The effectiveness of maternal pertussis vaccination in protecting newborn infants in Brazil: A case-control study |
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| Affiliation: | 1. Divisão de Imunização, Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac”, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil;2. Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo – USP, Brazil;3. Centro de Imunologia, Instituto Adolfo Lutz, São Paulo, Brazil;4. Divisão de Doenças de Transmissão Respiratória, Centro de Vigilância Epidemiológica “Prof. Alexandre Vranjac”, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil;5. Centro de Referência Nacional para Coqueluche, Centro de Bacteriologia, Instituto Adolfo Lutz, São Paulo, Brazil;6. Instituto de Medicina Tropical da Universidade de São Paulo – USP, Brazil;7. Coordenadoria de Vigilância em Saúde (COVISA), Secretaria Municipal da Saúde de São Paulo, Brazil;8. Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo – USP, Brazil;1. HealthPartners Institute, Minneapolis, United States;2. Obstetrics and Gynecology, Yale University, New Haven, United States;3. Kaiser Permanente Northern California, Oakland, United States;4. Kaiser Permanente Southern California, Pasadena, United States;5. Center for Health Research, Kaiser Permanente Northwest, Portland, United States;6. Institute for Health Research, Kaiser Permanente Colorado and Department of Ambulatory Care Services, Denver Health, Denver, United States;7. Harvard Pilgrim Health Care Institute & Lee Harvard Medical School, Boston, United States;8. Group Health Cooperative, Seattle, United States;9. Centers for Disease Control and Prevention, Atlanta, United States;1. Dirección Nacional de Control de Enfermedades Inmunoprevenibles (DiNaCEI), Ministerio de Salud de la Nación, Argentina;2. Fundacion INFANT, Buenos Aires, Argentina;3. Vanderbilt University, Nashville, TN, United States;4. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina;1. Department of Pediatrics, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;2. The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel;3. Clinical Microbiology Laboratory, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;4. Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;5. Department of Neonatology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;6. Department of Obstetrics and Gynecology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;1. Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, ICHC, 4° andar, sala 4028 Cerqueira César, 05403-000 São Paulo, SP, Brazil;2. Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 2° andar, sala 2228, CEP: 01246-903, São Paulo, SP, Brazil |
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| Abstract: | IntroductionIn 2014, the Brazilian Ministry of Health (MoH) recommended Tdap to pregnant women in response to a significant increase in the incidence of pertussis among infants. The present study assessed the effectiveness of maternal immunization in preventing pertussis in infants.MethodsAn unmatched case-control study was undertaken in São Paulo State, Brazil from February 2015 to July 2016. Cases were infants aged <8 weeks at onset of pertussis reported to the Surveillance System and confirmed by real-time polymerase chain reaction or culture. Four to six healthy infants were selected as controls per case from birth certificates in the Information System on Live Births database. General characteristics and mother’s vaccination status were compared between cases and controls. The vaccine effectiveness (VE) was calculated as 1 – odds ratio (OR). For the adjusted VE, the OR was calculated using logistic regression analysis.ResultsForty-two cases and 248 controls were enrolled in the study. Mothers of 8 cases (19.1%) and 143 controls (57.4%) were vaccinated during pregnancy, resulting in an unadjusted VE of 82.6% (95% confidence interval [CI], 60.8–92.3%). The VE was unchanged after adjusting for maternal age and monthly household income.ConclusionMaternal pertussis vaccination during pregnancy was effective in protecting infants aged <8 weeks from pertussis. |
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