Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap?

被引:260
作者
Cohen, Robert [1 ,2 ,3 ,4 ,5 ]
Ashman, Marion [1 ,6 ]
Taha, Muhamed-Kheir [7 ]
Varon, Emmanuelle [8 ]
Angoulvant, Francois [5 ,9 ,10 ]
Levy, Corinne [1 ,2 ,3 ,4 ,5 ]
Rybak, Alexis [1 ,4 ,5 ]
Ouldali, Naim [1 ,4 ,5 ,10 ,11 ]
Guiso, Nicole [12 ]
Grimprel, Emmanuel [5 ,13 ]
机构
[1] Assoc Clin & Therapeut Infantile Val de Marne, ACTIV, Creteil, France
[2] Ctr Hosp Intercommunal Creteil, Clin Res Ctr CRC, Creteil, France
[3] Univ Paris Est, IMRB GRC GEMINI, Creteil, France
[4] Assoc Fran Aise Pediatrie Ambulatoire, AFPA, St Germain En Laye, France
[5] Grp Pathol Infect Pediat, GPIP, Creteil, France
[6] Ctr Hosp Intercommunal Creteil, Creteil, France
[7] Inst Pasteur, Ctr Natl Reference Meningocoques, Paris, France
[8] Ctr Hosp Intercommunal Creteil, Ctr Natl Reference Pneumocoques, Creteil, France
[9] Univ Paris, Necker Enfants Malad Univ Hosp, AP HP, Dept Gen Pediat & Pediat Infect Dis, Assistance Publique Hopi, France
[10] Univ Paris, Sorbonne Univ, Ctr Rech Cordeliers, INSERM,UMRS 1138, Paris, France
[11] Univ Paris, Robert Debre Univ Hosp, AP HP, Dept Gen Pediat Pediat Infect Dis & Internal Med, Paris, France
[12] Inst Pasteur, Paris, France
[13] Ctr Hosp Armand Trousseau, Serv Pediat, Paris, France
来源
INFECTIOUS DISEASES NOW | 2021年 / 51卷 / 05期
关键词
RESPIRATORY SYNCYTIAL VIRUS; EPIDEMIOLOGY; CHILDREN; VACCINATION; PREVENTION; OPTIONS; BURDEN;
D O I
10.1016/j.idnow.2021.05.004
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Since the beginning of the COVID-19 pandemic, reduced incidence of many viral and bacterial infections has been reported in children: bronchiolitis, varicella, measles, pertussis, pneumococcal and meningococcal invasive diseases. The purpose of this opinion paper is to discuss various situations that could lead to larger epidemics when the non-pharmaceutical interventions (NPI) imposed by the SARS-CoV-2 epidemic will no longer be necessary. While NPIs limited the transmission of SARS-CoV-2, they also reduced the spread of other pathogens during and after lockdown periods, despite the re-opening of schools since June 2020 in France. This positive collateral effect in the short term is welcome as it prevents additional overload of the healthcare system. The lack of immune stimulation due to the reduced circulation of microbial agents and to the related reduced vaccine uptake induced an "immunity debt" which could have negative consequences when the pandemic is under control and NPIs are lifted. The longer these periods of "viral or bacterial low-exposure" are, the greater the likelihood of future epidemics. This is due to a growing proportion of "susceptible" people and a declined herd immunity in the population. The observed delay in vaccination program without effective catch-up and the decrease in viral and bacterial exposures lead to a rebound risk of vaccine-preventable diseases. With a vaccination schedule that does not include vaccines against rotavirus, varicella, and serogroup B and ACYW Neisseria meningitidis, France could become more vulnerable to some of these rebound effects.
引用
收藏
页码:418 / 423
页数:6
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