Understanding the impact of adult pertussis and current approaches to vaccination: A narrative review and expert panel recommendations

ABSTRACT

Pertussis has several notable consequences, causing economic burden, increased strain on healthcare facilities, and reductions in quality of life. Recent years have seen a trend toward an increase in pertussis cases affecting older children and adults. To boost immunity, and protect vulnerable populations, an enduring approach to vaccination has been proposed, but gaps remain in the evidence surrounding adult vaccination that are needed to inform such a policy. Gaps include: the true incidence of pertussis and its complications in adults; regional variations in disease recognition and reporting; and incidence of severe disease, hospitalizations, and deaths in older adults. Better data on the efficacy/effectiveness of pertussis vaccination in adults, duration of protection, and factors leading to poor vaccine uptake are needed. Addressing the critical evidence gaps will help highlight important areas of unmet need and justify the importance of adult pertussis vaccination to healthcare professionals, policymakers, and payers.

KEYWORDS:

• Bordetella pertussis
• disease burden
• underreporting
• Tdap vaccination
• adults

Acknowledgments

Medical writing support funded by Sanofi was provided by Caroline Minshull of Inizio Medical who captured the outline, wrote the initial draft of the manuscript based on the discussions of the authors, and incorporated comments from the authors.

Disclosure statement

PK received honoraria for participating in the 2022 Zoom meetings by Sanofi; he also received honoraria for participation in advisory boards and lectures, and travel costs from the following companies: AstraZeneca, Bionorica, Chiesi, Engelhard, GSK, Janssen, Klosterfrau, Novartis, MSD, and Schwabe. His institution received honoraria for clinical trial participation from Bellus, the ERS NEuroCOUGH Initiative, and MSD. JCS received research support from AstraZeneca and GSK; and honoraria from AstraZeneca, GSK, Bial, Sanofi, and Medinfar, He also participated in a company-sponsored speaker’s bureau for AstraZeneca and Sanofi. UH received consulting fees from Sanofi and GSK, and lecture fees from GSK, Infectopharm, Merck, Moderna, Pfizer, Roche, Sanofi Genzyme and Sanofi-Pasteur. He participated on the Data Monitoring Committees of a poliomyelitis vaccine (Takeda), a phase II study of an adjuvanted pandemic influenza vaccine (GSK/Watermark), the Norovirus Bivalent VLP Vaccine Program (Takeda/HilleVax), and the Cell culture influenza vaccine (Seqirus/IQVIA). He is a member of the Meta Data Safety Monitoring Board for CEPI (Coalition for Epidemic Preparedness Innovations) and of the Varicella Advisory Board, Switzerland (Merck). CRM is supported by an NHMRC Investigator Grant, grant no. [2016907]. She is on the WHO COVID-19 Vaccine Composition Technical Advisory Group and the WHO SAGE Working Group on Smallpox and Monkeypox. She currently receives funding from Sanofi for influenza and pertussis research. DM received personal fees from Dynavax, Seqirus, Sanofi, and GSK; and grants and personal fees from Pfizer. TN received research contracts to conduct clinical trials, with funding to the institution from Moderna, Sanofi, GSK, Iliad Biotechnologies, Dynavax, Seqirus, Janssen, and MSD; consulting fees from GSK, Seqirus, MSD, Sanofi, AstraZeneca, Moderna, BioNet, and Pfizer; and has served on data safety and monitoring boards for Seqirus, Clover, Moderna, Emergent, Serum Institute of India, SK Bioscience Korea, Emergent Biosolutions, and Novavax. AP received grants or contracts from Chiesi, AstraZeneca, GSK, Sanofi, and Agenzia Italiana del Farmaco (AIFA); consultancy fees from Chiesi, AstraZeneca, GSK, Novartis, Sanofi, Avillion, and Elpen Pharmaceuticals; payment or honoraria for lectures, presentations, manuscript writing or educational events from Chiesi, AstraZeneca, GSK, Menarini, Novartis, Zambon, Mundipharma, Sanofi, Edmond Pharma, Iqvia, Avillion, and Elpen Pharmaceuticals; and participated on a data safety monitoring board or advisory board for Chiesi, AstraZeneca, GSK, MSD, Novartis, Sanofi, Iqvia, Avillion, and Elpen Pharmaceuticals. AR received consulting fees, honoraria for lectures, presentations, speakers’ bureaus or educational events, and participated in advisory boards from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK and Sanofi; and received support for travel/attending meetings from Chiesi. KS received a salary from the Australian Immunisation Coalition which has received funding towards some of its activities from industry sources, including GSK, Sanofi, Roche and Seqirus. He also received a consultancy fee from APACI, which derives its income from similar sources. AS is a consultant for AstraZeneca Pharmaceuticals, Calyptus Pharmaceuticals, Inc, Darwin Health, EmerVax, EUROIMMUN, F. Hoffman-La Roche Ltd, Fortress Biotech, Gilead Sciences, Granite bio., Gritstone Oncology, Guggenheim Securities, Moderna, Pfizer, RiverVest Venture Partners, and Turnstone Biologics. La Jolla Institute for Immunology has filed for patent protection for various aspects of T cell epitope and vaccine design work. TT received grants from Merck and Sanofi; personal fees from GSK Biologicals and Sanofi; and honoraria from Sanofi. CWO received grants/contracts and payment/honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, GSK, Janssen, MedImmune, Pfizer, Sanofi, and Sanofi-Aventis; consulting fees, acting as a punctual consultant or directly as an independent expert, from AstraZeneca, GSK, Janssen, MedImmune, MSD, Pfizer, Sanofi, and Sanofi-Aventis; and acted in a leadership or fiduciary role for Coalition for Life Course Immunisation and Infovac-France. BW received honoraria for participation in advisory boards and lectures, and travel costs from the following companies: GSK, MSD, Sanofi, Moderna. TW received research funding and consultancy fees from Synairgen Research Ltd. CHWVK received honoraria for attending meetings sponsored by Sanofi, GSK Biologicals and MSD. AK, AAR, and ES have no competing interests to declare.

Author contributions

In July 2022, 24 international academic experts convened to discuss the challenges associated with the detection, monitoring, and vaccination of pertussis in adults. Authors listed are those who wished to develop two publications associated with the discussions. Given the nature of discussions, all authors contributed to the paper equally. It was agreed that Dr Peter Kardos would take overall responsibility and serve as lead and corresponding author; all other authors are listed alphabetically.

The second publication is titled: ‘Public health management of pertussis in adults: practical challenges and future strategies,’ authored by Professor C Raina MacIntyre, Dr Jaime Correia de Sousa, Professor Ulrich Heininger, Dr Peter Kardos, Professor Andreas Konstantopoulos, Dr Donald Middleton, Professor Terry Nolan, Professor Alberto Papi, Dr Adrian Rendon, Dr Albert Rizzo, Mr Kim Sampson, Dr Alessandro Sette, Ms Elizabeth Sobczyk, Dr Tina Tan, Professor Catherine Weil-Olivier, Dr Birgit Weinberger, Professor Tom Wilkinson, and Dr Carl Heinz Wirsing von König.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2324547.

Additional information

Funding

This work was supported by Sanofi. However, Sanofi was not involved in the development of this manuscript. The opinions and views expressed in this manuscript are solely those of the authors and do not reflect the position of Sanofi.