.
SUMMARY AND CONCLUSIONS
In Poland, in the years 2018-2019, there was a decrease in the number of cases of pertussis, the most common were children under the age of four (the highest incidence). A worrying trend is the decreasing number of vaccinations in children aged 2 years against pertussis covered by compulsory primary vaccinations in individual provinces. In the current epidemiological situation, the best way to prevent new cases of pertussis is to use vaccination according to the current regimen and to recommend to adults a single dose of dTpa vaccination, which should be repeated every 10 years.
Topics: Adolescent; Adult; Age Distribution; Child; Communicable Diseases; Disease Outbreaks; Female; Humans; Incidence; Infant; Male; Pentetic Acid; Pertussis Vaccine; Poland; Registries; Rural Population; Urban Population; Whooping Cough
PubMed: 35543567
DOI: 10.32394/pe.75.57 -
Praxis Sep 2019Vaccination During Pregnancy Vaccinations administered to women during pregnancy can provide protection against serious infectious diseases for the mother, for the...
Vaccination During Pregnancy Vaccinations administered to women during pregnancy can provide protection against serious infectious diseases for the mother, for the newborn, or both. Two vaccines are routinely recommended during pregnancy: Influenza and Pertussis. While the influenza vaccine protects mainly the pregnant mother, who is at an increased risk for severe affection, the pertussis vaccine is an effective protection to infants who are at particularly high risk of pertussis complications and mortality in the first three months of life.
Topics: Female; Humans; Infant; Infant, Newborn; Influenza Vaccines; Pertussis Vaccine; Pregnancy; Pregnancy Complications, Infectious; Vaccination; Whooping Cough
PubMed: 31571544
DOI: 10.1024/1661-8157/a003312 -
Developmental Medicine and Child... Apr 2021
Topics: COVID-19 Vaccines; Health Knowledge, Attitudes, Practice; History, 20th Century; History, 21st Century; Humans; Mass Media; Measles-Mumps-Rubella Vaccine; Peer Review; Pertussis Vaccine; Scientific Misconduct
PubMed: 33675061
DOI: 10.1111/dmcn.14801 -
Vaccine Feb 2022Pertussis hospitalisation is more common among infants born prematurely, who have significant comorbidities, or are Indigenous, but acellular pertussis (aP) vaccine...
BACKGROUND
Pertussis hospitalisation is more common among infants born prematurely, who have significant comorbidities, or are Indigenous, but acellular pertussis (aP) vaccine effectiveness (VE) estimates in these sub-groups are lacking. We measured aP VE by Indigenous status, and policy-relevant categories of prematurity and comorbidity, in a population-based Australian cohort.
METHODS
Perinatal, disease notification, hospitalisation, mortality, and vaccination data were linked to birth records in two Australian states (Western Australia and New South Wales) 2001-2012, with follow-up to the end of 2013. Children followed to 18 months of age were stratified by Aboriginality, prematurity (<32 vs 32-<37 weeks gestation) and comorbidities identified from hospital discharge coding. Rates, rate ratios and VE were calculated for first episode of hospitalised and non-hospitalised pertussis notifications using adjusted Cox proportional hazards models.
RESULTS
Among >1,300,000 children, 63,867 (4·9%) were Aboriginal, 47,721 (3·6%) had at least one comorbidity and 3,771 first episodes of notified pertussis occurred <18 months of age; of these, 1,207 (32.0%) had an associated pertussis-coded hospitalisation. For hospitalised pertussis in Aboriginal and non-Aboriginal children, there was significant protection post dose 1 (VE 51% v 25%), 2 (VE 69% v 74%) and 3 (VE 76% v 80%). For children with co-morbidities, VE for hospitalised pertussis was low and non-significant post dose 1 (0%) and 2 (30%). Post dose 3, VE was significant for hospitalised pertussis (70%; 95% CI 29-87) but not for non-hospitalised pertussis (24%; 95% CI -49 to 61).
CONCLUSIONS
For most Aboriginal and non-Aboriginal children, improved timeliness of current infant doses and higher antenatal coverage should further improve protection against pertussis of any severity. For children at highest risk of severe pertussis (born <32 weeks gestation or with significant medical comorbidities), our data suggest that additional measures-such as extra doses of pertussis-containing vaccines and/or vaccines with improved immunogenicity-are needed for protection.
Topics: Australia; Child; Cohort Studies; Female; Humans; Infant; Pertussis Vaccine; Pregnancy; Vaccination; Vaccine Efficacy; Whooping Cough
PubMed: 35101268
DOI: 10.1016/j.vaccine.2021.10.013 -
Pediatrics Sep 2021Infant influenza and pertussis disease causes considerable morbidity and mortality worldwide. We examined the effectiveness of maternal influenza and pertussis vaccines...
BACKGROUND AND OBJECTIVES
Infant influenza and pertussis disease causes considerable morbidity and mortality worldwide. We examined the effectiveness of maternal influenza and pertussis vaccines in preventing these diseases in infants.
METHODS
This inception cohort study comprised women whose pregnancies ended between September 1, 2015, and December 31, 2017, in Victoria, Australia. Maternal vaccination status was sourced from the Victorian Perinatal Data Collection and linked to 5 data sets to ascertain infant outcomes and vaccination. The primary outcome of interest was laboratory-confirmed influenza or pertussis disease in infants aged <2 months, 2 to <6 months, and <6 months combined. Secondary outcomes included infant hospitalization (emergency presentation or admission) and death. Risk ratios and 95% confidence intervals (CIs) were estimated by Poisson regression. Vaccine effectiveness (VE) was estimated as (1 minus the risk ratio) x 100%.
RESULTS
Among 186 962 pregnant women, 85 830 (45.9%) and 128 060 (68.5%) were vaccinated against influenza and pertussis, respectively. There were 175 and 51 infants with laboratory-confirmed influenza and pertussis disease, respectively. Influenza VE was 56.1% (95% CI, 23.3% to 74.9%) for infants aged <2 months and 35.7% (2.2% to 57.7%) for infants aged 2 to <6 months. Pertussis VE was 80.1% (95% CI, 37.1% to 93.7%) for infants aged <2 months and 31.8% (95% CI, -39.1% to 66.6%) for infants aged 2 to <6 months.
CONCLUSIONS
Our study provides evidence of the direct effectiveness of maternal influenza and pertussis vaccination in preventing these diseases in infants aged <2 months. The findings strengthen the importance of maternal vaccination to prevent these diseases in infants.
Topics: Adult; Cohort Studies; Diphtheria-Tetanus-acellular Pertussis Vaccines; Female; Humans; Infant; Infant, Newborn; Influenza Vaccines; Influenza, Human; Parturition; Pertussis Vaccine; Pregnancy; Pregnancy Complications, Infectious; Pregnant Women; Vaccination; Victoria; Whooping Cough
PubMed: 34446538
DOI: 10.1542/peds.2021-051076 -
Vaccine May 2021A comprehensive review of observational pertussis vaccine effectiveness (VE) studies is needed to update gaps from previous reviews. We conducted a systematic review of... (Meta-Analysis)
Meta-Analysis Review
A comprehensive review of observational pertussis vaccine effectiveness (VE) studies is needed to update gaps from previous reviews. We conducted a systematic review of VE and duration of protection studies for the whole-cell (wP) and acellular (aP) pertussis vaccines and conducted a formal meta-analysis using random effects models. Evidence continues to suggest that receipt of any pertussis vaccine confers protection in the short-term against disease although this protection wanes rapidly for aP vaccine. We detected significant heterogeneity in pooled estimates due, in part, to factors such as bias and confounding which may be mitigated by study design. Our review of possible sources of heterogeneity may help interpretation of other VE studies and aid design decisions in future pertussis VE research.
Topics: Biomedical Research; Humans; Pertussis Vaccine; Research Design; Whooping Cough
PubMed: 33934917
DOI: 10.1016/j.vaccine.2021.04.032 -
Pediatrics Nov 2023Following the introduction of jurisdictional maternal pertussis vaccination programs in Australia, we estimated maternal vaccine effectiveness (VE) and whether maternal...
OBJECTIVES
Following the introduction of jurisdictional maternal pertussis vaccination programs in Australia, we estimated maternal vaccine effectiveness (VE) and whether maternal pertussis vaccination modified the effectiveness of the first 3 primary doses of pertussis-containing vaccines.
METHODS
We conducted a population-based cohort study of 279 418 mother-infant pairs using probabilistic linkage of administrative health records in 3 Australian jurisdictions. Infants were maternally vaccinated if their mother had a documented pertussis vaccination ≥14 days before birth. Jurisdictional immunization records were used to identify receipt of the first 3 infant doses of pertussis-containing vaccines. Infant pertussis infections were identified using notifiable disease records. VE was estimated using Cox proportional hazard models.
RESULTS
Pertussis was administered during 51.7% (n = 144 429/279 418) of pregnancies, predominantly at 28-31 weeks' gestation. VE of maternal pertussis vaccination declined from 70.4% (95% confidence interval [CI], 50.5-82.3) among infants <2 months old to 43.3% (95% CI, 6.8-65.6) among infants 7-8 months old and was not significant after 8 months of age. Although we observed slightly lower VE point estimates for the third dose of infant pertussis vaccine among maternally vaccinated compared with unvaccinated infants (76.5% vs 92.9%, P = .002), we did not observe higher rates of pertussis infection (hazard ratio, 0.70; 95% CI, 0.61-3.39).
CONCLUSIONS
Pertussis vaccination near 28 weeks' gestation was associated with lower risk of infection among infants through 8 months of age. Although there was some evidence of lower effectiveness of infant vaccination among maternally vaccinated infants, this did not appear to translate to greater risk of disease.
Topics: Pregnancy; Female; Infant; Humans; Child; Whooping Cough; Cohort Studies; Australia; Pertussis Vaccine; Vaccination; Diphtheria-Tetanus-acellular Pertussis Vaccines
PubMed: 37807881
DOI: 10.1542/peds.2023-062664