Longitudinal assessment of asymptomatic infection of Bordetella pertussis among pertussis acellular vaccinated adolescents

doi:10.1016/j.vaccine.2026.128567

Longitudinal assessment of asymptomatic infection of Bordetella pertussis among pertussis acellular vaccinated adolescents

Epidemiology & Environmental Health

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Recent animal model data suggest that acellular pertussis (aP) vaccines do not prevent asymptomatic Bordetella pertussis infection. We conducted a longitudinal study among a convenience sample of adolescents during the latter part of an outbreak to estimate the prevalence of B. pertussis asymptomatic infection and describe the associated serologic response in an aP-vaccinated population. Methods: From October–December 2019, we enrolled a convenience sample of adolescent students during a high school-based outbreak; a subset of participants was followed over a 6-week period. Epidemiologic and symptom data were collected at 3 separate time points (study rounds) each separated by 3 weeks; specimens (nasopharyngeal aspirates, blood) were collected at the first 2 study rounds. Nasopharyngeal aspirates were tested for B. pertussis by culture and real-time polymerase chain reaction (RT-PCR); serum was tested for IgG anti-pertussis toxin antibody (anti-PT). Asymptomatic infection was defined as B. pertussis laboratory-confirmation (RT-PCR or culture) during at least one study round in an asymptomatic participant who remained asymptomatic at the subsequent round. Results: The study included 534 participants; 75.3% had received only aP vaccines as children, and 100% received an adolescent booster. Fifteen participants were laboratory-confirmed for B. pertussis at ≥1 round. Nine of 15 participants remained asymptomatic at the subsequent study round resulting in an asymptomatic infection prevalence of 1.7%. Of the nine participants with asymptomatic B. pertussis infection, one (11%) was seropositive for anti-PT IgG. Discussion: We detected a low prevalence of B. pertussis asymptomatic infection among an aP-vaccinated adolescent population, with variable antibody response. While follow-up studies are needed, this information could help inform public health prevention strategies and development of new pertussis vaccines.

Original language	English
Article number	128567
Number of pages	10
Journal	Vaccine
Volume	81
DOIs	https://doi.org/10.1016/j.vaccine.2026.128567
State	Published - May 10 2026

Bibliographical note

Publisher Copyright:
Published by Elsevier Ltd.

Funding

We would like to thank the following individuals who assisted with this study:●CDC and Illinois Department of Public Health (IDPH) and Lake County Health Department personnel that helped with study preparations, logistics, subject enrollment and data and specimen collection●Laboratory personnel from the Minnesota Department of Health who assisted with incubation and reading of culture plates●IDPH in Chicago for providing space and equipment for processing, testing and shipping of specimens●IDPH personnel for assistance with protocol review and IRB●The staff and students at Stevenson High School in Lincolnshire, IL during the 2019/2020 academic year

Funders
Centers for Disease Control and Prevention
Illinois Department of Public Health
Lake County Health Department
Minnesota Department of Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Asymptomatic infection
Bordetella pertussis
Pertussis

ASJC Scopus subject areas

Molecular Medicine
General Immunology and Microbiology
General Veterinary
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1016/j.vaccine.2026.128567

Cite this

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title = "Longitudinal assessment of asymptomatic infection of Bordetella pertussis among pertussis acellular vaccinated adolescents",

abstract = "Background: Recent animal model data suggest that acellular pertussis (aP) vaccines do not prevent asymptomatic Bordetella pertussis infection. We conducted a longitudinal study among a convenience sample of adolescents during the latter part of an outbreak to estimate the prevalence of B. pertussis asymptomatic infection and describe the associated serologic response in an aP-vaccinated population. Methods: From October{\textendash}December 2019, we enrolled a convenience sample of adolescent students during a high school-based outbreak; a subset of participants was followed over a 6-week period. Epidemiologic and symptom data were collected at 3 separate time points (study rounds) each separated by 3 weeks; specimens (nasopharyngeal aspirates, blood) were collected at the first 2 study rounds. Nasopharyngeal aspirates were tested for B. pertussis by culture and real-time polymerase chain reaction (RT-PCR); serum was tested for IgG anti-pertussis toxin antibody (anti-PT). Asymptomatic infection was defined as B. pertussis laboratory-confirmation (RT-PCR or culture) during at least one study round in an asymptomatic participant who remained asymptomatic at the subsequent round. Results: The study included 534 participants; 75.3\% had received only aP vaccines as children, and 100\% received an adolescent booster. Fifteen participants were laboratory-confirmed for B. pertussis at ≥1 round. Nine of 15 participants remained asymptomatic at the subsequent study round resulting in an asymptomatic infection prevalence of 1.7\%. Of the nine participants with asymptomatic B. pertussis infection, one (11\%) was seropositive for anti-PT IgG. Discussion: We detected a low prevalence of B. pertussis asymptomatic infection among an aP-vaccinated adolescent population, with variable antibody response. While follow-up studies are needed, this information could help inform public health prevention strategies and development of new pertussis vaccines.",

keywords = "Asymptomatic infection, Bordetella pertussis, Pertussis",

author = "Brown, \{Nicole E.\} and Pawloski, \{Lucia C.\} and Kathleen Winter and Kathleen Harriman and Sana Ahmed and Lisa Dallmeyer and Williams, \{Margaret M.\} and Cassiday, \{Pamela K.\} and Tondella, \{M. Lucia\} and Weil, \{Lauren M.\} and Acosta, \{Anna M.\} and Skoff, \{Tami H.\}",

note = "Publisher Copyright: Published by Elsevier Ltd.",

year = "2026",

month = may,

day = "10",

doi = "10.1016/j.vaccine.2026.128567",

language = "English",

volume = "81",

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T1 - Longitudinal assessment of asymptomatic infection of Bordetella pertussis among pertussis acellular vaccinated adolescents

AU - Brown, Nicole E.

AU - Pawloski, Lucia C.

AU - Winter, Kathleen

AU - Harriman, Kathleen

AU - Ahmed, Sana

AU - Dallmeyer, Lisa

AU - Williams, Margaret M.

AU - Cassiday, Pamela K.

AU - Tondella, M. Lucia

AU - Weil, Lauren M.

AU - Acosta, Anna M.

AU - Skoff, Tami H.

N1 - Publisher Copyright: Published by Elsevier Ltd.

PY - 2026/5/10

Y1 - 2026/5/10

N2 - Background: Recent animal model data suggest that acellular pertussis (aP) vaccines do not prevent asymptomatic Bordetella pertussis infection. We conducted a longitudinal study among a convenience sample of adolescents during the latter part of an outbreak to estimate the prevalence of B. pertussis asymptomatic infection and describe the associated serologic response in an aP-vaccinated population. Methods: From October–December 2019, we enrolled a convenience sample of adolescent students during a high school-based outbreak; a subset of participants was followed over a 6-week period. Epidemiologic and symptom data were collected at 3 separate time points (study rounds) each separated by 3 weeks; specimens (nasopharyngeal aspirates, blood) were collected at the first 2 study rounds. Nasopharyngeal aspirates were tested for B. pertussis by culture and real-time polymerase chain reaction (RT-PCR); serum was tested for IgG anti-pertussis toxin antibody (anti-PT). Asymptomatic infection was defined as B. pertussis laboratory-confirmation (RT-PCR or culture) during at least one study round in an asymptomatic participant who remained asymptomatic at the subsequent round. Results: The study included 534 participants; 75.3% had received only aP vaccines as children, and 100% received an adolescent booster. Fifteen participants were laboratory-confirmed for B. pertussis at ≥1 round. Nine of 15 participants remained asymptomatic at the subsequent study round resulting in an asymptomatic infection prevalence of 1.7%. Of the nine participants with asymptomatic B. pertussis infection, one (11%) was seropositive for anti-PT IgG. Discussion: We detected a low prevalence of B. pertussis asymptomatic infection among an aP-vaccinated adolescent population, with variable antibody response. While follow-up studies are needed, this information could help inform public health prevention strategies and development of new pertussis vaccines.

AB - Background: Recent animal model data suggest that acellular pertussis (aP) vaccines do not prevent asymptomatic Bordetella pertussis infection. We conducted a longitudinal study among a convenience sample of adolescents during the latter part of an outbreak to estimate the prevalence of B. pertussis asymptomatic infection and describe the associated serologic response in an aP-vaccinated population. Methods: From October–December 2019, we enrolled a convenience sample of adolescent students during a high school-based outbreak; a subset of participants was followed over a 6-week period. Epidemiologic and symptom data were collected at 3 separate time points (study rounds) each separated by 3 weeks; specimens (nasopharyngeal aspirates, blood) were collected at the first 2 study rounds. Nasopharyngeal aspirates were tested for B. pertussis by culture and real-time polymerase chain reaction (RT-PCR); serum was tested for IgG anti-pertussis toxin antibody (anti-PT). Asymptomatic infection was defined as B. pertussis laboratory-confirmation (RT-PCR or culture) during at least one study round in an asymptomatic participant who remained asymptomatic at the subsequent round. Results: The study included 534 participants; 75.3% had received only aP vaccines as children, and 100% received an adolescent booster. Fifteen participants were laboratory-confirmed for B. pertussis at ≥1 round. Nine of 15 participants remained asymptomatic at the subsequent study round resulting in an asymptomatic infection prevalence of 1.7%. Of the nine participants with asymptomatic B. pertussis infection, one (11%) was seropositive for anti-PT IgG. Discussion: We detected a low prevalence of B. pertussis asymptomatic infection among an aP-vaccinated adolescent population, with variable antibody response. While follow-up studies are needed, this information could help inform public health prevention strategies and development of new pertussis vaccines.

KW - Asymptomatic infection

KW - Bordetella pertussis

KW - Pertussis

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U2 - 10.1016/j.vaccine.2026.128567

DO - 10.1016/j.vaccine.2026.128567

M3 - Article

C2 - 41967186

AN - SCOPUS:105035415595

SN - 0264-410X

VL - 81

JO - Vaccine

JF - Vaccine

M1 - 128567

ER -

Longitudinal assessment of asymptomatic infection of Bordetella pertussis among pertussis acellular vaccinated adolescents

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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