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A systematic review of the burden of pertussis disease in infants and the effectiveness of maternal immunization against pertussis.
Expert Review of Vaccines ( IF 5.5 ) Pub Date : 2020-08-09 , DOI: 10.1080/14760584.2020.1791092
Walid Kandeil 1, 2 , Caroline van den Ende 3 , Eveline M Bunge 3 , Victoria A Jenkins 1 , Maria Angeles Ceregido 1 , Adrienne Guignard 1
Affiliation  

Introduction

Infants too young to be fully immunized are the most vulnerable to severe pertussis disease. To close this susceptibility gap, passive infant immunization through vaccination of pregnant women against pertussis was first introduced in 2011 in the United States and has been extended since then to more than 40 countries.

Areas covered

We conducted two systematic literature searches to describe the worldwide burden of pertussis disease in infants <6 months of age since 2005, and the effectiveness and impact of maternal pertussis vaccination in preventing infant pertussis since 2011.

Expert opinion

Pertussis disease incidence rates in infants aged <2-3 months were substantial in all countries with available data, exceeding 1000 cases per 100,000 population during outbreaks. Virtually all pertussis deaths occurred in this age group. Data from Africa, Eastern Mediterranean, and Asia were limited, but suggest a similar or higher disease burden than in Europe or the Americas. Estimates of effectiveness of second/third trimester pertussis vaccination in preventing pertussis disease in <2-3 months old infants were consistently high (69%–93%) across the observational studies reviewed, conducted in various settings with different designs. Maternal vaccination programs appear to be achieving their goal of reducing the burden of disease in very young infants.

Plain language summary

What is the context?

  • Pertussis, also known as whooping cough, is a highly contagious disease of the respiratory tract.

  • Infants too young to be fully vaccinated are at the highest risk of severe pertussis disease, hospitalization, and death.

  • Vaccinating pregnant women against pertussis with a Tdap vaccine is recommended in more than 40 countries as a safe and effective strategy to protect infants for the first months of life.

What is new?

  • This review summarizes recent literature describing the burden of pertussis disease in infants worldwide prior to the introduction of maternal vaccination programs; pertussis disease incidence rates in infants aged <2-3 months were substantial in all countries with available data, exceeding 1000 cases per 100,000 population during outbreaks.

  • Immunization of pregnant women with a Tdap vaccine can prevent about 70–90% of pertussis disease and up to 90.5% of pertussis hospitalizations in infants under 3 months of age.

What is the impact?

  • Limited available data suggest that incidence rates of pertussis disease after the introduction of Tdap maternal immunization have declined in infants.

  • Current knowledge supports the implementation of Tdap maternal immunization programs.



中文翻译:

对婴儿百日咳疾病负担和孕产妇针对百日咳的免疫效果的系统评价。

介绍

年龄太小而无法完全免疫的婴儿最容易患上严重的百日咳疾病。为了弥合这一易感性差距,美国于2011年首次通过孕妇接种百日咳疫苗对婴儿进行被动免疫,此后已扩展到40多个国家。

覆盖区域

我们进行了两项系统的文献检索,以描述自2005年以来全球<6个月大的婴儿百日咳疾病的负担,以及自2011年以来预防母婴百日咳疫苗的有效性和影响。

专家意见

在所有具有可用数据的国家中,<2-3个月大的婴儿百日咳疾病的发病率很高,暴发期间每十万人口中有超过1000例。几乎所有百日咳死亡都发生在该年龄段。非洲,东地中海和亚洲的数据有限,但表明疾病负担与欧洲或美洲相似或更高。在所审查的观察性研究中,在不同设置,不同设计下进行的观察性研究中,估计在2-3个月以下的婴儿中,中期/中期百日咳疫苗接种的有效性一直很高(69%–93%)。产妇疫苗接种计划似乎正在实现其减轻非常小的婴儿疾病负担的目标。

普通语言摘要

上下文是什么?

  • 百日咳,也称为百日咳,是一种高度传染性的呼吸道疾病。

  • 年龄太小而不能完全接种疫苗的婴儿患严重百日咳疾病,住院和死亡的风险最高。

  • 在40多个国家/地区,建议使用Tdap疫苗为孕妇接种百日咳疫苗,这是一种安全有效的策略,可以保护婴儿出生后的头几个月。

有什么新东西?

  • 这篇综述总结了最近的文献,这些文献描述了全世界在引入孕产妇疫苗接种计划之前婴儿百日咳疾病的负担;在所有具有可用数据的国家中,<2-3个月大的婴儿百日咳疾病的发病率很高,暴发期间每十万人口中有超过1000例。

  • 对Tdap疫苗的孕妇进行免疫可以预防3个月以下婴儿约70-90%的百日咳疾病和多达90.5%的百日咳住院。

有什么影响?

  • 有限的可用数据表明,在婴儿中进行Tdap产妇免疫后,百日咳病的发病率有所下降。

  • 当前的知识支持Tdap产妇免疫计划的实施。

更新日期:2020-08-31
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