Seroprevalence of IgG antibodies against pertussis toxin in the Chinese population: A systematic review and meta-analysis

Hum Vaccin Immunother. 2024 Dec 31;20(1):2341454. doi: 10.1080/21645515.2024.2341454. Epub 2024 May 2.


Pertussis is a vaccine-preventable infectious disease; however, data on pertussis antibody levels in a nationwide population are still limited in China. We aimed to pool the seropositivity rates of IgG antibodies against pertussis toxin (PT-IgG) across the country. We systematically searched PubMed, Web of Science, Embase, and the China National Knowledge Infrastructure Database for studies published between January 1, 2010, and June 30, 2023. Studies reporting the seroprevalence of PT-IgG among a healthy Chinese population were included. Pooled estimates were obtained using random-effects meta-analyzes. The meta-analysis included 39 studies (47,778 participants) reporting anti-PT IgG seropositivity rates. The pooled rate for all ages was 7.06% (95% CI, 5.50%-9.07%). Subgroup analyzes showed rates ranging from 6.36% to 12.50% across different age groups. This meta-analysis indicated a low anti-PT IgG seropositivity rate in the Chinese population, particularly among school-aged children and young adults. This finding underscores the urgent need to refine immunization strategies.

Keywords: China; Pertussis; antibodies; meta-analysis; pertussis toxin.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Bacterial* / blood
  • Child
  • Child, Preschool
  • China / epidemiology
  • East Asian People
  • Humans
  • Immunoglobulin G* / blood
  • Middle Aged
  • Pertussis Toxin* / immunology
  • Pertussis Vaccine / administration & dosage
  • Pertussis Vaccine / immunology
  • Seroepidemiologic Studies
  • Whooping Cough* / epidemiology
  • Whooping Cough* / immunology
  • Whooping Cough* / prevention & control
  • Young Adult


  • Pertussis Toxin
  • Immunoglobulin G
  • Antibodies, Bacterial
  • Pertussis Vaccine

Grants and funding

This work was supported by the Zhejiang Provincial Medical and Health Science and Technology Program [grant number: 2024KY885].