Pertussis in fully vaccinated infants and children. Are new vaccination strategies required?

Fernando A. Moraga-Llop, Natàlia Mendoza-Palomar, Antoni Muntaner-Alonso, Gemma Codina-Grau, Anna Fàbregas-Martori, Magda Campins-Martí

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8 Citations (Scopus)


Objective To analyse the vaccination status of children diagnosed with pertussis and to compare the clinical manifestations of fully vaccinated with unvaccinated, or incompletely-vaccinated, children. Methods The clinical histories and vaccination cards of patients under 16 years of age seen in the Emergency Room of the University Hospital Vall d'Hebron, Barcelona (Spain), for pertussis confirmed by a microbiological study were reviewed. The study period lasted from January 1, 2009 to December 31, 2011. Results Two hundred and twelve cases were studied: 35 in 2009, 28 in 2010 and 149 in 2011. RT-PCR was positive in 210 patients, and 73 had a positive culture. Infants under 6 months of age account for 36.8% of all cases. Forty-four patients (21.5%) were not vaccinated. Forty-four (21.5%) children were between 2 and 5 months of age and had received 1-2 vaccine doses. One hundred and seventeen (57%) children were fully vaccinated; 76.9% (90 cases) had received the last dose less than 4 years ago. When clinical manifestations of the fully vaccinated patients were compared with those of the non-vaccinated or incompletely-vaccinated children, only cyanosis was found with a higher frequency in the latter group (P <.001). The age-adjusted probability of hospitalisation was significantly associated with non-vaccination (P =.001). The case mortality rate among inpatients was 1.3%. Conclusions The number of pertussis cases seen in our centre has risen significantly in the last year. More than half (57%) of the patients were fully vaccinated, and 76.9% had received the last dose in the previous 4 years. Other vaccination strategies, such as vaccination of adolescents, adults, and pregnant women, as well as a cocoon strategy are required to protect infants under 6 months of age. More effective vaccines need to be developed. © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Todos los derechos reservados.
Original languageEnglish
Pages (from-to)236-241
JournalEnfermedades Infecciosas y Microbiologia Clinica
Issue number4
Publication statusPublished - 1 Jan 2014


  • Children
  • Epidemiology
  • Pertussis
  • Pertussis vaccines


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