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Review
. 2024 Dec 31;20(1):2377904.
doi: 10.1080/21645515.2024.2377904. Epub 2024 Jul 17.

Public health management of pertussis in adults: Practical challenges and future strategies

C Raina MacIntyre  1 , Jaime Correia de Sousa  2 , Ulrich Heininger  3 , Peter Kardos  4 , Andreas Konstantopoulos  5 , Donald Middleton  6 , Terry Nolan  7 , Alberto Papi  8 , Adrian Rendon  9 , Albert Rizzo  10 , Kim Sampson  11 , Alessandro Sette  12 , Elizabeth Sobczyk  13 , Tina Tan  14 , Catherine Weil-Olivier  15 , Birgit Weinberger  16 , Tom Wilkinson  17 , Carl Heinz Wirsing von König  18
Affiliations
Review

Public health management of pertussis in adults: Practical challenges and future strategies

C Raina MacIntyre et al. Hum Vaccin Immunother. .

Abstract

A panel of 24 international experts met in July 2022 to discuss challenges associated with pertussis detection, monitoring, and vaccination in adults; conclusions from this meeting are presented. There has been a shift in the epidemiology of pertussis toward older children and adults. This shift has been attributed to the waning of infection- or vaccine-induced immunity, newer detection techniques causing detection bias, and possibly the replacement of whole-cell pertussis with acellular vaccines in high-income countries, which may lead to immunity waning more quickly. The burden of adult pertussis is still likely under-ascertained due to widespread under-recognition by healthcare professionals (HCPs), under-diagnosis, and under-reporting in this age group. Non-standardized testing guidance and varied case definitions have contributed to under-reporting. Key barriers to HCP engagement with the tetanus, diphtheria, and pertussis (Tdap) vaccine include low awareness, lack of time/funding, and lack of motivation due to low prioritization of Tdap.

Keywords: Bordetella pertussis; Tdap vaccination; adults; comorbidities; disease burden; under-reporting.

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Conflict of interest statement

CRM is supported by an NHMRC Investigator Grant, grant no. [2016907]. She is on the WHO COVID-19 Vaccine Composition Technical Advisory Group and the WHO SAGE Working Group on Smallpox and Monkeypox. She currently receives funding from Sanofi for influenza and pertussis research. JCS received research support from AstraZeneca and GSK; and honoraria from AstraZeneca, GSK, Bial, Sanofi, and Medinfar. He also participated in a company-sponsored speaker’s bureau for AstraZeneca and Sanofi. UH received consulting fees from Sanofi-Pasteur, Sanofi Aventis France, and GSK, and lecture fees from GSK, Infectopharm, Merck, Moderna, Pfizer, Roche, Sanofi Genzyme, and Sanofi-Pasteur. He participated on the Data Monitoring Committees of a poliomyelitis vaccine (Takeda), a phase II study of an adjuvanted pandemic influenza vaccine (GSK/Watermark), the Norovirus Bivalent VLP Vaccine Program (Takeda/HilleVax), and the Cell culture influenza vaccine (Seqirus/IQVIA). He is a member of the Meta Data Safety Monitoring Board for CEPI (Coalition for Epidemic Preparedness Innovations) and of the Varicella Advisory Board, Switzerland (Merck). PK received honoraria for participating in the 2022 Zoom meetings by Sanofi; he also received honoraria for participation in advisory boards and lectures, and travel costs from the following companies: AstraZeneca, Bionorica, Chiesi, Engelhard, GSK, Jansen, Klosterfrau, Novartis, MSD, and Schwabe. His institution received honoraria for clinical trial participation from Bellus, the ERS NEuroCOUGH Initiative, and MSD. DM received personal fees from Dynavax, Seqirus, Sanofi, and GSK; and grants and personal fees from Pfizer. TN received research contracts to conduct clinical trials, with funding to the institution from Moderna, Sanofi, GSK, Iliad Biotechnologies, Dynavax, Seqirus, Janssen, and MSD; consulting fees from GSK, Seqirus, MSD, Sanofi, AstraZeneca, Moderna, BioNet, and Pfizer; and has served on data safety and monitoring boards for Seqirus, Clover, Moderna, Emergent, Serum Institute of India, SK Bioscience Korea, Emergent Biosolutions, and Novavax. AP received grants or contracts from Chiesi, AstraZeneca, GSK, Sanofi, and Agenzia Italiana del Farmaco (AIFA); consultancy fees from Chiesi, AstraZeneca, GSK, Novartis, Sanofi, Avillion, and Elpen Pharmaceuticals; payment or honoraria for lectures, presentations, manuscript writing or educational events from Chiesi, AstraZeneca, GSK, Menarini, Novartis, Zambon, Mundipharma, Sanofi, Edmond Pharma, Iqvia, Avillion, and Elpen Pharmaceuticals; and participated on a data safety monitoring board or advisory board for Chiesi, AstraZeneca, GSK, MSD, Novartis, Sanofi, Iqvia, Avillion, and Elpen Pharmaceuticals. AR received consulting fees, honoraria for lectures, presentations, speakers’ bureaus or educational events, and participated in advisory boards from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, and Sanofi; and received support for travel/attending meetings from Chiesi. KS received a salary from the Australian Immunisation Coalition which has received funding towards some of its activities from industry sources, including GSK, Sanofi, Roche, and Seqirus. He also received a consultancy fee from APACI, which derives its income from similar sources. AS is a consultant for AstraZeneca Pharmaceuticals, Calyptus Pharmaceuticals, Inc, Darwin Health, EmerVax, EUROIMMUN, F. Hoffman-La Roche Ltd, Fortress Biotech, Gilead Sciences, Granite bio., Gritstone Oncology, Guggenheim Securities, Moderna, Pfizer, RiverVest Venture Partners, and Turnstone Biologics. La Jolla Institute has filed for patent protection for various aspects of T cell epitope and vaccine design work. TT received grants from Merck and Sanofi; personal fees from GSK Biologicals and Sanofi; and honoraria from Sanofi. CWO received grants/contracts and payment/honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, GSK, Janssen, MedImmune, Pfizer, Sanofi, and Sanofi-Aventis; consulting fees, acting as a punctual consultant or directly as an independent expert, from AstraZeneca, GSK, Janssen, MedImmune, MSD, Pfizer, Sanofi, and Sanofi-Aventis; and acted in a leadership or fiduciary role for Coalition for Life Course Immunisation and Infovac-France. BW received honoraria for participation in advisory boards and lectures, and travel costs from the following companies: GSK, MSD, Sanofi, Moderna. TW received research funding and consultancy fees from Synairgen Research Ltd. CHWVK received honoraria for attending meetings sponsored by Sanofi, GSK Biologicals, and MSD. AK, AAR, and ES have no competing interests to declare. Sanofi funded the expert meeting from which this publication resulted. Following the meeting, the authors independently initiated the publication and requested Sanofi’s support for medical writing via an external third party. The opinions and views expressed in this manuscript are solely those of the authors and do not reflect the position of Sanofi. Sanofi had the opportunity to review the manuscript, but the authors had the final decision to submit.

Figures

Figure 1.
Figure 1.
Findings from previous studies highlight low awareness of the pertussis vaccine, and low perception of pertussis as an adult disease among HCPs and the public.
Figure 2.
Figure 2.
Barriers to pertussis vaccine uptake in adults and strategies to overcome them.
See this image and copyright information in PMC

References

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    1. CDC . 2021 final pertussis surveillance report [Internet]. Centres for Disease Control and Prevention; 2021. [accessed 2023 Aug 18]. https://www.cdc.gov/pertussis/downloads/pertuss-surv-report-2021.pdf.

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