Pertussis Epidemiology and new Vaccination Concepts

Background: Despite national vaccination programs, pertussis has reemerged and has shown a tendency to increase worldwide for many years. Young infants are at particular risk of a life-threatening course of pertussis. Objective: Description of the current epidemiology of pertussis in Germany, review of available pertussis vaccines and the current German vaccination recommendations of the German Standing Committee on Vaccinations (STIKO) of the Robert Koch Institute and discussion of innovative vaccination concepts. Material and methods: Evaluation of statistics on the incidence of pertussis, analysis of the literature on the effectiveness of vaccines in different age groups and in pregnant women. Results: The nationwide incidence of reported and confirmed cases of pertussis in the last 15 years ranged from 10 to 42 per 100,000 inhabitants, which implies a significant (up to a factor of 50) underestimation of the true number of cases. Most commonly affected are adolescents and young adults, who represent important sources of infection for especially vulnerable young infants. For a better protection from pertussis between birth and induction of their own immune protection, the vaccination of newborns has been evaluated in studies; however, this led to a significant immune interference in the subsequent regular vaccination series in infancy so that this concept has not been further developed. Currently, pertussis vaccination in the second or third trimester of pregnancy is the most efficient measure to protect neonates, as passively transferred maternal pertussis antibodies can prevent infant disease and its complications. Conclusion: The existing vaccine recommendations need to be implemented in a better way. Vaccination of pregnant women is a promising strategy. The suboptimal protective effect of acellular pertussis vaccines and the rapid decline of immunity even after booster vaccinations justify the search for new and more effective vaccines. © 2016, Springer-Verlag Berlin Heidelberg.