An alternative route to pertussis protection?

Around 40 years ago, growing concern in many countries about severe adverse events in infants after receipt of parenteral whole-cell pertussis vaccines combined with diphtheria and tetanus toxoids (DTP) drove the development of more highly purified acellular pertussis vaccines. These diphtheria–tetanus acellular pertussis (DTaP) vaccines, which are also administered parenterally, contain one or more purified pertussis proteins. DTaP provides excellent protection against disease in infants and toddlers and its safety profile is much better than that of DTP. 1 Edwards KM Decker MD Pertussis vaccines. in: Plotkin SA Orenstein WA Offit PA Edwards KM Plotkin's vaccines. 7th edn. Elsevier, Philadelphia, PA2018: 711-761 Crossref Scopus (5) Google Scholar Pertussis transmission and disease seemed to be well controlled for many years after the introduction of DTaP. 1 Edwards KM Decker MD Pertussis vaccines. in: Plotkin SA Orenstein WA Offit PA Edwards KM Plotkin's vaccines. 7th edn. Elsevier, Philadelphia, PA2018: 711-761 Crossref Scopus (5) Google Scholar Immunogenicity and safety of BPZE1, an intranasal live attenuated pertussis vaccine, versus tetanus–diphtheria–acellular pertussis vaccine: a randomised, double-blind, phase 2b trialBPZE1 induced nasal mucosal immunity and produced functional serum responses. BPZE1 has the potential to avert B pertussis infections, which ultimately could lead to reduced transmission and diminished epidemic cycles. These results should be confirmed in large phase 3 trials. Full-Text PDF