Recent Pertussis Outbreaks:

“The district was asked if unvaccinated students were the cause of the outbreak. The district says that’s not the case. Less than half a percent of the student population is unvaccinated. None of those who tested positive for pertussis displayed symptoms.” https://fox2now.com/2019/11/04/fifteen-students-test-positive-for-whooping-cough-at-festus-schools/?fbclid=IwAR0VIG5_-V7Ao4Yb9cuHbLmjLO8bOKylVshRO__1h85fFZxH__IMfCFpH_Q

“Yen added that he knows the cases were present in kids with vaccinations, but he does think it could possibly be a stronger strain of whooping cough this year.” https://signalscv.com/2019/09/40-cases-of-whooping-cough-diagnosed-last-week-in-santa-clarita/

“But all of the sick students had been vaccinated against the disease, according to school officials. In fact, all 90 people who have recently come down with pertussis — the official name for whooping cough — in Los Angeles County this year had been immunized against it, according to county officials.” https://www.latimes.com/local/california/la-me-ln-whooping-cough-vaccine-20190316-story.html

“Of about 1,600 students attend Harvard-Westlake, where tuition is close to $40,000 a year, only 18 opted out of vaccinations for medical reasons. None of the 30 students who contracted whooping cough were not vaccinated.” https://losangeles.cbslocal.com/2019/02/27/whooping-cough-harvard-westlake/amp/

“A disturbing theme has emerged in an analysis of all eight cases of California infants who died from whooping cough this year: Despite the patients’ multiple visits to clinics and hospitals, doctors typically failed to make a swift, accurate diagnosis. By the time these infants developed severe respiratory distress, it was usually too late for any intervention to prevent their tragic deaths.” https://www.latimes.com/archives/la-xpm-2010-sep-07-la-me-whooping-cough-20100907-story.html

Scientists Speak:

“This disease is back because we didn’t really understand how our immune defenses against whooping cough worked, and did not understand how the vaccines needed to work to prevent it,” said Christopher J. Gill, associate professor of global health and lead author of the article. “Instead we layered assumptions upon assumptions, and now find ourselves in the uncomfortable position of admitting that we may made some crucial errors. This is definitely not where we thought we’d be in 2017.” https://www.bu.edu/sph/2017/09/21/resurgence-of-whooping-cough-may-owe-to-vaccines-inability-to-prevent-infections/

“Centers for Disease Control and Prevention researchers say that the vaccine used for whooping cough is less effective because the bacteria behind the disease has mutated. The researchers analyzed lab samples from whooping cough patients between 2000 and 2013 and found that Bordetella pertussis, which causes whooping cough, has undergone genetic changes over time.” https://www.usatoday.com/story/life/allthemoms/2019/03/14/whooping-cough-vaccine-less-effective-cdc-warns-as-outbreaks-hit-schools/3161859002/

“The vaccine for whooping cough doesn’t work as well as it used to, and new research suggests it’s largely because the bacteria behind the disease has mutated. Researchers at the Centers for Disease Control and Prevention analyzed lab samples from patients with whooping cough between 2000 and 2013 and found Bordetella pertussis, which causes whooping cough, has gone through genetic changes over time.” https://www.nbcnews.com/health/kids-health/whooping-cough-vaccine-less-effective-because-bacteria-mutating-study-suggests-n982816

CDC report for 2017: “Over 95% of all children 19-35 months of age have received at least 3 doses of DTaP. This table illustrates a similar trend among the pertussis cases reported
during 2017—the majority have received at least 3 doses of DTaP. Because protection from DTaP wanes over time, even children who are up to date with their pertussis vaccines may contract pertussis.” https://www.cdc.gov/pertussis/downloads/pertuss-surv-report-2017.pdf

Studies:

“The observation that aP, which induces an immune response mismatched to that induced by natural infection, fails to prevent colonization or transmission provides a plausible explanation for the resurgence of pertussis and suggests that optimal control of pertussis will require the development of improved vaccines.” https://www.ncbi.nlm.nih.gov/m/pubmed/24277828/

 “Strictly mucosal infections such as B. pertussis poorly reactivate memory B and T cells residing deep in lymph nodes or tissues.” https://www.ncbi.nlm.nih.gov/m/pubmed/28289058/

“Our results support a period of natural immunity that is, on average, long-lasting (at least 30 years) but inherently variable.” (just contrasting natural immunity which is very long lasting). https://www.ncbi.nlm.nih.gov/m/pubmed/19876392/

“Bordetella pertussis shows polymorphism in two proteins, pertactin (Prn) and the pertussis toxin (PT) S1 subunit, which are important for immunity. A previous study has shown antigenic shifts in these proteins in the Dutch B. pertussis population, and it was suggested that these shifts were driven by vaccination.” https://www.ncbi.nlm.nih.gov/m/pubmed/10463173/

“We present evidence that in the Netherlands the dramatic increase in pertussis is temporally associated with the emergence of Bordetella pertussis strains carrying a novel allele for the pertussis toxin promoter, which confers increased pertussis toxin (Ptx) production. Epidemiologic data suggest that these strains are more virulent in humans. We discuss changes in the ecology of B. pertussis that may have driven this adaptation. Our results underline the importance of Ptx in transmission, suggest that vaccination may select for increased virulence, and indicate ways to control pertussis more effectively.” https://www.ncbi.nlm.nih.gov/m/pubmed/19751581/

“Pertussis cases aged 2 months-1 year were 90% vaccinated following the current DTaP schedule for their age group in Catalonia, and cases of 5-9 years were 87% fully vaccinated with 5 doses of DTaP vaccine. There were no deaths, although 8% of cases were hospitalized. Pertussis was more severe in infants, 30% required hospitalization despite having received the vaccine doses corresponding to their age. Children of 5-9 years were most often identified as primary cases in households or school clusters.

CONCLUSION: Despite high levels of vaccination coverage, pertussis circulation cannot be controlled at all. The results question the efficacy of the present immunization programmes.” https://www.ncbi.nlm.nih.gov/m/pubmed/24216286/

The resurgence of pertussis cases coincides with the emergence of virulent, NON-vaccine strains of pertussis. https://www.ncbi.nlm.nih.gov/m/pubmed/22841154/

“However, significant changes in B. pertussis populations have been observed after the introduction of vaccinations, suggesting a role for pathogen adaptation in the persistence and resurgence of pertussis. These changes include antigenic divergence with vaccine strains and increased production of pertussis toxin. Antigenic divergence will affect both memory recall and the efficacy of antibodies, while higher levels of pertussis toxin may increase suppression of the innate and acquired immune system.” https://www.ncbi.nlm.nih.gov/m/pubmed/23406868/

“This study and other studies have reported the increasing prevalence of isolates not expressing Prn in many countries that have a high up-take of ACV. The overall effect of lack of expression of an antigen on herd immunity is unknown.

These findings suggest that B. pertussis not expressing Prn arose independently multiple times since 2008, rather than by expansion of a single Prn-negative clone. All but 1 isolate had ptxA1, prn2, and ptxP3, the alleles representative of currently circulating strains in Australia. This pattern is consistent with continuing evolution of B. pertussis in response to vaccine selection pressure.“ https://www.researchgate.net/publication/261032619_Rapid_Increase_in_Pertactin-deficient_Bordetella_pertussis_Isolates_Australia

“Following the increase of pertussis vaccination coverage, we observed a relative increase of B parapertussis cases in comparison to B pertussis cases. In vaccinated children B pertussis disease frequently presented as a mild disease, clinically difficult to distinguish from diseases associated with coughing caused by B parapertussis and other viral or bacterial infections.” https://www.ncbi.nlm.nih.gov/m/pubmed/12876162/

“Because of linked-epitope suppression, all children who were primed by DTaP vaccines will be more susceptible to pertussis throughout their lifetimes, and there is no easy way to decrease this increased lifetime susceptibility.” https://www.ncbi.nlm.nih.gov/m/pubmed/30793754/