Next-Generation Pertussis Vaccines

Dear Colleagues,

The incidence of pertussis is increasing in many countries, especially those using acellular pertussis (aP) vaccines, and this has resulted in renewed research focus on a disease that was once thought to be on the way out. Pertussis is a life-threatening disease in infants characterized caused by Bordetella pertussis, a Gram-negative obligate human pathogen that colonizes the upper respiratory tract. B. pertussis was first cultured by Jules Bordet and Octave Gengou in 1906. Whole cell pertussis (wP) vaccines were developed in the 1930s and 1940s and by the 1970s had decreased incidence of the disease down to the point that clinicians and scientists believed it could be eradicated. However, wP vaccines were reactogenic, and media coverage on adverse reactions associated with their use led to public concern about vaccine safety. In Japan, the wP vaccine was removed from use, and overall incidence of pertussis rose dramatically. Yuji Sato and Hiroko Sato developed an “adsorbed purified pertussis vaccine" which contained formaldehyde detoxified pertussis toxin (PT) and filamentous haemagglutinin (FHA), and in 1981, the first aP vaccine was being used in Japan.

aP vaccines were developed in the US and Europe in the 1980s–1990s, and the DTaP infant vaccine series was implemented in the late 1990s or early 2000s. However, in recent years, the incidence of pertussis in the US and Europe has been increasing. In 2012, the US experienced the highest number of cases in 50 years, 50-fold over the lowest incidence back in 1976 during the wP vaccine era. There are several possible reasons for the return of pertussis, including: (1) waning of protective immunity following immunization with aP vaccines, (2) evolution of strain due to vaccine-driven immune selection pressure, (3) a failure of aP vaccines to induce effective T cell response, and (4) the inability of aP vaccines to block nasal colonization and transmission of B. pertussis. Epidemiology and genomics studies have revealed considerable evolution of the pathogen. The baboon model of pertussis has demonstrated that aP vaccines do not protect against transmission and asymptomatic infection. Studies in the mouse model have shown that the aP vaccine fails to generate protective T cells, especially those in the respiratory tissue that maintain long-term memory. In the US, the oldest acellular-only vaccinated population is currently 23 years of age, so we are at the point where a new generation of children will be born to acellular-only immunized parents. There is general agreement that we need to develop a “next generation” pertussis vaccine; however, there is no clear roadmap for their development, but it is clear that it must solve some of the issues with the current one. Since the solutions are not obvious, we would like to invite cutting-edge manuscripts for a Special Issue of Vaccines on ‘Next-Generation Pertussis Vaccines’. We invite authors to contribute original articles or reviews that address this public health concern.

We encourage submissions of manuscripts that investigate novel formulations that include the use of new antigens and adjuvants, or changes in routes of administration. Manuscripts that investigate the role of adjuvants and T cell responses to study the longevity of protection and waning vaccine immunity are also encouraged. In addition, we also welcome the submission of manuscripts investigating the use of preclinical models, platforms strategies, and clinical surrogate endpoints to better understand protection.

Prof. Kingston Mills
Dr. F. Heath Damron
Guest Editors

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