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).

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中文翻译：

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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。