Principi Nicola, Bianchini Sonia, Esposito Susanna
Università degli Studi di Milano, 20122 Milan, Italy.
Pediatric Unit, ASST Santi Carlo e Paolo, 20153 Milan, Italy.
Vaccines (Basel). 2024 Sep 9;12(9):1030. doi: 10.3390/vaccines12091030.
In the last twelve months, a significant global increase in pertussis cases has been observed, particularly among infants under three months of age. This age group is at the highest risk for severe disease, hospitalization, and death. Maternal immunization with the Tdap vaccine during pregnancy has been recommended to protect newborns by transferring maternal antibodies transplacentally. This review examines the current epidemiology of pertussis, the importance of preventing it in young children, and the effectiveness of maternal immunization. Despite the proven benefits of maternal vaccination, which has been found effective in pertussis prevention in up to 90% of cases, coverage remains suboptimal in many countries. Factors contributing to low vaccination rates include vaccine hesitancy due to low trust in health authority assessments, safety concerns, practical barriers to vaccine access, and the impact of the COVID-19 pandemic, which disrupted routine vaccination services. The recent increase in pertussis cases may also be influenced by the natural cyclic nature of the disease, increased () activity in older children and adults, and the genetic divergence of circulating strains from vaccine antigens. Given the high efficacy of maternal vaccination in preventing pertussis in infants, increasing coverage rates is crucial. Efforts to improve vaccine uptake should address barriers to access and vaccine hesitancy, ensuring consistent immune protection for the youngest and most vulnerable populations. Enhanced maternal vaccination could significantly reduce the incidence of whooping cough in infants, decreasing related hospitalizations and deaths.
在过去十二个月中，全球百日咳病例显著增加，尤其是在三个月以下的婴儿中。这一年龄组患重病、住院和死亡的风险最高。建议在孕期对母亲进行破伤风类毒素、白喉类毒素和无细胞百日咳疫苗（Tdap）免疫接种，以便通过胎盘传递母体抗体来保护新生儿。本综述探讨了百日咳的当前流行病学、预防幼儿百日咳的重要性以及母体免疫接种的有效性。尽管母体疫苗接种已被证明有益，在高达90%的病例中被发现对预防百日咳有效，但在许多国家，疫苗接种覆盖率仍不理想。导致疫苗接种率低的因素包括对卫生当局评估信任度低、安全担忧、获取疫苗的实际障碍以及新冠疫情的影响，新冠疫情扰乱了常规疫苗接种服务。近期百日咳病例的增加也可能受到该疾病自然周期性、大龄儿童和成人中（）活动增加以及流行菌株与疫苗抗原的基因差异的影响。鉴于母体疫苗接种在预防婴儿百日咳方面的高效性，提高覆盖率至关重要。提高疫苗接种率的努力应消除获取疫苗的障碍和对疫苗的犹豫态度，确保为最年幼和最脆弱人群提供持续的免疫保护。加强母体疫苗接种可显著降低婴儿百日咳的发病率，减少相关的住院和死亡病例。
