First children’s study of nasal whooping cough vaccine reports positive results

A nasal vaccine that could help halt the spread of whooping cough has shown promising results in children and teenagers, according to a major international study.

The trial was led by researchers from Southampton's NIHR Clinical Research Facility and NIHR Biomedical Research Centre, working with ILiAD Biotechnologies and partners across the UK, Australia and Costa Rica.

The findings, published in The Lancet Infectious Diseases, suggest the vaccine could help overcome some of the limitations of current vaccines by boosting immunity where the infection first takes hold in the nose and airways. 

First paediatric study

Whooping cough, also known as pertussis, is a highly contagious bacterial infection that can cause severe illness, particularly in babies. Although vaccination has dramatically reduced serious disease, outbreaks continue to occur around the world because current vaccines do not fully prevent people from carrying and spreading the bacteria.

The SUPER (Stand Up to Pertussis) trial involved 366 children and teenagers aged six to 17 years from 16 research sites across three continents.

Researchers tested BPZE1, an experimental vaccine given as a single spray into the nose. They found that the vaccine generated strong immune responses in the nasal passages and was well tolerated, whether it was given on its own or alongside a routine booster vaccine.

Professor Saul Faust, Professor of Paediatric Immunology and Infectious Diseases at the University of Southampton and Director of the NIHR Clinical Research Facility: Southampton, was coordinating investigator of the study. He is a theme co-lead at the NIHR Biomedical Research Centre: Southampton. He said: 

"Whooping cough remains a major global health challenge despite longstanding vaccination programmes. These findings show that BPZE1 can stimulate a strong immune response in the nose, which is where the bacteria first enter the body. This is an encouraging step towards a next generation of vaccines that could not only protect people from disease, but also help reduce transmission within communities."

Stopping disease spread

Importantly, the Phase 2b study met its main goal by showing a significant increase in protective antibodies in the nose. These antibodies are thought to play a key role in preventing the whooping cough bacteria from establishing itself in the airways and spreading to others. 

The researchers also found that BPZE1 did not interfere with the immune response generated by the standard tetanus, diphtheria and pertussis (Tdap) booster vaccine. No vaccine-related serious adverse events were reported, and most side effects were mild or moderate.

Dr Stephanie Noviello, Chief Medical Officer of ILiAD Biotechnologies, said:

"The publication of the SUPER study results marks an important step in expanding our understanding of BPZE1's potential in children and adolescents who previously received the acellular pertussis vaccine series, a population that continues to play an important role in pertussis transmission.

“We are deeply grateful to the children who participated in the study, their families and caregivers, and the investigators, study coordinators, and site personnel whose commitment made this research possible."

Advancing vaccine development

The findings build on a growing body of Southampton-led research into BPZE1.

In 2025, researchers reported results from the CHAMPION-1 human challenge study, which provided the first evidence that a vaccine could prevent the bacteria that cause whooping cough from living in the nose and throat. Researchers said this could be a crucial step towards reducing the spread of infection.

The latest results support the continued development of BPZE1 and future late-stage clinical trials to determine whether the vaccine can help prevent infection, transmission and disease in real-world settings.