Subdirectorate of Epidemiology, Health Department of the Community of Madrid, Madrid, Spain.
Subdirectorate of Epidemiology, Health Department of the Community of Madrid, Madrid, Spain.
Vaccine. 2018 Mar 14;36(12):1643-1649. doi: 10.1016/j.vaccine.2018.01.070. Epub 2018 Feb 10.
Pertussis is a communicable disease that primarily affects infants. Vaccination has led to an important reduction in the incidence of the disease, however, resurgence of the disease has been observed. This study aimed to analyze the incidence of pertussis and assess the vaccination effectiveness (VE) of different schedules of acellular pertussis vaccination in the community of Madrid.
Pertussis cases notified to the Mandatory Disease Reporting System from 1998 to 2015 were analyzed. Five comparison periods were created: 1998-2001 (reference), 2002-2005, 2006-2009, 2010-2012 and 2013-2015. The incidence ratio (IR) between inter-epidemic periods was analyzed using a Poisson regression. VE was calculated using the screening method. Vaccine status data were collected from the vaccine registry.
In total, 3855 cases were notified. Inter-epidemic periods were observed every 3-4 years. The incidence increased (IR: 5.99, p < 0.05) in the 2013-2015 period, particularly among infants younger than 1 month (IR: 32.41, p < 0.05). Vaccination data were available in 89% of cases. For those receiving the last dose at ≤6-month VE was 89.9% (95% confidence interval (CI): 87.3-92.0) after one year of follow-up, and 85.5% (95% CI: 82.4-88.1) after 11 years of follow-up. For those receiving the last dose at 18-months VE decreased from 98.8% (95% CI: 98.3-99.1) to 85.1% (95% CI: 81.9-87.7) in the same period, and for those receiving the last dose at 4-year VE decreased from 99.6% (95% CI: 99.3-99.7) to 79.3% (95% CI: 74.6-83.1).
B. pertussis is circulating in our population, as shown by the epidemic peaks and increased incidence of pertussis in recent years. VE increased with the number of doses and decreased with the follow-up period. The effect of this and other vaccination strategies must be monitored to control the disease.
百日咳是一种主要影响婴儿的传染病。疫苗接种已显著降低了该病的发病率，但该病的发病率又出现了回升。本研究旨在分析马德里社区百日咳的发病率，并评估不同无细胞百日咳疫苗接种时间表的疫苗有效性（VE）。
对 1998 年至 2015 年向强制疾病报告系统报告的百日咳病例进行分析。创建了五个比较期：1998-2001 年（参考）、2002-2005 年、2006-2009 年、2010-2012 年和 2013-2015 年。使用泊松回归分析流行间隔期的发病率比值（IR）。使用筛查法计算 VE。从疫苗登记处收集疫苗接种数据。
共报告了 3855 例病例。每隔 3-4 年就会出现流行间隔期。2013-2015 年期间发病率上升（IR：5.99，p＜0.05），尤其是 1 个月以下的婴儿（IR：32.41，p＜0.05）。89%的病例可获得疫苗接种数据。对于最后一剂在≤6 个月时接种的婴儿，在随访 1 年后 VE 为 89.9%（95%可信区间：87.3-92.0），随访 11 年后 VE 为 85.5%（95%可信区间：82.4-88.1）。对于最后一剂在 18 个月时接种的婴儿，VE 从 98.8%（95%可信区间：98.3-99.1）下降到同期的 85.1%（95%可信区间：81.9-87.7），对于最后一剂在 4 岁时接种的婴儿，VE 从 99.6%（95%可信区间：99.3-99.7）下降到 79.3%（95%可信区间：74.6-83.1）。
B. pertussis 在人群中传播，近年来的流行高峰和百日咳发病率上升表明了这一点。VE 随接种次数的增加而增加，随随访时间的延长而降低。必须监测这种疫苗和其他疫苗接种策略的效果，以控制疾病。
