PAHO issues alert over spike in pertussis cases
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Key takeaways:
- Pertussis cases have increased in Brazil, Mexico, Peru and the United States this year.
- Pertussis vaccination rates dropped during COVID-19.
- PAHO recommends 95% vaccination coverage among children.
The Pan American Health Organization issued an epidemiological alert in July regarding a significant rise in pertussis cases in the Americas and across the globe, according to a press release.
Although North and South America together as a region had experienced an annual decline from 72,328 cases in 2012 to 3,283 cases in 2022, Brazil, Mexico, Peru and the United States reported a higher number of cases in 2024 than 2023. Specifically, in the first half of this year, the U.S. saw a 300% higher incidence of pertussis compared with the same period in 2023, and a 15% higher incidence compared with the same period in 2019. Pennsylvania reported 1,035 cases and California reported 702.
Moreover, as Healio previously reported, Fayette County, Kentucky, declared a pertussis outbreak with origins in two schools this past April and May.
According to the Pan American Health Organization (PAHO), there has been a significant decline in diphtheria, tetanus and pertussis vaccination in recent years, especially during the COVID-19 pandemic. In 2021, North and South America hit a 20-year low coverage of 87% for a first dose and 81% for a third dose. Coverage increased to 90% for first dose and 88% for third dose by 2023.
The PAHO recommends countries aim for vaccination coverage of 95% among children for all three doses. The organization also recommends vaccination for health care workers and pregnant women.
The CDC recommends that children aged younger than 7 years in the U.S. receive five doses of DTaP — the first three at ages 2, 4 and 6 months and the last two at 15 to 18 months and 4 to 6 years. Older children and adults receive Tdap.
Reference:
- As global cases of whooping cough rise, PAHO calls on countries to strengthen surveillance and increase vaccination. https://www.paho.org/en/news/24-7-2024-global-cases-whooping-cough-rise-paho-calls-countries-strengthen-surveillance-and. Published July 24, 2024. Accessed July 30, 2024.
- CDC. Pertussis: Summary of vaccine recommendations. https://www.cdc.gov/vaccines/vpd/pertussis/recs-summary.html. Last reviewed Jan. 22, 2020. Accessed July 30, 2024.
- Epidemiological alert: Pertussis (whooping cough) in the region of the Americas. https://www.paho.org/en/documents/epidemiological-alert-pertussis-whooping-cough-region-americas-22-july-2024. Published July 22, 2024. Accessed July 30, 2024.
Perspective
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Tina Q. Tan, MD, FAAP, FIDSA, FPIDS
Since the COVID-19 pandemic, routine vaccination coverage in all age groups has significantly declined globally. During the COVID-19 pandemic, the decrease in vaccination coverage in many areas was due to the isolation policies and inability to access and administer the vaccines. However, currently, vaccine hesitancy is accounting for the majority of the decrease that is being seen in vaccination coverage rates. This decrease continues everywhere in the world, with a slow recovery toward pre-pandemic levels.
During the COVID-19 pandemic, there was a decrease in the surveillance for pertussis and other vaccine-preventable diseases. The vaccine-preventable diseases were still present, but because of isolation and protective protocols, people did not have as much contact with others and there was less spread of these organisms. With the return to more normal social activities, people are having more contact with others, allowing for the uptick in cases of vaccine-preventable diseases that is being seen. This is in addition to a larger number of individuals who are either not up to date with their vaccines or who are unvaccinated.
The PAHO’s recommendation of a vaccination coverage rate of 95% in children is a worthy and ambitious goal that may take some time to achieve and will require vaccination campaigns. It is based on the fact that pertussis is a very contagious disease that requires high community immunization rates to stop spread, much like measles. Barriers to achieving this coverage rate include vaccine access and availability in some areas, costs and vaccine hesitancy.
Health care providers need to ensure that their patients are up to date on all their vaccines. Vaccine-preventable diseases are still with us, and vaccines are the best tool to prevent a patient from becoming ill. The increase in pertussis and other vaccine-preventable diseases are in part due to declining vaccination coverage rates, fueled by the growing issue of vaccine hesitancy.
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