Pertussis vaccination for adolescents and adults.
Following the introduction of vaccines, the incidence of pertussis declined; however, since 1990, a progressive increase was noted, even in highly immunised populations. Periodic pertussis outbreaks are due to suboptimal efficacy of the vaccine and waning immunity with increasing age. A significant proportion of adolescents and adults with a prolonged cough present Bordetella pertussis, and infection is often transmitted to infants too young to be vaccinated. A high vaccination coverage in the whole population would be necessary to interrupt the circulation of B. pertussis, but immunisation programmes for adolescents and adults have been introduced recently and are accepted with difficulty. The lack of cost-benefit analysis and consistent epidemiological data makes it difficult to assess the role of pertussis elimination among public health priorities. At present, programmes targeted at risk groups for close contacts with infants are the most convenient for adult population, as more epidemiological and economic evidence is needed before a universal strategy can be discussed.
University Tor Vergata, Department of Public Health, Via Montpellier, 1 00133 Rome, Italy. franco@med.uniroma2.it
Elisabetta
E
Franco
Cristina
C
Giambi
Rita
R
Ialacci
Massimo
M
Maurici
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000940:Antigenic Variation / Q000235:genetics; D001886:Bordetella pertussis / Q000235:genetics / Q000276:immunology; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D016358:Contact Tracing; D004196:Disease Outbreaks; D004198:Disease Susceptibility; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control; D010567:Pertussis Vaccine / Q000276:immunology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D014611:Vaccination; D022282:Vaccines, Acellular; D014917:Whooping Cough / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission
D010567:Pertussis Vaccine; D022282:Vaccines, Acellular