Effectiveness of maternal pertussis vaccination in England: an observational study
Effectiveness of maternal pertussis vaccination in England: an observational study
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DOI：
10.1016/s0140-6736(14)60686-3
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发表时间：
2014-10-25
期刊：
影响因子：
168.9
通讯作者：
Ramsay, Mary
中科院分区：
文献类型：
--
作者：
Amirthalingam, Gayatri;Andrews, Nick;Ramsay, Mary
背景2012年10月，为应对英格兰各地的疫情，引入了孕妇百日咳疫苗接种计划。我们的目的是评估疫苗的有效性和疫苗计划在预防婴儿百日咳的整体效果。方法我们对2008年1月1日至2013年9月30日期间婴儿百日咳的实验室确诊病例和住院病例进行了分析，使用提交给英国公共卫生部的数据作为其加强对英格兰百日咳监测的一部分，调查疫苗接种计划的效果。我们计算疫苗的有效性，通过比较确诊病例的母亲的疫苗接种状况与全国人口的孕妇的疫苗覆盖率估计，从临床实践研究Datalink.Findings的数据的基础上，每月确诊病例总数达到高峰，2012年10月（1565例），随后下降，在所有年龄组。与2012年同期相比，2013年前9个月，确诊病例的最大比例下降（2012年328例vs 2013年72例，-78%，95%CI-72至-83）和住院（2012年440例入院，2013年140例入院，-68%，-61至-74）发生在3个月以下的婴儿中，尽管该年龄组的发病率仍然最高。3个月以下的婴儿也是2013年病例少于2011年的唯一年龄组（2011年118例，2013年72例）。2012年10月1日至2013年9月3日期间，临床实践研究数据链中纳入的26684名妇女有活产;基于该队列的分娩前平均疫苗覆盖率为64%。基于2012年10月1日以后出生且发病时小于3个月的82例婴儿确诊病例的疫苗有效性为91%（95%CI 84 - 95）。疫苗的有效性为90%（95%CI 82至95）时，分析仅限于在小于2 months.Interpretation的儿童的情况下，我们的评估方案，百日咳疫苗接种在英国怀孕是一致的高疫苗的有效性。这种有效性可能是由于被动抗体和母亲接触减少对婴儿的保护，并将为国际决策者提供有价值的信息。
Background In October, 2012, a pertussis vaccination programme for pregnant women was introduced in response to an outbreak across England. We aimed to assess the vaccine effectiveness and the overall effect of the vaccine programme in preventing pertussis in infants.Methods We undertook an analysis of laboratory-confirmed cases and hospital admissions for pertussis in infants between Jan 1, 2008, and Sept 30, 2013, using data submitted to Public Health England as part of its enhanced surveillance of pertussis in England, to investigate the effect of the vaccination programme. We calculated vaccine effectiveness by comparing vaccination status for mothers in confirmed cases with estimates of vaccine coverage for the national population of pregnant women, based on data from the Clinical Practice Research Datalink.Findings The monthly total of confirmed cases peaked in October, 2012 (1565 cases), and subsequently fell across all age groups. For the first 9 months of 2013 compared with the same period in 2012, the greatest proportionate fall in confirmed cases (328 cases in 2012 vs 72 cases in 2013, -78%, 95% CI -72 to -83) and in hospitalisation admissions (440 admissions in 2012 vs 140 admissions in 2013, -68%, -61 to -74) occurred in infants younger than 3 months, although the incidence remained highest in this age group. Infants younger than 3 months were also the only age group in which there were fewer cases in 2013 than in 2011 (118 cases in 2011 vs 72 cases in 2013), before the resurgence. 26 684 women included in the Clinical Practice Research Datalink had a livebirth between Oct 1, 2012 and Sept 3, 2013; the average vaccine coverage before delivery based on this cohort was 64%. Vaccine effectiveness based on 82 confirmed cases in infants born from Oct 1, 2012, and younger than 3 months at onset was 91% (95% CI 84 to 95). Vaccine effectiveness was 90% (95% CI 82 to 95) when the analysis was restricted to cases in children younger than 2 months.Interpretation Our assessment of the programme of pertussis vaccination in pregnancy in England is consistent with high vaccine effectiveness. This effectiveness probably results from protection of infants by both passive antibodies and reduced maternal exposure, and will provide valuable information to international policy makers.