Session Title: VACCINE AND PREVENTION
CONSENSUS ON PERTUSSIS BOOSTER VACCINATION IN EUROPE (C.O.P.E)
F. Zepp1, E. Bernatowska2, N. Guiso3, U. Heininger4, J. Mertsola5, J. Roord6, A. Tozzi7
1Children's Hospital, Johannes-Gutenberg-University, Mainz, Germany, 2The Children's Memorial Health Institute, Warszawa, Poland, 3Institut Pasteur, Paris, France, 4University Children's Hospital, Basel, Switzerland, 5Turku Institute Hospital, Turku, Finland, 6Free University Medical Center, Amsterdam, The Netherlands, 7Bambino Gesu' Hospital, Roma, Italy
Background: When introduced, infant immunisation against pertussis dramatically reduced the number of reported cases in children. Recently, pertussis has been increasingly recognised, particularly amongst adolescents and adults (peak incidence: 10-19 and 35-64 years), who transmit the disease to vulnerable infants. Many healthcare providers underestimate the impact of pertussis and do not consider adult vaccination.1
Methods: A panel of European experts recently discussed the need for pertussis booster vaccinations in adolescents and adults.
Results: The panel recommended that:
Adolescents (10-18 years) should receive a single dose of combined reduced-antigen-content-tetanus-diphtheria-acellular pertussis (dTpa) vaccine instead of dT, irrespective of a complete primary vaccination schedule.
Adolescents with a history of pertussis should receive dTpa according to routine recommendations.
Adults (≥19 years) should receive a single dTpa dose instead of Td for active booster vaccination if their last dT dose was ≥10 years earlier, irrespective of disease history.
The cocoon strategy (vaccinating close-contacts of newborns with dTpa) should continue until immunisation coverage in adults is sufficient for herd protection.
The need for improved surveillance with standardised biological diagnoses, health economic analyses and education to raise disease awareness and capitalise on the opportunities to administer booster vaccinations was emphasised.
Conclusions: Control of B. pertussis circulation is crucial and will require regular boosters for the whole population. As an initial step, practical recommendations for booster vaccination of adolescents and adults in Europe have been proposed. Implementation of these recommendations is likely to increase protection of the population as a whole.
1Hoffait M et al, ESPID 2009