Public health management of pertussis in adults: Practical challenges and future strategies
C. Raina MacIntyre, Jaime Correia de Sousa, Ulrich Heininger, Péter Kardos, Andreas Konstantopoulos, Donald B. Middleton, Terry Nolan, Alberto Papi, Adrián Rendón, Albert Rizzo, Kim Sampson, Alessandro Sette, Elizabeth Sobczyk, Tina Q. Tan, Catherine Weil-Olivier, Birgit Weinberger, Tom Wilkinson, Carl Heinz Wirsing von König
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.