By et al.
Source The Lancet
The increasing number of pertussis cases and fatalities in China is concerning, with decreased immunity after acellular vaccination being a key reason for the increase.1 However, to understand the current increase in the number of pertussis cases in China, attention should be paid to the resurgence of cases before the COVID-19 pandemic and the apparent change in the Bordetella pertussis pathogen.
Although China is among the few countries using copurified acellular pertussis vaccines in national immunisation programmes, declining protection after inoculation is not a unique problem. Reduced vaccine-induced immunity contributes to the resurgence of pertussis. Remarkably, the coverage of the diphtheria, tetanus, and acellular pertussis vaccine in China has remained above 98% during 2009–22, despite the COVID-19 pandemic.2 If waning immunity was solely responsible, logically more cases would be observed in adolescents and adults.
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