An important cause of morbidity in children 1 to 5 years of age1

- Toxin-mediated disease; transmitted via respiratory droplets

- From mild respiratory symptoms to distressing paroxysmal cough (whoop) w/ severe complications (apnea, cyanosis, death)1

- Highest severity/mortality in 1st weeks/months of life1

- Main aim of vaccination = reduce death in infants

- Recognized waning of immunity after primary vaccination

- Disease resurgence in aP- and wP-using countries despite high vaccine coverage

- Highly transmissible, up to 90% secondary attack rate1 among susceptible household contacts (e.g. parents, siblings)

- School-age children increasingly recognized as a reservoir of transmission for infants2,3

    1. WHO. WER, 2015;90(35
    2. Bertilone. Commun Dis Intell Q Rep, 2014;38(3)
    3. Skoff. Pediatrics, 2015;136(4)

Waning Anti-Pertussis Immunity

School-entry booster is needed to maintain immunity through primary school1

Immune responses after a DTaP-IPV/Hib toddler booster (n=69) and before/2 monthsmafter DTaP-IPV school-entry booster (n=232) at 5-6 years in children primed w/ DTaP-IPV/Hib at 2-3-4/2-4-6 months (3+1 schedule, France, 2000-01)1

NA: not available; mo: months; yr: years

    1. Mallet. Vaccine, 2004;22(11-12)

Pertussis vaccination is primarily intended to reduce transmission to vulnerable infants who suffer the highest morbidity and mortality from disease1

  • School-aged children are recognized as an increasingly important source of in fection (SOI) for infant pertussis2,3
  • Implementation of a school-entry pertussis booster is beneficial:
    • To offset vaccine-induced waning immunity4,5
    • To mitigate the shift of SOI from parents to school-aged siblings3,6
    • By providing protection to both the target age group and infants7,9
    1. WHO. WER, 2015;90(35)
    2. Bertilone. Commun Dis Intell Q Rep, 2014;38(3)

    3. Skoff. Pediatrics, 2015;136(4)

    4. Haller. PIDJ, 2015;34(5)

    5. Mallet.Vaccine, 2004;22(11-12)

    6. Domenech de Cell s. Sci Transl Med, 2018;10(434)

    7. Amirthalingam. Euro Surveill, 2013;18(38)

    8. Carlsson. Pertussis Surveillance in Sweden 20-year report.2018

    9. de Greef. PIDJ, 2008;27(3)

Vaccination Recommendations - WHO

School-entry boosters are recommended for long-lived protection1,5

    1. WHO. WER, 2017;92(31)
    2. WHO. WER, 2017;92(6)

    3. WHO. WER, 2015;90(351)

    4. WHO. WER, 2016;91(12)

    5. Martinon-Torres. Expert Rev Vaccines, 2018;17(4)

    6. Carlsson. Pertussis Surveillance in Sweden 20-year report.2018

    7. de Greef. PIDJ, 2008;27(3)