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Epidemiology

Authoring team

Before the introduction of pertussis immunisation in the 1950s, the average annual number of notifications exceeded 120,000 in the UK. By 1972, when vaccine coverage was around 80%, there were only 2069 notifications of pertussis.

  • Two major epidemics occurred in 1977-79 and 1981-83 due to a report published which suggested a possible link between the vaccine and brain damage (which resulted in immunisation coverage dropping to 30%).
  • Since the mid-1990s, coverage has been consistently over 90% by the second birthday has exceeded 95% since 2009/10 (1).

Despite sustained levels of vaccine coverage above 95% from 2010, an increase in pertussis activity was observed in England and Wales from October 2011 and continued into 2012 (2):

  • initially affecting adolescents and adults and later extending to young infants
  • national outbreak was declared in April 2012

Despite the current low levels of disease, pertussis in the very young remains a significant cause of illness and death (1).

  • Highest incidence of the disease is seen in infants less than 3 months - laboratory confirmed pertussis: 77 per 100,000 population in 2015 (2).
  • Young infants are at highest risk of severe complications, hospitalisation and death (3).

In response to this outbreak, in October 2012, the Department of Health introduced a temporary programmed to offer pertussis vaccination to pregnant women ideally between 28-31 weeks (but up to 38 weeks) of their pregnancy (1,2).

  • In February 2016, JCVI (Joint Committee on Vaccination and Immunisation) advised that maternal pertussis immunisation can take place from week 16 of pregnancy (1).

Note:

  • resurgence in disease in the presence of sustained high vaccine coverage may potentially be explained by improved case ascertainment, change from whole-cell to acellular vaccines, waning immunity, and genetic changes in B. pertussis (1)

Reference:

 

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