Paediatrics, Flinders University and Flinders Medical Centre, Bedford Park, Adelaide 5042, Australia.
Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Vaccine. 2018 Nov 19;36(48):7270-7275. doi: 10.1016/j.vaccine.2018.10.028. Epub 2018 Oct 15.
Pertussis is a vaccine-preventable disease that causes morbidity and mortality, particularly in infants and children <5 years of age. The Global Pertussis Initiative (GPI) recommendations represent a systematic evaluation and prioritization of strategies to prevent pertussis-related infant and child deaths, reduce global disease burden and prevent resurgence through vaccination strategies and public health policies at national, regional and local levels. The GPI recommendations are based on clinical trials and observational and surveillance data, which are essential in the planning, implementation and evaluation of vaccination practices and best use of available resources. Many low- and middle-income countries (LMIC) continue to use whole-cell pertussis (wP) vaccines for primary vaccination, while most high-income countries have replaced wP with the less-reactogenic acellular pertussis (aP) vaccines. This present manuscript pertains to discussions held during the GPI's meeting on November 11-13, 2016, in Cape Town, Republic of South Africa. The GPI recommends that LMIC aim for high coverage of infant series pertussis vaccines as a priority. In LMIC and countries with constrained vaccine funding, if wP vaccines are currently used, wP should continue to be used. Furthermore, given that protection against disease and death due to pertussis in neonates is a key priority of the GPI, it recommends that ap immunization in pregnancy should be implemented as a priority in all countries if resources allow. Given that surveillance and epidemiology data on which to base vaccine decisions are important, the GPI also suggests that, in areas where wP vaccines are implemented, standardization and calibration of wP vaccines are checked, considering the many different manufacturers and variable standards of production and quality control. In addition, as immunity to pertussis wanes following the primary infant series of vaccination, the GPI further recommends that toddlers, adolescents, healthcare and childcare workers receive booster vaccine doses, where resources allow.
百日咳是一种可通过疫苗预防的疾病，会导致发病率和死亡率，尤其是在 5 岁以下的婴儿和儿童中。全球百日咳倡议（GPI）的建议代表了对预防与百日咳相关的婴儿和儿童死亡、减轻全球疾病负担和通过国家、地区和地方各级的疫苗接种策略和公共卫生政策防止其死灰复燃的策略进行系统评估和优先排序。GPI 的建议基于临床试验和观察性及监测数据，这些数据对于规划、实施和评估疫苗接种实践以及最佳利用现有资源至关重要。许多低收入和中等收入国家（LMIC）继续使用全细胞百日咳（wP）疫苗进行基础免疫，而大多数高收入国家已用不良反应性更低的无细胞百日咳（aP）疫苗替代了 wP 疫苗。本文件涉及 2016 年 11 月 11 日至 13 日在南非开普敦举行的 GPI 会议期间进行的讨论。GPI 建议，LMIC 应将提高婴儿系列百日咳疫苗的高覆盖率作为优先事项。在 LMIC 和疫苗资金有限的国家，如果目前使用 wP 疫苗，应继续使用 wP 疫苗。此外，由于保护新生儿免受百日咳疾病和死亡的影响是 GPI 的一个关键优先事项，因此，如果资源允许，建议所有国家将孕期接种 aP 疫苗作为优先事项。鉴于监测和流行病学数据对于制定疫苗决策很重要，GPI 还建议在实施 wP 疫苗的地区，应根据许多不同的制造商以及生产和质量控制的不同标准，检查 wP 疫苗的标准化和校准。此外，由于在婴儿基础系列疫苗接种后百日咳免疫力会减弱，GPI 还建议在资源允许的情况下，为幼儿、青少年、医护人员和儿童保育工作者接种加强疫苗。
