More than 10 years after introduction of an acellular pertussis vaccine in infancy: a cross-sectional serosurvey of pertussis in the Netherlands

Pauline Versteegen; Guy A M Berbers; Gaby Smits; Elisabeth A M Sanders; Fiona R M van der Klis; Hester E de Melker; Nicoline A T van der Maas

doi:10.1016/j.lanepe.2021.100196

More than 10 years after introduction of an acellular pertussis vaccine in infancy: a cross-sectional serosurvey of pertussis in the Netherlands

Lancet Reg Health Eur. 2021 Sep 6:10:100196. doi: 10.1016/j.lanepe.2021.100196. eCollection 2021 Nov.

Authors

Pauline Versteegen¹, Guy A M Berbers¹, Gaby Smits¹, Elisabeth A M Sanders^{1

2}, Fiona R M van der Klis¹, Hester E de Melker¹, Nicoline A T van der Maas¹

Affiliations

¹ National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, 3720 BA, Netherlands.
² Wilhelmina Children's Hospital, Department of Paediatric Immunology and Infectious Diseases, Lundlaan 6, 3584 EA Utrecht, Netherlands.

Abstract

Background: Pertussis is a respiratory disease and still endemic despite high vaccination coverage. In the Dutch national immunisation programme (NIP) whole cell pertussis (wP) priming vaccines for infants were replaced by acellular pertussis (aP) priming vaccines in 2005. Serosurveillance gives the opportunity to objectively monitor effects of changes in the NIP on infection prevalence and vaccine response in the population over time.

Methods: For this population-based cross-sectional serosurvey a representative sample of Dutch residents (0-89 years) was drawn in 2016/2017. Primary outcome was the percentage of participants with pertussis toxin specific antibody concentrations ≥ 100 IU/ml as an indicator of recent infection, and to identify groups possibly more vulnerable to pertussis infection. Percentages were compared with previous results from 2006/2007.

Findings: In total 7621 persons were included in the analysis. An increase in recent infections from 3•5% to 5•9% was found in the population from 7 years and older (n=6013) in 2016/2017 compared with 2006/2007. Most noteworthy increase was seen in 12-18-year-olds who were wP primed and aP boosted.

Interpretation: Infection prevalence is still increasing in the Netherlands inducing a risk of pertussis disease in vulnerable (age) groups. Delaying the preschool booster might prolong the period of protection during primary school and thereby possibly protect younger siblings. Extra boosters might be considered for risk populations like older adults and people with (pulmonary) co-morbidities, since they have higher chances of complications and hospitalisation.An unedited Dutch translation of the abstract is available in : Nederlandse samenvatting.

Funding: The Dutch Ministry of Health, Welfare, and Sport.

Keywords: Bordetella pertussis; cross-sectional, population-based study; immunoglobulin G; pertussis toxin; seroepidemiological study.