ABSTRACT

Introduction

Despite high vaccination coverage among children and adolescents, pertussis remains a public health problem, with large outbreaks occurring periodically in the US and other developed countries.

Areas covered

We examine lessons learned more than 20 years after implementation of programs which use only acellular pertussis vaccines and propose avenues for possible effective use of acellular pertussis vaccine to prevent large outbreaks.

Expert Opinion

Acellular pertussis vaccines were introduced more than 20 years ago, yet the incidence of pertussis has been increasing over the past decade, with periodic large outbreaks marked by notable shifts in disease burden from infants and young children toward fully vaccinated adolescents and young adults. This age shift is mainly driven by the waning of vaccine immunity. To better protect adolescents against pertussis, modification of the current acellular pertussis vaccination schedule or adoption of new vaccination strategies should be considered. For infants not yet eligible to be vaccinated, maternal vaccination against pertussis during pregnancy is an effective way to protect infants from infection, severe disease and death. Implementation of maternal vaccination programs should be encouraged in countries without one or efforts to improve coverage should be supported in countries with existing program.

中文翻译：

---

成熟的无细胞百日咳疫苗接种计划的经验教训和克服疫苗效果不佳的策略

摘要

介绍

尽管儿童和青少年的疫苗接种覆盖率很高，但百日咳仍然是一个公共卫生问题，在美国和其他发达国家定期发生大规模暴发。

涵盖的领域

我们研究了在实施仅使用无细胞百日咳疫苗的计划后 20 多年的经验教训，并提出了可能有效使用无细胞百日咳疫苗以防止大规模爆发的途径。

专家意见

20 多年前引入了无细胞百日咳疫苗，但在过去十年中，百日咳的发病率一直在增加，周期性大爆发的特点是疾病负担从婴儿和幼儿向完全接种疫苗的青少年和年轻人的显着转变。这种年龄变化主要是由于疫苗免疫力下降所致。为了更好地保护青少年免受百日咳的侵害，应考虑修改当前的无细胞百日咳疫苗接种计划或采用新的疫苗接种策略。对于尚未符合接种条件的婴儿，孕期孕产妇接种百日咳疫苗是保护婴儿免受感染、重症和死亡的有效方法。