Waning Protection after Fifth Dose of Acellular Pertussis Vaccine in Children
Waning Protection after Fifth Dose of Acellular Pertussis Vaccine in Children
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DOI：
10.1056/nejmoa1200850
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发表时间：
2012-09-13
影响因子：
158.5
通讯作者：
Baxter, Roger
中科院分区：
文献类型：
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作者：
Klein, Nicola P.;Bartlett, Joan;Baxter, Roger
在美国，儿童在7岁之前接受五剂白喉、破伤风和无细胞百日咳（DTaP）疫苗。五剂DTaP后的保护持续时间尚不清楚。方法评估加州儿童百日咳发病风险与2006年至2011年接种第五剂百日咳后时间的关系。这一时期包括2010年的一次大规模疫情。我们进行了一项病例对照研究，涉及在47至84月龄接种DTaP疫苗的北加州凯撒医疗机构的成员。我们将聚合酶链反应（PCR）检测阳性的百日咳患儿与两组对照进行比较：百日咳PCR阴性患儿和来自健康计划成员的普通人群的密切匹配对照。我们使用逻辑回归来检查百日咳风险与第五次DTaP剂量后持续时间的关系。排除了在婴儿期接受全细胞百日咳疫苗或在第五次DTaP后接受任何含百日咳疫苗的儿童。结果我们比较了277名4 - 12岁的百日咳pcr阳性儿童与3318名pcr阴性对照和6086名匹配对照。与pcr阴性对照相比，pcr阳性儿童更有可能更早接受第五次DTaP剂量(P
BackgroundIn the United States, children receive five doses of diphtheria, tetanus, and acellular pertussis (DTaP) vaccine before 7 years of age. The duration of protection after five doses of DTaP is unknown.MethodsWe assessed the risk of pertussis in children in California relative to the time since the fifth dose of DTaP from 2006 to 2011. This period included a large outbreak in 2010. We conducted a case-control study involving members of Kaiser Permanente Northern California who were vaccinated with DTaP at 47 to 84 months of age. We compared children with pertussis confirmed by a positive polymerase-chain-reaction (PCR) assay with two sets of controls: those who were PCR-negative for pertussis and closely matched controls from the general population of health-plan members. We used logistic regression to examine the risk of pertussis in relation to the duration of time since the fifth DTaP dose. Children who received whole- cell pertussis vaccine during infancy or who received any pertussis-containing vaccine after their fifth dose of DTaP were excluded.ResultsWe compared 277 children, 4 to 12 years of age, who were PCR-positive for pertussis with 3318 PCR-negative controls and 6086 matched controls. PCR-positive children were more likely to have received the fifth DTaP dose earlier than PCR-negative controls (P