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. 2022 Feb 28;22(1):405.
doi: 10.1186/s12889-022-12830-9.

Impact of the COVID-19 pandemic on Bordetella pertussis infections in England

Elise Tessier  1 , Helen Campbell  2 , Sonia Ribeiro  2 , Yuma Rai  2 , Simon Burton  2 , Partho Roy  2 , Norman K Fry  3 , David Litt  3 , Gayatri Amirthalingam  2
Affiliations

Impact of the COVID-19 pandemic on Bordetella pertussis infections in England

Elise Tessier et al. BMC Public Health. .

Abstract

Background: In March 2020, England went into its first lockdown in response to the COVID-19 pandemic. Restrictions eased temporarily, followed by second and third waves in October 2020 and January 2021. Recent data showed that the COVID-19 pandemic resulted in reduced transmission of some invasive diseases. We assess the impact of the COVID-19 pandemic on pertussis incidence and on the immunisation programme in England.

Methods: We assessed trends in pertussis cases from 2012 to 2020 by age group and month. Incidence from the time that England eased its initial lockdown measures in July 2020 through to summer 2021 was calculated and the incidence rate ratios of pertussis cases from five years prior to the pandemic (July 2014 - June 2019) compared to the same time period during the pandemic (July 2020 - June 2021). Vaccine coverage estimates for pertussis containing vaccines were reviewed for the maternal and childhood programmes.

Results: A substantial decline in pertussis cases was observed from April 2020 onwards, marking the lowest number of cases in the last decade. Pertussis incidence dropped in all age groups, particularly among infants less than one year old (0.50 / 100,000 during July 2020 to June 2021 compared to 24.49/ 100,000 from July 2014 to June 2019). The incidence rate ratio was 0.02 (95% CI 0.01 to 0.02) for July 2014 to June 2019 (pre-pandemic) compared to the pandemic period of July 2020 to June 2021. None of the cases had a co-infection with SARS-CoV-2. Vaccine coverage for infants born between January to March 2020 with three doses of pertussis vaccine by 12 months of age decreased by 1.1% points compared to infants born between January to March 2019 (91.6% and 92.7%, respectively). Prenatal pertussis coverage for the 2020 to 2021 financial year was 2.7% points lower than the year prior to the pandemic (70.5% and 76.8%, respectively).

Conclusions: Lockdown measures due to the COVID-19 pandemic have had a significant impact on pertussis transmission. With the easing of restrictions it is important to continue monitoring pertussis cases in England alongside coverage of the maternal and childhood immunisation programmes.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant for the content of this article.

Figures

Fig. 1
Fig. 1
Total number of pertussis cases between January and March annually, England 2012 to 2021
Fig. 2
Fig. 2
Total number of pertussis cases from January 2012 to June 2021 by month and age group
Fig. 3
Fig. 3
Total number of oral fluid, PCR and serology B. Pertussis tests and percent positivity by age group from January 2014 to June 2021 in England. The section in grey represents when SARS-CoV-2 restrictions changed across England.* *Grey area represents when lockdown measures changed in England
Fig. 4
Fig. 4
Vaccine coverage for the prenatal pertussis vaccination programme, completed course of Hexavalent vaccine observed at 6 months from ImmForm and completed course of Hexavalent vaccine at 12 months from the COVER collection. † Prenatal pertussis vaccines coverage among pregnant women vaccinated up to 14 weeks prior to delivery. † † Prenatal pertussis vaccines coverage among pregnant women vaccinated up to 16 weeks prior to delivery and excluding miscarriages and stillbirths regardless of gestational age. † † † Prenatal pertussis vaccines coverage among pregnant women vaccinated up to 26 weeks prior to delivery and excluding miscarriages and stillbirths regardless of gestational age. § Hexavalent vaccine coverage for 2014/15 estimates based on monthly extracts from June 2017 to March 2018. §§ Hexavalent vaccine coverage for 2021/22 estimates based on monthly extracts from April 2021 to June 2021
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