University of Nantes, Institut d'Economie et de Management - IAE, LEMNA, Chemin de la Censive du Tertre, BP 52241, 44322 Nantes Cedex 03, France.
Public Health. 2012 Feb;126(2):117-22. doi: 10.1016/j.puhe.2011.11.007. Epub 2012 Jan 5.
To compare universal recommended and compulsory pertussis vaccination strategies in developed countries, and to discuss their effectiveness in terms of the proportion of infants and children who complete their primary course of pertussis vaccine.
Retrospective analysis.
National pertussis surveillance and vaccination coverage data, official pertussis vaccination recommendations, and medical and epidemiological sources related to the use, safety and efficacy of whole-cell and acellular vaccines were analysed.
Similar vaccine coverage rates among children (above 94%) can be achieved at national level regardless of the type of vaccination legislation in place. Mandatory and recommended vaccination strategies appear to be equally effective.
The choice of vaccination strategy is based on the national history of pertussis infection, the safety of available whole-cell vaccines and the willingness of health authorities to introduce acellular vaccines into routine use. The strategies adopted in the UK and the USA are two contrasting examples of immunization policies developed on the basis of different epidemiological backgrounds. They attest to the various associations between the type of pertussis vaccine and the type of universal vaccination strategies that can be undertaken for successful pertussis control. The introduction of a mandatory policy generally takes place during a period of low vaccination coverage, and is vindicated by the need for a rapid increase in immunization uptake. Countries that have already succeeded in implementing sustainable and high rates of uptake with a voluntary approach are expected to recommend pertussis vaccination, considering this to be the most justifiable policy.
比较发达国家普遍推荐和强制百日咳疫苗接种策略，并讨论其在完成百白破疫苗基础免疫的婴儿和儿童比例方面的有效性。
回顾性分析。
对国家百日咳监测和疫苗接种覆盖率数据、官方百日咳疫苗接种建议，以及与全细胞和无细胞疫苗的使用、安全性和有效性相关的医学和流行病学资料进行分析。
无论采用哪种疫苗接种立法，都可以在国家层面上实现类似的儿童疫苗覆盖率（超过 94%）。强制性和推荐性接种策略似乎同样有效。
接种策略的选择取决于国家百日咳感染史、现有全细胞疫苗的安全性以及卫生当局是否愿意将无细胞疫苗纳入常规使用。英国和美国所采用的策略是根据不同的流行病学背景制定的两种截然不同的免疫政策范例。它们证明了百日咳疫苗的类型与可以实施的普遍接种策略之间存在多种关联，这些策略可以成功控制百日咳。强制性政策的引入通常发生在疫苗接种覆盖率较低的时期，需要迅速提高免疫接种率，这使其具有合理性。已经成功实施可持续和高接种率的自愿方法的国家预计将推荐百日咳疫苗接种，因为这是最合理的政策。
