Queensland Children's Medical Research Institute, University of Queensland, Brisbane, QLD, Australia.
Metro South Public Health Unit, Brisbane, QLD, Australia.
Med J Aust. 2014 Apr 7;200(6):334-8. doi: 10.5694/mja13.11069.
OBJECTIVES To assess the effectiveness of three, four and five doses of acellular pertussis vaccine against pertussis notification for children aged 1 - < 4 years and 5 - < 12 years, and the effectiveness of three doses of acellular pertussis vaccine against pertussis hospitalisation for children aged 1 - < 4 years.
DESIGN, SETTING AND PARTICIPANTS: A population-based retrospective study of children aged 1 - < 12 years residing in Queensland, Australia, during 2009 and 2010. Routinely collected notification, hospitalisation, testing and vaccination data were used to describe notification rates and testing patterns and to assess vaccine effectiveness (VE) by the screening method.
VE against pertussis notification for children aged 1 - < 4 years and 5 - < 12 years, by birth year, and VE against pertussis hospitalisation for children aged 1 - < 4 years.
1961 notifications and 29 hospitalisations were included in the VE calculations. VE point estimates against pertussis notification and hospitalisation in children aged 1 - < 4 years were similar in 2009 and 2010, and ranged between 83.5% and 89.4%. VE point estimates against notification among children aged 5 - < 12 years were between 71.2% and 87.7% in 2009, and between 34.7% and 70.3% in 2010. The numbers of pertussis tests performed for children, particularly polymerase chain reaction (PCR) tests, increased between 2009 and 2010.
Acellular pertussis vaccine provided good protection within the first years of priming, but this waned as age increased. Changes in pertussis testing behaviour, because of increases in PCR use and awareness, may have contributed to increased pertussis notification rates and lower estimates of VE against notification owing to identification of milder disease.
评估三剂、四剂和五剂无细胞百日咳疫苗对 1 岁至<4 岁和 5 岁至<12 岁儿童百日咳通知的有效性，以及三剂无细胞百日咳疫苗对 1 岁至<4 岁儿童百日咳住院的有效性。
设计、地点和参与者：这是一项基于人群的回顾性研究，对象为澳大利亚昆士兰州 2009 年至 2010 年期间 1 岁至<12 岁的儿童。使用常规收集的通知、住院、检测和疫苗接种数据，描述通知率和检测模式，并采用筛查法评估疫苗有效性（VE）。
按出生年份评估 1 岁至<4 岁和 5 岁至<12 岁儿童的百日咳通知的 VE，以及 1 岁至<4 岁儿童的百日咳住院的 VE。
纳入 VE 计算的有 1961 例通知和 29 例住院。2009 年和 2010 年，1 岁至<4 岁儿童百日咳通知和住院的 VE 点估计值相似，范围在 83.5%至 89.4%之间。2009 年，5 岁至<12 岁儿童通知的 VE 点估计值在 71.2%至 87.7%之间，2010 年在 34.7%至 70.3%之间。2009 年至 2010 年，为儿童进行的百日咳检测数量（尤其是聚合酶链反应（PCR）检测）增加。
无细胞百日咳疫苗在初始接种后的最初几年内提供了良好的保护，但随着年龄的增长而减弱。由于 PCR 检测的使用和意识的提高，百日咳检测行为发生变化，可能导致百日咳通知率增加，以及由于识别出较轻的疾病而导致通知的 VE 估计值降低。
