The Ongoing Challenge of Pertussis in Eastern and Northern Europe: Recommendations from the Global Pertussis Initiative

Pertussis (whooping cough), a vaccine-preventable disease that affects people of any age, has resurged globally after the COVID-19 pandemic. Key reasons for recent pertussis outbreaks include suboptimal pertussis vaccination coverage (particularly for vaccination during pregnancy) and growing vaccination hesitancy. During the 2023-2024 pertussis outbreaks in Europe, adolescents aged 10-14 years and 15-19 years had the first and third highest incidence rates, respectively. To reduce pertussis burden, it is essential to strengthen vaccination programs in the indicated target groups. This requires increased awareness among healthcare professionals about the local epidemiology of pertussis and its clinical presentation, alongside reinforcement of the benefits of vaccination for disease prevention. In parallel, robust surveillance systems and strong public health capacity for early disease detection and response are crucial to effectively manage outbreaks and build resilience against future outbreaks. Infants remain at high risk for pertussis, with complications, hospitalisation, and death being more common than in other age groups. Immunisation programmes combining vaccination during pregnancy, to protect newborn infants until their primary immunisation series has induced immunity, and infant immunisation are key to reducing morbidity and mortality. Strategies to improve pertussis vaccination uptake among adolescents and adults, especially those with high-risk medical conditions, are also essential. Strengthening global collaborations to invest in and build surveillance systems capable of identifying and responding to future outbreaks, to align national policies, to scale up immunisation during pregnancy, and to adopt a life-long immunisation approach are needed to better control endemic pertussis and manage future outbreaks.