Shinall Myrick C, Peters Timothy R, Zhu Yuwei, Chen Qingxia, Poehling Katherine A
School of Medicine, Divinity School, Vanderbilt University, Nashville, Tennessee, USA.
Pediatrics. 2008 Nov;122(5):1021-6. doi: 10.1542/peds.2007-3025.
This study estimates the potential impact, on rates of pertussis infections, hospitalizations, and deaths among infants in the United States, of administering the first dose of diphtheria and tetanus toxoids and acellular pertussis vaccine at 6 weeks rather than 2 months of age.
We used existing data to estimate current US rates of pertussis infections, hospitalizations, and deaths according to age and infant population in 2004. We then estimated the potential impact of accelerating the administration of the first dose of diphtheria and tetanus toxoids and acellular pertussis vaccine from 2 months to 6 weeks of age, an alternative schedule consistent with current vaccination guidelines. We used Poisson distribution analysis to determine 95% confidence intervals for projected rates of pertussis disease.
Acceleration of administration of the first dose of diphtheria and tetanus toxoids and acellular pertussis vaccine from 2 months to 6 weeks of age is expected to prevent 1236 cases of pertussis, 898 hospitalizations, and 7 deaths attributable to pertussis per year in the United States. These decreases represent 9% reduction in cases, 9% reduction in hospitalizations, and 6% reduction in deaths attributable to pertussis among infants <3 months of age. Acceleration of the second and third doses by 2 weeks is expected to prevent an additional 923 cases, 520 hospitalizations, and 2 deaths attributable to pertussis each year.
Acceleration of administration of diphtheria and tetanus toxoids and acellular pertussis vaccine from 2 months to 6 weeks should reduce the burden of pertussis among young infants.
本研究评估在美国，将白喉破伤风类毒素和无细胞百日咳疫苗首剂接种时间从2月龄提前至6周龄，对婴儿百日咳感染率、住院率和死亡率的潜在影响。
我们利用现有数据，根据2004年美国的年龄和婴儿人口情况，估算当前百日咳感染、住院和死亡的发生率。然后，我们估算了将白喉破伤风类毒素和无细胞百日咳疫苗首剂接种时间从2月龄提前至6周龄的潜在影响，这一替代接种程序符合当前的疫苗接种指南。我们使用泊松分布分析来确定百日咳疾病预计发生率的95%置信区间。
将白喉破伤风类毒素和无细胞百日咳疫苗首剂接种时间从2月龄提前至6周龄，预计每年可预防美国1236例百日咳病例、898例住院以及7例百日咳相关死亡。这些减少量分别代表3月龄以下婴儿百日咳病例减少9%、住院减少9%、死亡减少6%。将第二剂和第三剂接种时间提前2周，预计每年可额外预防923例百日咳病例、520例住院以及2例百日咳相关死亡。
将白喉破伤风类毒素和无细胞百日咳疫苗接种时间从2月龄提前至6周龄应可减轻幼儿的百日咳负担。
