Guiso Nicole, Levy Corinne, Romain Olivier, Guillot Sophie, Werner Andreas, Rondeau Marie Charlotte, Béchet Stéphane, Cohen Robert
Institut Pasteur, Molecular Prevention and Therapy of Human Infections Unit, Paris, France.
ACTIV, Association Clinique Thérapeutique Infantile du Val de Marne, Saint Maur des Fossés, France; AFPA, Association Française de Pédiatrie Ambulatoire, Villeneuve les Avignons, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, France.
Vaccine. 2017 Oct 27;35(45):6083-6088. doi: 10.1016/j.vaccine.2017.09.072. Epub 2017 Sep 30.
Increasing incidence of whooping cough (pertussis) has been reported in many countries, attributed to a switch from whole-cell pertussis-containing vaccine (wPV) to acellular PV (aPV) and circulation of the pertactin non-producing Bordetella pertussis. The present study aimed to estimate the duration of immunity conferred by PVs in children in France with data from an ongoing pediatric ambulatory surveillance of pertussis.
A total of 64 pediatricians throughout France enrolled children with suspected pertussis. A standardized data form was used to collect data on age sex, vaccination status, brand of wPV or aPV and source of infection. Confirmed cases were positive on culture and/or real-time Polymerase Chain Reaction (for B.-non-classified or B. pertussis or B. parapertussis) and/or pertussis serology.
Between October 2006 and December 2015, 149 cases of confirmed Bordetella infections were reported, 86 infected with B. pertussis and 55 B. non-classified. Fifteen children (10.1%) were not vaccinated, and 26 (17.4%) were partially vaccinated. The mean age was greater for children who received 4 doses of wPV (11.3±2.2, p<0.001) or a combination of wPV and aPV (10.5±3.3, p<0.001) than only aPV (7.2±2.4years). The mean duration of cough before a visit to a pediatrician was longer for children with wPV or a combination of wPV and aPV than only aPV (23.8±10.1 and 25.0±25.6vs 13.6±10.0days).
Despite the use of a more sensitive diagnostic method and emergence of pertactin non producing B. pertussis, in France context, aPV-induced immunity still protects against pertussis; however, the mean duration of immunity is about 6 to 7years, compared to 9years for wPV vaccine, after the primary vaccination and one booster (3+1 doses).
许多国家报告百日咳（pertussis）发病率不断上升，原因是从含全细胞百日咳疫苗（wPV）转向无细胞百日咳疫苗（aPV），以及不产生百日咳黏附素的百日咳博德特菌的传播。本研究旨在利用正在进行的儿童百日咳门诊监测数据，评估法国儿童中百日咳疫苗所赋予的免疫持续时间。
法国各地共有64名儿科医生纳入疑似百日咳患儿。使用标准化数据表格收集年龄、性别、疫苗接种状况、wPV或aPV品牌以及感染源的数据。确诊病例在培养和/或实时聚合酶链反应（针对未分类的博德特菌、百日咳博德特菌或副百日咳博德特菌）和/或百日咳血清学检测中呈阳性。
2006年10月至2015年12月期间，报告了149例确诊的博德特菌感染病例，86例感染百日咳博德特菌，55例未分类博德特菌。15名儿童（10.1%）未接种疫苗，26名（17.4%）部分接种疫苗。接种4剂wPV（11.3±2.2，p<0.001）或wPV与aPV联合接种（10.5±3.3，p<0.001）的儿童平均年龄大于仅接种aPV的儿童（7.2±2.4岁）。与仅接种aPV的儿童相比，接种wPV或wPV与aPV联合接种的儿童在看儿科医生前咳嗽的平均持续时间更长（23.8±10.1和25.0±25.6天对13.6±10.0天）。
尽管使用了更敏感的诊断方法且出现了不产生百日咳黏附素的百日咳博德特菌，但在法国，aPV诱导的免疫仍可预防百日咳；然而，在初次接种和一次加强接种（3 + 1剂）后，免疫的平均持续时间约为6至7年，而wPV疫苗为9年。
