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Review
. 2024 Sep 9;12(9):1030.
doi: 10.3390/vaccines12091030.

Pertussis Epidemiology in Children: The Role of Maternal Immunization

Nicola Principi  1 , Sonia Bianchini  2 , Susanna Esposito  3
Affiliations
Review

Pertussis Epidemiology in Children: The Role of Maternal Immunization

Nicola Principi et al. Vaccines (Basel). .

Abstract

In the last twelve months, a significant global increase in pertussis cases has been observed, particularly among infants under three months of age. This age group is at the highest risk for severe disease, hospitalization, and death. Maternal immunization with the Tdap vaccine during pregnancy has been recommended to protect newborns by transferring maternal antibodies transplacentally. This review examines the current epidemiology of pertussis, the importance of preventing it in young children, and the effectiveness of maternal immunization. Despite the proven benefits of maternal vaccination, which has been found effective in pertussis prevention in up to 90% of cases, coverage remains suboptimal in many countries. Factors contributing to low vaccination rates include vaccine hesitancy due to low trust in health authority assessments, safety concerns, practical barriers to vaccine access, and the impact of the COVID-19 pandemic, which disrupted routine vaccination services. The recent increase in pertussis cases may also be influenced by the natural cyclic nature of the disease, increased Bordetella pertussis (Bp) activity in older children and adults, and the genetic divergence of circulating Bp strains from vaccine antigens. Given the high efficacy of maternal vaccination in preventing pertussis in infants, increasing coverage rates is crucial. Efforts to improve vaccine uptake should address barriers to access and vaccine hesitancy, ensuring consistent immune protection for the youngest and most vulnerable populations. Enhanced maternal vaccination could significantly reduce the incidence of whooping cough in infants, decreasing related hospitalizations and deaths.

Keywords: Bordetella pertussis; maternal immunization; pertussis; pertussis vaccine; whooping cough.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Global trends in pertussis cases among infants under three months of age (2023–2024).
Figure 2
Figure 2
Maternal immunization coverage and pertussis incidence in infants under 3 months.
See this image and copyright information in PMC

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