According to the Public Relations Office of the Iranian Pediatric Association, citing the ANA News Agency, Dr. Fariba Shirvani, a pediatric infectious disease specialist, addressed the webinar “Evaluation of Pertussis Vaccines and Novel Prevention Strategies” organized by the Pediatric Infectious Diseases Subspecialists Association. She highlighted the current epidemiological situation of pertussis, noting that despite Iran’s high vaccination coverage—exceeding 95% among children under seven years of age—the incidence of pertussis is increasing both globally and nationally.
Changing Clinical Presentation in Infants: Cough Is No Longer the Main Symptom
Dr. Shirvani explained that widespread vaccination has altered the clinical presentation of the disease. In infants younger than three months, pertussis is no longer primarily characterized by severe coughing spells. Instead, it often presents as apnea (cessation of breathing), cyanosis (bluish discoloration of the skin due to lack of oxygen), and bradycardia (abnormally slow heart rate).
She further noted that intensive care unit (ICU) admissions are currently being observed in some hospitals, where infants develop severe leukocytosis (marked elevation of white blood cell counts), leading to pulmonary hypertension. This complication is associated with a high risk of mortality among affected newborns.
Immunity Gap in Individuals Older Than Seven Years
The member of the Iranian Pediatric Association identified inadequate vaccine coverage among older age groups as a key factor contributing to the continued circulation of Bordetella pertussis. She explained that the vaccines currently used in Iran are whole-cell pertussis vaccines, which are not recommended for individuals older than seven years of age.
Because vaccine-induced immunity gradually wanes over time, adolescents and adults may become infected without developing severe symptoms. These individuals can serve as reservoirs of infection and unknowingly transmit the disease to vulnerable infants.
Acellular Vaccine: A Key Strategy for Protecting Mothers and Newborns
Referring to the introduction of a new generation of acellular pertussis vaccines into the country, Dr. Shirvani stated that these vaccines, designed for individuals older than seven years, have been approved by the Center for Communicable Disease Management of the Ministry of Health.
She emphasized that the primary vaccination strategy at present is immunization of pregnant women.
According to Dr. Shirvani, maternal vaccination allows protective antibodies to be transferred across the placenta to the fetus. As a result, newborns receive passive immunity during the most vulnerable period of life—before they begin the routine national immunization schedule. She described this approach as a highly effective strategy that simultaneously protects both mother and child.
Vaccine Availability and Current Priorities
In concluding her remarks, Dr. Shirvani discussed vaccine distribution and accessibility. She noted that the acellular combined vaccine is currently being imported through the private sector and made available in coordination with the Ministry of Health.
Pregnant women are currently the highest-priority group for vaccination and can receive the vaccine with a prescription from an obstetrician, gynecologist, or qualified midwife. She expressed hope that future public health planning will enable the incorporation of this vaccine into the national immunization program for additional age groups.
