Bento Ana I, King Aaron A, Rohani Pejman
Odum School of Ecology, University of Georgia, Athens, GA, United States.
Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, United States.
Euro Surveill. 2017 Apr 13;22(15). doi: 10.2807/1560-7917.ES.2017.22.15.30510.
The increase in whooping cough (pertussis) incidence in many countries with high routine vaccination coverage is alarming, with incidence in the US reaching almost 50,000 reported cases per year, reflecting incidence levels not seen since the 1950s. While the potential explanations for this resurgence remain debated, we face an urgent need to protect newborns, especially during the time window between birth and the first routine vaccination dose. Maternal immunisation has been proposed as an effective strategy for protecting neonates, who are at higher risk of severe pertussis disease and mortality. However, if maternally derived antibodies adversely affect the immunogenicity of the routine schedule, through blunting effects, we may observe a gradual degradation of herd immunity. 'Wasted' vaccines would result in an accumulation of susceptible children in the population, specifically leading to an overall increase in incidence in older age groups. In this Perspective, we discuss potential long-term epidemiological effects of maternal immunisation, as determined by possible immune interference outcomes.
在许多常规疫苗接种覆盖率高的国家，百日咳发病率的上升令人担忧，美国每年报告的病例数几乎达到5万例，反映出自20世纪50年代以来未见的发病率水平。虽然这种复苏的潜在原因仍在争论中，但我们迫切需要保护新生儿，特别是在出生至首次常规疫苗接种剂量之间的时间窗口内。母体免疫已被提议作为保护新生儿的有效策略，因为新生儿患严重百日咳疾病和死亡的风险更高。然而，如果母体来源的抗体通过钝化作用对常规免疫程序的免疫原性产生不利影响，我们可能会观察到群体免疫的逐渐退化。“浪费”的疫苗将导致人群中易感儿童的积累，特别是导致老年年龄组发病率的总体上升。在这篇观点文章中，我们讨论了母体免疫可能产生的长期流行病学影响，这些影响由可能的免疫干扰结果决定。
