Early intervention in pertussis outbreak with high attack rate in cohort of adolescents with complete acellular pertussis vaccination in Valencia, Spain, April to May 2015

In the Valencian Community (Spain), the programme of maternal pertussis vaccination during pregnancy started in January 2015. The objective of this study was to estimate in this region the vaccine effectiveness (VE) in protecting newborns against laboratory-confirmed pertussis infection. A matched case–control study was undertaken in the period between 1 March 2015 and 29 February 2016. Twenty-two cases and 66 controls (+/− 15 days of age difference) were included in the study. Cases were non-vaccinated infants < 3 months of age at disease onset testing positive for pertussis by real-time PCR. For every case three unvaccinated controls were selected. Odds ratios (OR) were calculated by multiple conditional logistic regression for association between maternal vaccination and infant pertussis. Other children in the household, as well as mother- and environmental covariates were taken into account. The VE was calculated as 1 − OR. Mothers of five cases (23%) and of 41 controls (62%) were vaccinated during pregnancy. The adjusted VE was 90.9% (95% confidence interval (CI): 56.6 to 98.1). The only covariate in the final model was breastfeeding (protective effect). Our study provides evidence in favour of pertussis vaccination programmes for pregnant women in order to prevent whooping cough in infants aged less than 3 months.

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“…Many countries with long-standing vaccination programmes have reported a resurgence of pertussis, despite sustained high vaccine coverage [1-4]. …”

Section: Introductionmentioning

confidence: 99%

A case–control study to assess the effectiveness of pertussis vaccination during pregnancy on newborns, Valencian community, Spain, 1 March 2015 to 29 February 2016

Bellido-Blasco

Guiral-Rodrigo²,

Míguez-Santiyán³

et al. 2017

Eurosurveillance

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“…According to CDC's report in 2012, annual incidence of 107,473 was recorded in year 1922, Over 264000 cases were reported in 1934 ( fig. 2) and 183,866 cases in 1940, 32 . The CDC's 2012 report shows that pertussis disease is once again becoming a public health problem with 92% increase in incidence from the late 1990s to 2011 and beyond 32 ; 13 In recent Valencia outbreak in Spain, about 90% of the pertussis cases had been vaccinated with DTaP vaccine 39 .…”

Section: Reported Cases Of Pertussismentioning

confidence: 95%

“…In 2011, Torres and colleagues reported that 86.4% of the incidence cases in the adolescent group were well vaccinated (Torres et al, 2011). In the US, there is more than six DOI: 10.21522/TIJPH.2013.06.02.Art016 ISSN: 2520-3134 fold increase from 7867 in year 2000 to 48,277 in 2012, 32 and according to Eshofonie and colleagues, all the cases of 2012 outbreak in a Rural Texas were fully vaccinated with aP 13 . The alarming rate of reemergence of the disease especially among the vaccinated group raises concerns about the longevity and waning effect of the acellular vaccine, 42 ; 1 .…”

Section: Waning Of Immune Induced Effect Of Ap Vaccinementioning

confidence: 99%

“…In the United States, the number of annual reported cases begun to increase when the whole cell vaccine was replaced with the acellular version of the vaccine; from 2,719 in 1991 ( fig. 2) to 25,827 in year 2004 and to 48,277 in 2012, 32 . Vaccination coverage against pertussis infection globally is on the high side especially among developed countries, 12 ; 28 .…”

mentioning

confidence: 99%

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Pertussis Vaccine; the Past, the Present and the Future (A Mini Review)

Mensah¹

2018

TIJPH

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The inception of the whole cell pertussis vaccine wP saw global reduction in reported cases, mortality and morbidity burden to the disease. But, in the late 90s, wP was replaced with acellular pertussis vaccine (aP) in most countries due to safety reasons. In recent years however, the annual reported cases of pertussis globally have increase greatly even among highly vaccinated groups, 1 ; 2. This nurtures concerns about the level of protection aP bestows on the vaccinated individuals, 2. The aim of this current mini review is therefore to assess some recent reports and developments on the matter, evaluate how alarming the situation is by comparing the present to the past and the recommendations for roadmap into the future. Methodology: Boolean search was carried out on popular sites like PubMed and Google on publications and reviews on the topic. Results: Some researchers have attributed the recent surge in reported pertussis cases and deaths to reasons like waning of vaccine induced immunity, inefficacy, resistant strain development and mutated forms in the pathogenic bacteria. Conclusion: For a successful control and eradication of the pertussis disease, new strategies needed to be implemented to factor in the estimated waning effect; 27% / year of 4 years in total reduction in efficacy. Multicomponent aP vaccine (n˃3) has also been reported to be as effective as the wP vaccine hence modification of the current aP vaccine or re-visiting of wP is can also be considered.

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“…20 Early contact tracing and chemoprophylaxis of contacts has been advanced as protective in control of school-based outbreaks. 21 Outbreak response immunization (ORI) has been employed if a particular group is disproportionately affected and it is feasible to reach and vaccinate this group in a relatively short period of time. 4 ORI is supplementary immunization given over and above the routine vaccination schedule, including to those who may be fully immunized or those who did not receive their scheduled vaccines.…”

Section: Recent Epidemiology Of Pertussismentioning

confidence: 99%

Peer Review #2 of "Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling (v0.2)"

2016

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Background. Pertussis control remains a challenge due to recently observed effects of waning immunity to acellular vaccine and suboptimal vaccine coverage. Multiple outbreaks have been reported in different ages worldwide. For certain outbreaks, public health authorities can launch an outbreak response immunization campaign to control pertussis spread. We investigated effects of an outbreak response immunization targeting young adolescents in averting pertussis cases. Methods. We developed an agent-based model for pertussis transmission representing disease mechanism, waning immunity, vaccination schedule and pathogen transmission in a spatially-explicit 500,000-person contact network representing a typical Canadian Public Health district. Parameters were derived from literature and calibration. We used published cumulative incidence and dose-specific vaccine coverage to calibrate the model's epidemiological curves. We endogenized outbreak response by defining thresholds to trigger simulated immunization campaigns in the 10-14 age group offering 80% coverage. We ran paired simulations with and without outbreak response immunization and included those resulting in a single ORI within a 10year span. We calculated the number of cases averted attributable to outbreak immunization campaign in all ages, in the 10-14 age group and in infants. The count of cases averted were tested using Mann-Whitney U test to determine statistical significance. Numbers needed to vaccinate during immunization campaign to prevent a single case in respective age groups were derived from the model. We varied adult vaccine coverage, waning immunity parameters, immunization campaign eligibility and tested stronger vaccination boosting effect in sensitivity analyses. Results. 189 qualified paired-runs were analyzed. On average, ORI was triggered every 26 years. On a per-run basis, there were an average of 124, 243 and 429 pertussis cases averted across all age groups within 1, 3 and 10 years of a campaign, respectively. During the same time periods, 53, 96, and 163 cases were averted in the 10-14 age group, and 6, 11, 20 in infants under 1 (p<0.

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Early intervention in pertussis outbreak with high attack rate in cohort of adolescents with complete acellular pertussis vaccination in Valencia, Spain, April to May 2015

Cited by 5 publications

References 10 publications

A case–control study to assess the effectiveness of pertussis vaccination during pregnancy on newborns, Valencian community, Spain, 1 March 2015 to 29 February 2016

A case–control study to assess the effectiveness of pertussis vaccination during pregnancy on newborns, Valencian community, Spain, 1 March 2015 to 29 February 2016

Pertussis Vaccine; the Past, the Present and the Future (A Mini Review)

Peer Review #2 of "Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling (v0.2)"

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