Pertussis vaccine overview

Abstract

Pertussis or whooping cough is a highly contagious, vaccine-preventable, respiratory disease caused by Bordetella pertussis, and transmitted through the respiratory tract. According to the reports of the World Health Organization and Centers for Disease Control and Prevention, the incidence of pertussis shows periodical variations in certain regions of the world. As humans are the sole reservoir of this bacteria complete vaccination against pertussis and high vaccination coverage is of utmost importance for reducing the incidence and severity of the disease. Two types of pertussis vaccine are available: wholecell (wP) and acellular pertussis vaccine (aP). wP contains whole nonviable bacteria, while aP usually contains two or more protein components. These protein components include inactivated pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae. The acellular vaccine was developed in response to reports of adverse reactions upon administering the whole-cell vaccine in certain countries. Both vaccines are usually formulated with diphtheria and tetanus toxoids, and more recently a trend of combining more antigenic sources such as Haemophilus influenzae type b, hepatitis B, and inactivated poliovirus vaccine has been accepted in many countries, including Serbia. The wP vaccine stimulates a strong immune response more similar to infection, while the response to aP vaccine differs in this respect. Due to the difference in the types of immune response predominating with different types of pertussis vaccines, there are differences in the duration of protection, and it has been reported that wP induces more durable protection. For countries that have adopted aP increased monitoring is advised as well as the inclusion of booster doses. The special focus is on the vaccination of pregnant women to protect the newborns. Incited by the recent surge in pertussis cases in Serbia here we provide a comprehensive literature overview of pertussis vaccines, covering their historical development, current status, challenges, and potential future directions.