Resurgence of pertussis in the post-vaccination era has been reported in western countries. A shift of cases from school-age children to adolescents, adults and children under 1 year of age has been described in the last decade, and mortality rates in infants are still sustained. Chiappini, et al. (2013) review and discuss the possible vaccination strategies which can be adopted in order to improve the pertussis control, by searches of Pubmed, and websites of U.S. and European Centers for Disease Control and Prevention, between Jan. 1, 2002, and March 1, 2013.
The researchers analyzed the following vaccination strategies: the cocooning strategy, the immunization of pregnant women and newborns, vaccination programs for preschool children, adolescents, adults and healthcare workers. Cost-effectiveness studies provide some contrasting data, mainly supporting both maternal vaccination and cocooning. Adolescent and/or adult vaccination seems to be cost-effective, however data from observational studies suggest that this vaccination strategy, used alone, leads to a reduced pertussis burden globally, but does not affect the disease incidence in infants. Moreover, substantial logistical and economic difficulties have to be overcome to vaccinate the largest number of individuals.
The researchers conclude that simultaneous use of more than one strategy, including cocooning strategy plus vaccination of adolescents and adults, seems to be the most reasonable preventive measure. They say that development of new highly immunogenic and efficacious pertussis vaccines continues to be a primary objective for the control of pertussis. Their research was published in BMC Infectious Diseases.
Reference: Chiappini E, Stival A, Galli L and de Martino M. Pertussis re-emergence in the post-vaccination era. BMC Infectious Diseases 2013, 13:151 doi:10.1186/1471-2334-13-151