Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Colorado Disease Control and Environmental Epidemiology Division, Department of Public Health and Environment, Denver.
Clin Infect Dis. 2017 Sep 1;65(5):811-818. doi: 10.1093/cid/cix421.
In 2012, >48000 pertussis cases were reported in the United States. Many cases occurred in vaccinated persons, showing that pertussis vaccination does not prevent all pertussis cases. However, pertussis vaccination may have an impact on disease severity.
We analyzed data on probable and confirmed pertussis cases reported through Enhanced Pertussis Surveillance (Emerging Infections Program Network) between 2010 and 2012. Surveillance data were collected through physician and patient interview and vaccine registries. We assessed whether having received an age-appropriate number of pertussis vaccines (AAV) (for persons aged ≥3 months) was associated with reduced odds of posttussive vomiting, a marker of more clinically significant illness, or of severe pertussis (seizure, encephalopathy, pneumonia, and/or hospitalization). Adjusted odds ratios were calculated using multivariable logistic regression.
Among 9801 pertussis patients aged ≥3 months, 77.6% were AAV. AAV status was associated with a 60% reduction in odds of severe disease in children aged 7 months-6 years in multivariable logistic regression and a 30% reduction in odds of posttussive vomiting in persons aged 19 months-64 years.
Serious pertussis symptoms and complications are less common among AAV pertussis patients, demonstrating that the positive impact of pertussis vaccination extends beyond decreasing risk of disease.
2012 年,美国报告了超过 48000 例百日咳病例。许多病例发生在已接种疫苗的人群中,表明百日咳疫苗接种并不能预防所有百日咳病例。然而,百日咳疫苗接种可能对疾病严重程度有影响。
我们分析了 2010 年至 2012 年通过强化百日咳监测(新兴传染病计划网络)报告的可能和确诊百日咳病例的数据。监测数据通过医生和患者访谈以及疫苗登记处收集。我们评估了是否接受了适当年龄的百日咳疫苗接种(AAV)(适用于≥3 个月的人群)与减少咳嗽后呕吐的几率(咳嗽后呕吐是更具临床意义疾病的标志物)或严重百日咳(癫痫发作、脑病、肺炎和/或住院)的几率是否相关。使用多变量逻辑回归计算调整后的优势比。
在 9801 例≥3 个月的百日咳患者中,77.6%接受了 AAV。多变量逻辑回归显示,在 7 个月至 6 岁的儿童中,AAV 状态与严重疾病的几率降低 60%相关,在 19 个月至 64 岁的人群中,与咳嗽后呕吐的几率降低 30%相关。
在接受 AAV 的百日咳患者中,严重百日咳症状和并发症较少,这表明百日咳疫苗接种的积极影响不仅在于降低疾病风险。