Effectiveness of four doses of pertussis vaccine during infancy diminished in elementary school age: A test-negative case-control study in Japan

被引：11

作者：

Ohfuji, Satoko ^{[1
]}

Okada, Kenji ^{[2
]}

Mouri, Yoko ^{[3
]}

Mihara, Yuka ^{[4
]}

Ishii, Shigeki ^{[5
]}

Miyata, Akiko ^{[6
]}

Fujino, Motoko ^{[7
]}

Motomura, Chikako ^{[8
]}

Ito, Hiroaki ^{[9
]}

Ohta, Mitsuhiro ^{[10
]}

Kasahara, Yoshihito ^{[11
]}

Nakamura, Hideo ^{[12
]}

Hasui, Masaki ^{[13
]}

Yoshikawa, Tetsushi ^{[14
]}

Tanaka, Takaaki ^{[15
]}

Nakano, Takashi ^{[15
]}

Koshida, Rie ^{[16
]}

Araki, Kaoru ^{[17
]}

Hara, Megumi ^{[17
]}

Hirota, Yoshio ^{[18
]}

机构：

[1] Osaka City Univ, Dept Publ Hlth, Grad Sch Med, Abeno Ku, 1-4-3 Asahi Machi, Osaka 5458585, Japan

[2] Fukuoka Nursing Coll, Div Basic Nursing, Sawara Ku, 2-15-1 Tamura, Fukuoka, Fukuoka 8140193, Japan

[3] Mouri Clin, Dept Pediat, 14017-5 Mimasaka,Yamauchi Cho, Takeo City, Saga 8492303, Japan

[4] Kariya Toyota Gen Hosp, Dept Pediat, 5-15 Sumiyoshi Cho, Kariya, Aichi 4488505, Japan

[5] Miyazaki Prefectural Miyazaki Hosp, Dept Pediat, 5-30 Kita Takamatsu Cho, Miyazaki, Miyazaki 8808510, Japan

[6] Saiwai Kodomo Clin, Dept Pediat, 1-11-3 Saiwai Cho, Tachikawa, Tokyo 1900002, Japan

[7] Tokyo Saiseikai Cent Hosp, Dept Pediat, Minato Ku, 1-4-17 Mita, Tokyo 1080073, Japan

[8] Natl Hosp Org Fukuoka Natl Hosp, Dept Pediat, Minami Ku, 4-39-1 Yakatabaru, Fukuoka, Fukuoka 8111394, Japan

[9] Kameda Med Ctr, Dept Pediat, 929 Higashi Cho, Kamogawa City, Chiba 2968602, Japan

[10] Dept Pediat, Ohta Pediat Clin, 7323-1 Takeo,Takeo Cho, Takeo City, Saga 8430022, Japan

[11] Kasahara Pediat Clin, Dept Pediat, 2-205 Oowada, Fukui, Fukui 9100836, Japan

[12] Nakamura Pediat Clin, Dept Pediat, 6-179 Oshino, Nonoichi, Ishikawa 9218802, Japan

[13] Hasui Pediat Clin, Dept Pediat, 105 Ryusuke Cho, Komatsu City, Ishikawa 9230926, Japan

[14] Fujita Hlth Univ, Sch Med, Dept Pediat, 1-98 Dengakugakubo,Kutsukake Cho, Toyoake, Aichi 4701192, Japan

[15] Kawasaki Med Sch, Dept Pediat, Gen Med Ctr, Kita Ku, 2-6-1 Nakasange, Okayama, Okayama 7008505, Japan

[16] Ekinishi Hlth & Welf Ctr, 3-4-25 Sainenn, Kanazawa, Ishikawa 9208533, Japan

[17] Saga Univ, Fac Med, Dept Prevent Med, 5-1-1 Nabeshima, Saga, Saga 8498501, Japan

[18] Med Co LTA SOUSEIKAI, Clin Epidemiol Res Ctr, Higashi Ku, 3-5-1 Kashii Teriha, Fukuoka, Fukuoka 8130017, Japan

来源：

VACCINE | 2021年 / 39卷 / 01期

关键词：

Effectiveness; Pertussis vaccine; School-aged children; Test-negative case-control study; Japan; WANING PROTECTION; DIPHTHERIA; INFECTION; OUTBREAK; CHILDREN; TETANUS;

D O I：

10.1016/j.vaccine.2020.11.035

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: The Japanese national immunization program recommends that children receive 4 doses of acellular pertussis vaccine between 3 months and 2 years of age. Nevertheless, the number of pertussis cases is increasing in elementary school children aged 6-12 years. Therefore, a test-negative case-control study was conducted to assess the effectiveness of the pertussis vaccine program. Methods: Subjects included children aged >= 3 months who visited a collaborating hospital due to pertussis-specific cough between October 2017 and November 2019. All subjects underwent diagnostic tests for pertussis, and those diagnosed as positive were regarded as cases. Subjects diagnosed as pertussis-negative were classified as controls. Vaccination history was collected using a questionnaire administered to parents with reference to immunization records. Logistic regression models were employed to calculate the odds ratio (OR) and 95% confidence interval for laboratory-confirmed pertussis. Results: Of 187 recruited subjects (120 cases and 67 controls), questionnaire responses were obtained for 145 subjects (95 cases and 50 controls). Compared with unvaccinated subjects, the vaccine effectiveness (VE) of 4 doses was 70% among all subjects and reached to 90% with marginal significance among subjects under 6 years of age. However, among school-aged subjects, the VE was not suggestive of protection against pertussis (VE: 8%). For vaccinees given 4 doses, the OR for developing pertussis increased significantly with longer duration since the fourth dose (compared with <4.5 years, OR of 6.0-8.2 years = 5.74; OR of >8.3 years = 3.88; P for trend by duration < 0.01). Conclusion: Effectiveness of administering 4 doses of pertussis vaccine during infancy decreases with time passed since the fourth dose. This regimen does not protect school-aged children against pertussis. (C) 2020 The Author(s). Published by Elsevier Ltd.

引用

页码：11 / 17

页数：7

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