Antibody responses and B cell immunity after pertussis booster vaccination: immunity in young and old in times of endemic pertussis

Abstract

Pertussis, commonly known as whooping cough, is caused by the Bordetella pertussis bacterium and is a respiratory tract infection with potentially severe complications, especially in unvaccinated infants. Vaccination against pertussis began in the 1950s, leading to a significant decline in its incidence. However, in recent decades, there has been a global resurgence of pertussis cases despite high vaccination rates. This resurgence is partly attributed to the transition from whole cell pertussis (wP) to acellular pertussis (aP) vaccines. Research presented in this thesis also revealed an increase in the pertussis infection prevalence in the Netherlands based on serosurveillance studies. This increase was most pronounced among adolescents but also observed in school-aged children and middle-aged adults. Subsequently, this thesis investigated antibody development in children and adults following a booster vaccination with an aP vaccine and describes the B-cell response post-vaccination. Robust pertussis-specific IgG antibody responses were observed in children, adolescents, and younger and older adults, with good neutralizing capacity. IgA antibody production post booster vaccination was more pronounced in older adults compared to younger individuals and contributed to serum neutralizing capacity. B-cell responses also expanded after booster vaccination, although memory responses were less pronounced in older adults compared to younger individuals. Since pertussis often presents mild or atypical in vaccinated children and adolescents, revaccination of these groups may not contribute much to their health while experiencing a pertussis infection can even broaden their immunity against pertussis. However, for older adults, who are more likely to experience complications from pertussis infection, booster vaccination could be considered. This is also true for other (medical) risk groups. Future research on new vaccines not only preventing disease symptoms but also transmission is crucial for better pertussis control. Continued investigation to immunological correlates of protection against pertussis remains relevant for this purpose.