Vaccine effectiveness of tetanus toxoid,reduced diphtheria toxoid,and acellular pertussis vaccine during a pertussis outbreak in Maine |
| |
| Institution: | 1. National Center for Immunizations and Respiratory Diseases, Division of Bacterial Diseases, CDC, United States;2. Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services Division of Scientific Education and Professional Development, CDC, United States;3. Penobscot County Department of Health, Bangor, ME, United States;4. Maine State Health Department, United States;1. Department of Allergology, Rheumatology and Clinical Immunology, University Children''s Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia;2. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia;1. Clinical Research Center, National Center for Child Health and Development, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology;2. Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology;1. Vaccination and Travel Medicine Centre, Hradec Kralove, Czech Republic;2. GSK Vaccines, Wavre, Belgium;3. GSK Pharmaceuticals, Mumbai, India;1. Hospital del Niño Panama, Panama City, Panama;2. Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama;3. Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT), Panama City, Panama;4. GSK Vaccines, CARICAM ANDINA, Panama City, Panama;5. GSK Pharmaceuticals Limited, Bangalore, India;6. GSK Vaccines, LATAM, Panama City, Panama;7. GSK Vaccines, LATAM, Bogotá, Colombia;1. Dipartimento di Matematica, Università di Trento, Trento, Italy;2. Basque Center for Applied Mathematics, Bilbao, Spain;3. Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands;1. National Immunization Programme, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Beijing 100050, China |
| |
| Abstract: | BackgroundMultiple school-associated pertussis outbreaks were reported in Maine from 2010 to 2011. These outbreaks were associated with an overall increase in pertussis cases statewide. Waning of protection in students recently vaccinated with tetanus, diphtheria, and acellular pertussis (Tdap) has been implicated in the increase in reported rates of pertussis nationally.MethodsWe conducted a retrospective cohort study to evaluate Tdap vaccine effectiveness (VE) among students aged 11–19 years in two schools reporting outbreaks in 2011. All pertussis cases reported from August through November, 2011 at the two schools were included. Vaccination history was verified using provider information, state vaccine registry data, and parental verification. Attack rates (AR) were calculated. VE and duration of protection was calculated as VE = 1 ? (ARvaccinated/ARunvaccinated) × 100% using a log binomial regression model.ResultsOf 416 students enrolled, 314 were included in the analyses. Twenty-nine cases collectively in Schools A and B. Tdap coverage was 65% at School A and 42% at School B before the start of the outbreak. Among students enrolled in the study, attack rates were 11.9% and 7.7% at Schools A and B, respectively. Overall VE was 68.5% (95% confidence interval (CI) 37.7–86.2). VE was 70.4% (95% CI 17.5–89.4) for School A and 65.2% (95% CI ?19.2 to 89.9) for School B. VE <2 years versus ≥2 years from outbreak onset was not significantly different.ConclusionsTdap was moderately effective in preventing disease among vaccinated students. Vaccine coverage of 65% or less was suboptimal and might contribute to outbreaks. Waning VE was not demonstrated. Increased vaccination coverage rates as well as further evaluation of the role of acellular vaccine on VE is needed. |
| |
| Keywords: | Pertussis Vaccine effectiveness |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
