Maternal pertussis immunisation: clinical gains and epidemiological legacy

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 22; no. 15; p. 3
• Main Authors: Bento, Ana I, King, Aaron A, Rohani, Pejman
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 13.04.2017; European Centre for Disease Prevention and Control (ECDC)
• Subjects: Adolescent; Age Distribution; Child; Child, Preschool; Epidemiology; Female; Georgia - epidemiology; Humans; Immunization; Immunization - utilization; Immunization Schedule; Infant; Infant, Newborn; Mothers; Pertussis Vaccine - administration & dosage; Pregnancy; Prevalence; Risk Factors; Treatment Outcome; Whooping cough; Whooping Cough - epidemiology; Whooping Cough - prevention & control; interference; pertussis; routine vaccination; maternal immunization
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES.2017.22.15.30510

The increase in whooping cough (pertussis) incidence in many countries with high routine vaccination coverage is alarming, with incidence in the US reaching almost 50,000 reported cases per year, reflecting incidence levels not seen since the 1950s. While the potential explanations for this resurgence remain debated, we face an urgent need to protect newborns, especially during the time window between birth and the first routine vaccination dose. Maternal immunisation has been proposed as an effective strategy for protecting neonates, who are at higher risk of severe pertussis disease and mortality. However, if maternally derived antibodies adversely affect the immunogenicity of the routine schedule, through blunting effects, we may observe a gradual degradation of herd immunity. 'Wasted' vaccines would result in an accumulation of susceptible children in the population, specifically leading to an overall increase in incidence in older age groups. In this Perspective, we discuss potential long-term epidemiological effects of maternal immunisation, as determined by possible immune interference outcomes.