Neonatal Immunity to Bordetella pertussis Infection and Current Prevention Strategies

Table 1

Advantages and disadvantages of infant protection strategies.

Strategy	Objective	Number of doses	Advantages	Disadvantages	References
Child vaccination with DTwP	Induce specific protection in children	3 doses in the first year of life and 2 boost doses	(i) Th1 response induction; (ii) Antibody response; (iii) Prevent pertussis symptoms	(i) Higher risk of local and systemic adverse reactions; (ii) Immunity lasts for 4-12 years	[41, 46–49, 53, 59–61]
Child vaccination with DTaP	Induce specific protection in children with less side effects	3 doses in the first year of life and 2 boost doses	(i) Less reatogenic than DTwP; (ii) Primes a Th1/Th2 response; (iii) Antibody response; (iv) Prevent pertussis symptoms	(i) Do not prevent bacterial colonization and transmission; (ii) Immunity lasts for a shorter period of time than DTwP	[41–43, 46–49, 52, 53, 55, 56, 59–61]
Mother post-partum vaccination with Tdap	Confer protection to mothers and prevent child contamination	1 dose after labour	(i) Protect the mother to transmit the disease	(i) Confers protection only to the mother, and after two weeks from vaccination	[85–87]
Newborn vaccination	Induce protection in children as soon as they are born avoiding the first two months of age being unprotected	1 dose just after birth	(i) First dose still in the hospital	(i) (wP) Immunological tolerance; lower antibody production; (ii) (aP) Antibody production and protection against experimental challenge	[72, 73, 75, 76]
Cocooning	Create a protected environment for unvaccinated children	1 dose for every relative, every time a child is born	(i) Prevent contamination of the unprotected child	(i) Costly; (ii) Difficult to implement; (iii) Child remains without specific protection	[79, 81, 84]
Vaccination with Tdap during pregnancy	Induce protection in mothers and transmit specific passive protection to the foetus and newborn, until the child’s vaccination	1 dose from the 20th to the 36th gestational week, in every pregnancy	(i) Induces specific protection in children; (ii) Just one dose for every pregnancy; (iii) Cost-effective; (iv) T cell responses remains unaffected by maternal antibodies inhibition	(i) High maternal antibody concentration can interfere in the child’s immune response	[77, 104–106]