MMWR Morb Mortal Wkly Rep. 2011 Oct 21;60(41):1424-6.
Compared with older children and adults, infants aged <12 months have substantially higher rates of pertussis and the largest burden of pertussis-related deaths. Since 2004, a mean of 3,055 infant pertussis cases with more than 19 deaths has been reported each year through the National Notifiable Diseases Surveillance System (CDC, unpublished data, 2011). The majority of pertussis cases, hospitalizations, and deaths occur in infants aged ≤2 months, who are too young to be vaccinated; therefore, other strategies are required for prevention of pertussis in this age group. Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) booster vaccines to unvaccinated postpartum mothers and other family members of newborn infants to protect infants from pertussis, a strategy referred to as cocooning. Over the past 5 years, cocooning programs have proven difficult to implement widely. Cocooning programs might achieve moderate vaccination coverage among postpartum mothers but have had limited success in vaccinating fathers or other family members. On June 22, 2011, ACIP made recommendations for use of Tdap in unvaccinated pregnant women and updated recommendations on cocooning and special situations. This report summarizes data considered and conclusions made by ACIP and provides guidance for implementing its recommendations.
与年龄较大的儿童和成人相比，<12 个月的婴儿百日咳发病率要高得多，百日咳相关死亡的负担也最大。自 2004 年以来，通过国家法定传染病监测系统（CDC，未公布数据，2011 年），每年平均报告 3055 例婴儿百日咳病例，超过 19 例死亡。大多数百日咳病例、住院和死亡发生在<2 个月的婴儿中，这些婴儿年龄太小不能接种疫苗；因此，需要其他策略来预防该年龄段的百日咳。自 2005 年以来，免疫实践咨询委员会（ACIP）建议对未接种疫苗的产后母亲和新生儿的其他家庭成员接种破伤风类毒素、白喉类毒素和无细胞百日咳（Tdap）加强疫苗，以保护婴儿免受百日咳的侵害，这一策略被称为“茧式保护”。在过去的 5 年中，“茧式保护”计划已被证明难以广泛实施。“茧式保护”计划可能会使产后母亲的疫苗接种率达到中等水平，但在为父亲或其他家庭成员接种疫苗方面收效甚微。2011 年 6 月 22 日，ACIP 就未接种疫苗的孕妇使用 Tdap 提出了建议，并更新了关于“茧式保护”和特殊情况的建议。本报告总结了 ACIP 审议的数据和结论，并为实施其建议提供了指导。
