Immunological insights into why pertussis continues to be endemic

Human Vaccines & Immunotherapeutics · Available online 30 Jun 2026 · In press · DOI 10.1080/21645515.2026.2692306

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Authors (12)

Mine Durusu Tanriover, Kevin Forsyth, Qiushui He, Dimitri A. Diavatopoulos, Rodrigo Orozco Fernández, Daniela Flavia Hozbor, Donald B. Middleton, Rudzani Muloiwa, Flor M. Muñoz, Anna Ong-Lim, Tina Q. Tan, Ulrich Heininger

Abstract

Pertussis (whooping cough) is a vaccine-preventable bacterial disease caused by Bordetella pertussis. Despite widespread vaccination, cases have increased globally since the 1990s, with notable outbreaks in 2012, 2016, and following the COVID-19 pandemic. Persistent endemicity and periodic epidemics are driven by limited prevention of nasal colonization, waning immunity after vaccination or natural infection, and pathogen adaptation. Differences between acellular (aP) and whole-cell (wP) vaccines reflect distinct immune profiles, with aP vaccines favoring Th2 responses and wP vaccines inducing Th1/Th17 responses and tissue-resident memory T cells. Circulating strains have evolved under vaccine pressure, including shifts in ptxP, ptxA and prn alleles, increasing pertussis toxin production, emergence of pertactin-deficient variants, and rising macrolide resistance linked to 23S rRNA mutations. Optimizing current vaccine strategies and developing next-generation vaccines that improve durable, Th1/Th17-polarized immunity and reduce transmission are essential for enhanced pertussis control.

Abstract from DOAJ. Public domain (CC0 1.0).

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Publication details

Year
2026

Citation

Tanriover, M., Forsyth, K., He, Q., et al. (2026). Immunological insights into why pertussis continues to be endemic. Human Vaccines & Immunotherapeutics. https://doi.org/10.1080/21645515.2026.2692306

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