Pertussis vaccination: reduction of pertussis in infancy remains primary goal
In a revised position paper, published in the Weekly Epidemiological Record today, WHO reaffirms that high coverage of infants with 3 doses of quality pertussis vaccine remains the most important element of pertussis vaccination programmes.
WHO recommends a 3-dose primary series with the first dose administered at 6 weeks of age, and subsequent doses given 4-8 weeks apart, at 10-14 and 14-18 weeks of age. The last dose of the recommended primary series should be completed by the age of 6 months, with a booster dose, given at least 6 months after the last primary dose, recommended for children 1- 6 years of age, preferably during the second year of life.
The position paper includes information on the relative merits, in terms of efficacy, safety and cost-effectiveness, of the whole-cell and acellular pertussis vaccines, and detailed information on the administration and schedules for pertussis vaccines.
There is currently insufficient evidence to support the addition of vaccine boosters in adolescents and adults, or vaccination of pregnant women and close household contacts, for achieving the primary goal of reducing severe pertussis in infants. However, countries with demonstrable nosocomial transmission of the disease are encouraged to vaccinate health-care workers, with emphasis on maternity and paediatric staff, if economically and logistically feasible.
Pertussis (commonly called whooping cough) is an important cause of infant death worldwide and continues to be a public health concern even in countries with high vaccination coverage. Estimates from WHO suggest that, in 2008, about 16 million cases of pertussis occurred worldwide, 95% of which were in developing countries, and that about 195 000 children died from the disease.