National Outbreak of Pertussis in England, 2011-2012: A Case-control Study Comparing 3-Component and 5-Component Acellular Vaccines With Whole-cell Pertussis Vaccines
National Outbreak of Pertussis in England, 2011-2012: A Case-control Study Comparing 3-Component and 5-Component Acellular Vaccines With Whole-cell Pertussis Vaccines
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DOI：
10.1093/cid/ciz199
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发表时间：
2020-01-15
影响因子：
11.8
通讯作者：
Amirthalingam, Gayatri
中科院分区：
文献类型：
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作者：
Carvalho, Carlos F. A.;Andrews, Nick;Amirthalingam, Gayatri
背景在英格兰，2004年10月，无细胞百日咳（aP）疫苗在初级免疫过程中取代了全细胞百日咳（wP）疫苗。尽管疫苗覆盖率持续较高，但2011-2012年英格兰确诊了10454例病例，其中1648例（16%）发生在10-19岁人群中。由于暂时供应短缺，这些个体已接种3组分（aP 3）或5组分（aP 5）aP疫苗或wP疫苗。我们的目的是比较不同的百日咳疫苗提供的保护。我们进行了病例对照研究。1997年至2005年出生的人，在英格兰完全接种疫苗，包括在内。病例在2011年1月至2012年12月期间得到实验室确认。控制措施是从代表20%人口的人口疫苗接种登记册中确定的。我们比较了病例和对照组接受不同类型疫苗的几率，调整了出生年份和上次接种疫苗的时间。计算比值比（OR）和95%置信区间（CI）。我们分析了403例病例和581 971名对照，记录了4种百日咳疫苗。与接受3剂wP治疗的患者相比，接受3剂aP 3治疗的患者的几率更高（OR，3.86 [95%CI，2.56-5.82]），但与接受3剂aP 5治疗无显著相关性（OR，0.89 [95%CI，0.29 -2.73]）。先前的研究表明aP 3和aP 5疫苗提供的保护持续时间比wP疫苗短。我们的研究结果表明，与wP相比，aP 3的初级病程与确诊百日咳的风险增加相关。虽然aP 5队列的随访时间较短，但其风险似乎与wP没有差异。
Background. In England, acellular pertussis (aP) vaccines replaced whole-cell pertussis (wP) vaccine in the primary immunization course in October 2004. Despite sustained high vaccine coverage, 10 454 cases were confirmed in England in 2011-2012, including 1648 (16%) in those aged 10-19 years. These individuals had been primed with either 3-component (aP3) or 5-component (aP5) aP vaccines or wP vaccine due to temporary supply shortages. We aimed to compare protection provided by different pertussis vaccines.Methods. We conducted a case-control study. Individuals born between 1997 and 2005, fully vaccinated in England, were included. Cases were laboratory confirmed between January 2011 and December 2012. Controls were identified from population vaccination registers, representing 20% of the population. We compared the odds of receiving different types of vaccines in cases and controls, adjusting for year of birth and time since last vaccine received. Odds ratios (ORs) were calculated with 95% confidence intervals (CIs).Results. We analyzed 403 cases and 581 971 controls with 4 pertussis vaccines recorded. Compared to those who received 3 doses of wP for the primary course, cases had higher odds of receiving 3 doses of aP3 (OR, 3.86 [95% CI, 2.56-5.82]) but no significant association with receipt of 3 doses of aP5 (OR, 0.89 [95% CI, .29-2.73]).Conclusions. Previous studies have suggested that aP3 and aP5 vaccines provide shorter duration of protection than wP vaccine. Our findings suggest that a primary course with aP3 is associated with increased risk of confirmed pertussis compared with wP. Although follow-up was shorter for aP5 cohorts, their risk did not seem to differ from wP.