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在加泰罗尼亚和纳瓦拉(西班牙),儿童期(<7岁)无细胞百日咳疫苗接种对预防1-9岁家庭接触者百日咳的有效性。

Effectiveness of acellular pertussis vaccination during childhood (<7 years of age) for preventing pertussis in household contacts 1-9 years old in Catalonia and Navarra (Spain).

作者信息

Plans P, Toledo D, Sala M R, Camps N, Villanova M, Rodríguez R, Alvarez J, Solano R, García-Cenoz M, Barrabeig I, Godoy P, Minguell S

机构信息

Department of Health of Catalonia, Public Health Agency of Catalonia, Roc Boronat 83-95, 008005, Barcelona, Spain.

CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Eur J Clin Microbiol Infect Dis. 2016 Dec;35(12):2059-2067. doi: 10.1007/s10096-016-2766-x. Epub 2016 Sep 9.

Abstract

Pertussis vaccination with 4-5 doses of acellular vaccines is recommended in Spain to all children at 2 months to 6 years of age. The effectiveness of the acellular pertussis vaccination was assessed in this study by comparing the incidence of secondary pertussis in vaccinated (4-5 doses) and unvaccinated or partially vaccinated (0-3 doses) household contacts 1-9 years old of confirmed cases of pertussis in Spain in 2012-13. Eighty-five percent of contacts had been vaccinated with 4-5 doses of acellular pertussis vaccines. During the 2-year study period, 64 cases of secondary pertussis were detected among 405 household contacts 1-9 years old: 47 among vaccinated and 17 among unvaccinated or partially vaccinated contacts. The effectiveness for preventing secondary pertussis, calculated as 1 minus the relative risk (RR) of secondary pertussis in vaccinated vs. unvaccinated/partially vaccinated contacts, was 50 % [95 % confidence interval (CI): 19-69 %, p < 0.01] when household contacts were vaccinated using DTaP, Tdap, hexavalent or heptavalent vaccines, and it was 51.3 % (95 % CI: 21-70 %, p < 0.01) when they were vaccinated using DTaP or TdaP vaccines. The effectiveness adjusted for age, sex, pertussis chemotherapy and type of household contact was 58.6 % (95 % CI: 17-79 %, p < 0.05) when contacts were vaccinated using available acellular vaccines, and it was 59.6 % (95 % CI: 18-80 %, p < 0.01) when they were vaccinated using DTaP vaccines. Acellular pertussis vaccination during childhood was effective for preventing secondary pertussis in household contacts 1-9 years old of pertussis cases in Catalonia and Navarra, Spain.

摘要

在西班牙,建议对所有2个月至6岁的儿童接种4 - 5剂无细胞疫苗进行百日咳疫苗接种。本研究通过比较2012 - 2013年西班牙确诊百日咳病例中1 - 9岁已接种(4 - 5剂)和未接种或部分接种(0 - 3剂)的家庭接触者中继发性百日咳的发病率,评估了无细胞百日咳疫苗的有效性。85%的接触者接种了4 - 5剂无细胞百日咳疫苗。在为期2年的研究期间,在405名1 - 9岁的家庭接触者中检测到64例继发性百日咳病例:接种疫苗的接触者中有47例,未接种或部分接种疫苗的接触者中有17例。预防继发性百日咳的有效性计算为1减去接种疫苗与未接种/部分接种疫苗的接触者中继发性百日咳的相对风险(RR),当家庭接触者使用白百破疫苗(DTaP)、破伤风类毒素吸附百日咳疫苗(Tdap)、六价或七价疫苗接种时,有效性为50% [95%置信区间(CI):19 - 69%,p < 0.01];当他们使用DTaP或Tdap疫苗接种时,有效性为51.3%(95% CI:21 - 70%,p < 0.01)。当接触者使用现有的无细胞疫苗接种时,经年龄、性别、百日咳化疗和家庭接触类型调整后的有效性为58.6%(95% CI:17 - 79%,p < 0.05);当他们使用DTaP疫苗接种时,有效性为59.6%(95% CI:18 - 80%,p < 0.01)。在西班牙加泰罗尼亚和纳瓦拉,儿童期接种无细胞百日咳疫苗对预防百日咳病例中1 - 9岁家庭接触者的继发性百日咳有效。

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