Pertussis jab use may need to widen

Whooping cough jabs may need to be given to adolescents and adults to boost falling immunity, and to pregnant women to protect unborn children, HPA research suggests.

Pertussis case numbers have risen in older children and adolescents (Photograph: SPL)
Pertussis case numbers have risen in older children and adolescents (Photograph: SPL)

Dr Helen Campbell, based at the HPA's Centre for Infections, said there were a number of future strategies to tackle rising case numbers.

Speaking at the HPA health protection conference in Coventry last week, she said concerns had been raised by data showing an increase in cases since 2006.

In 2008, cases exceeded pre-2001 rates when a booster dose was introduced into the children's vaccine schedule.

The HPA's study on the epidemiology of pertussis in England and Wales from 1994 to 2009 showed that pertussis was well controlled in young infants.

However, it remains the most common vaccine-preventable disease in under-one-year-olds.

Cases among older children, in particular those aged over 10 years, have increased over the past few years. But this, Dr Campbell said, is principally a result of improved diagnosis of cases, rather than a true increase in prevalence.

However, future strategies will need to stem rises in cases among adolescents and adults and to reduce cases among children under one year old.

'The big question at the moment is what future control strategies should be considered,' she said.

'One that is the forerunner is adolescent and adult boosters. A number of countries have already introduced adolescent boosters, including the US, France and Germany.'

She said that US data suggest there has been a direct impact on those immunised, but that the added benefit of an impact on the youngest infants has not yet been shown.

'Other possibilities are immunisation during pregnancy to offer support to neonatal protection until the baby is ready to be immunised, and neonatal immunisation for similar reasons,' she said. 'But we need to generate a lot more data before embarking on these.'

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