Preventive and Protective Properties of Pertussis Vaccines: Current Situation and Future Challenges

Abstract

Pertussis, more commonly known as whooping cough, is a potentially fatal respiratory disease caused by Bordetella pertussis. Two different types of vaccines provide effective protection: killed whole-cell vaccines (wPV) and more recently available acellular vaccines (aPVs) formulated with specific components. Disturbingly, while the vaccines are widely used, the incidence of disease is increasing in several developed countries that have switched from wPV to an aPV. It is suggested that the single most important underlying cause suggested for the resurgence is transmission through asymptomatic infections. While both vaccines protect against disease, a newly developed baboon model has shown that they do not prevent infection. Importantly, wPV-vaccinated animals appeared to clear an infection more rapidly than those vaccinated with aPV, which can relate to the period of possible disease transmission. To ultimately control whooping cough, it is clear that a more effective vaccine is needed that can prevent both disease and transmission. Modifications underway include the elimination of LPS from wPVs to improve their safety profiles and augmentation of aPVs with other bacterium proteins to increase immunogenicity and the longevity of protection. In the interim, vaccinations with aPV during pregnancy appear to protect newborns, the most susceptible to deadly pertussis.