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Incidence and mortality of pertussis disease in infants <12 months of age following introduction of pertussis maternal universal mass vaccination in Bogotá, Colombia
Vaccine ( IF 4.5 ) Pub Date : 2020-10-02 , DOI: 10.1016/j.vaccine.2020.07.046
Gabriel Carrasquilla , Alexandra Porras , Sandra Martinez , Rodrigo DeAntonio , Raghavendra Devadiga , Diana C. Caceres , Patricia Juliao

Background

Maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine confers protection to young infants. We aimed to describe trends in pertussis incidence and associated mortality in children aged <12 months before and after introduction of maternal Tdap immunization in Bogotá, Colombia.

Methods

Data on pertussis-related cases/deaths in infants aged <12 months were collected from SIVIGILA for the period 2005–2016, and compared incidence for the pre-vaccine introduction (2005–2012) and post-maternal Tdap vaccination (2014–2016) periods in infants aged <12 months and in three distinct age-strata; ≤6 weeks, 7–<28 weeks, and 28–52 weeks. Mortality comparisons were performed in all infants <12 months.

Results

From 2005 to 2016, 2315 laboratory or clinically-confirmed pertussis cases were reported in infants <12 months of age (278 cases in young infants aged ≤6 weeks); 55 pertussis deaths were reported in children aged <12 months. No pertussis deaths were reported in the 2014–2016 period. Since maternal Tdap introduction in 2013, a consistent decline in pertussis incidence and mortality was observed. In the time-series analysis, incidence declined from 209.4/100,000 persons (2005–2012) to 49.1/100,000 persons (2014–2016) in all children <12 months; a 87.5% (95%CI: 77.2-93.2%) reduction. For these same period’s incidence in young infants ≤6 weeks declined from 196.7 to 89.6/100,000 person-years (an 54.4% [95% CI: 35.4–67.9%] reduction). Greater incidence reductions were observed in older infants; 73.4% (95% CI: 68.4–77.6%) in those aged 7–<28 weeks, and 100% in those aged 28–52 weeks. A 100% reduction in Pertussis mortality in infants <12 months was observed. Since Tdap introduction, maternal vaccine coverage rose from <60% in 2013–2015 to 80% in 2016.

Conclusions

Implementation of maternal immunization in Bogotá may have contributed to the reduction in pertussis incidence and mortality among infants <12 months of age (ClinicalTrials.gov: NCT02569879).

An Audio Summary linked to this article that can be found on Figshare https://doi.org/10.6084/m9.figshare.12943316



中文翻译:

在哥伦比亚波哥大实施百日咳产妇全民大规模疫苗接种后,<12个月大的婴儿百日咳疾病的发病率和死亡率

背景

破伤风,白喉和脱细胞百日咳(Tdap)疫苗的孕产妇免疫可为幼儿提供保护。我们的目的是描述在哥伦比亚波哥大实施孕产妇Tdap免疫前后12岁以下儿童百日咳发病率和相关死亡率的趋势。

方法

从SIVIGILA收集了2005-2016年期间小于12个月的婴儿与百日咳有关的病例/死亡数据,并比较了疫苗接种前(2005-2012年)和产后Tdap疫苗接种(2014-2016年)的发生率小于12个月的婴儿以及三个不同年龄层的时期 ≤6周,7- <28周和28-52周。在所有<12个月的婴儿中进行死亡率比较。

结果

从2005年到2016年,报告了2315例<12个月以下婴儿的实验室或临床确诊的百日咳病例(278例≤6周龄的婴儿);<12个月的儿童中报告了55例百日咳死亡。2014-2016年期间未报告百日咳死亡。自2013年引入母体Tdap以来,观察到百日咳的发病率和死亡率持续下降。在时间序列分析中,所有12岁以下儿童的发病率从209.4 / 100,000人(2005-2012年)下降到49.1 / 100,000人(2014-2016年);减少87.5%(95%CI:77.2-93.2%)。在同一时期,≤6周的婴儿的发病率从196.7下降到89.6 / 100,000人年(减少了54.4%[95%CI:35.4-67.9%])。观察到较大的婴儿发病率降低更大;7岁至7岁以下人群中有73.4%(95%CI:68.4–77.6%)28周,在28-52周的年龄段中为100%。观察到小于12个月的婴儿百日咳死亡率降低了100%。自引入Tdap以来,孕产妇疫苗接种率从2013-2015年的<60%上升到2016年的80%。

结论

波哥大实施产妇免疫接种可能有助于降低12岁以下婴儿的百日咳发病率和死亡率(ClinicalTrials.gov:NCT02569879)。

可以在Figshare https://doi.org/10.6084/m9.figshare.12943316上找到与本文链接的音频摘要。

更新日期:2020-10-14
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