Choi Jung-Hyun, Correia de Sousa Jaime, Fletcher Monica, Gabutti Giovanni, Harrington Lauriane, Holden Michael, Kim Hyungwoo, Michel Jean-Pierre, Mukherjee Piyali, Nolan Terry, Welte Tobias, Maggi Stefania
Catholic University of Eunpyeuong St. Mary's Hospital, Seoul, South Korea.
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
Aging Clin Exp Res. 2022 Jan;34(1):1-8. doi: 10.1007/s40520-021-02018-3. Epub 2022 Jan 10.
Despite the implementation of effective paediatric vaccination programmes, pertussis remains a global health problem. Disease epidemiology has changed over time, shifting towards the adolescent and adult populations. In adults, the true burden of pertussis is greatly underestimated and pertussis vaccine coverage rates are suboptimal, including individuals with chronic conditions. Here, we report the outcomes of a virtual international scientific workshop to assess the evidence on the burden of pertussis in older adults and identify potential solutions to improve uptake of pertussis vaccines. In adults, pertussis is underdiagnosed in part due to atypical or milder clinical presentation and the lack of testing and case confirmation. However, contemporary epidemiological data denoted an increase in the burden of pertussis among adolescents and adults. This might be related to a variety of reasons including the waning of immunity over time, the lack of booster vaccination, and the improved diagnostic methods that led to increased recognition of the disease in adults. Pertussis sequelae can be severe in older adults, particularly those with existing chronic medical conditions, and the vulnerability of these groups is further enhanced by low pertussis vaccine coverage. Possible measures to increase vaccine uptake include strengthening and harmonisation of immunisation guidelines, healthcare professionals taking a more active role in recommending pertussis vaccination, involvement of vaccination centres and pharmacies in the vaccination process, and improving knowledge of pertussis burden and vaccine efficacy among the general population.
尽管实施了有效的儿童疫苗接种计划，但百日咳仍然是一个全球健康问题。疾病流行病学随时间发生了变化，逐渐转向青少年和成人人群。在成人中，百日咳的实际负担被大大低估，百日咳疫苗接种覆盖率不理想，包括患有慢性病的个体。在此，我们报告了一次虚拟国际科学研讨会的成果，该研讨会旨在评估老年人百日咳负担的证据，并确定提高百日咳疫苗接种率的潜在解决方案。在成人中，百日咳部分由于非典型或较轻的临床表现以及缺乏检测和病例确诊而未得到充分诊断。然而，当代流行病学数据表明青少年和成人中百日咳负担有所增加。这可能与多种原因有关，包括随着时间推移免疫力下降、缺乏加强免疫接种以及诊断方法的改进导致成人中对该疾病的认识增加。百日咳后遗症在老年人中可能很严重，尤其是那些患有现有慢性疾病的人，而这些人群的脆弱性因百日咳疫苗覆盖率低而进一步加剧。提高疫苗接种率的可能措施包括加强和统一免疫指南、医护人员在推荐百日咳疫苗接种方面发挥更积极的作用、疫苗接种中心和药房参与接种过程，以及提高普通人群对百日咳负担和疫苗效力的认识。
