Carrasquilla Gabriel, Porras Alexandra, Martinez Sandra, DeAntonio Rodrigo, Devadiga Raghavendra, Caceres Diana C, Juliao Patricia
ASIESALUD, Bogotá, Colombia.
ASIESALUD, Bogotá, Colombia; Grupo de Medicina Comunitaria y Salud Colectiva, Universidad El Bosque, Bogotá, Colombia.
Vaccine. 2020 Oct 27;38(46):7384-7392. doi: 10.1016/j.vaccine.2020.07.046. Epub 2020 Oct 2.
Maternal immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine confers protection to young infants. We aimed to describe trends in pertussis incidence and associated mortality in children aged <12 months before and after introduction of maternal Tdap immunization in Bogotá, Colombia.
Data on pertussis-related cases/deaths in infants aged <12 months were collected from SIVIGILA for the period 2005-2016, and compared incidence for the pre-vaccine introduction (2005-2012) and post-maternal Tdap vaccination (2014-2016) periods in infants aged <12 months and in three distinct age-strata; ≤6 weeks, 7-<28 weeks, and 28-52 weeks. Mortality comparisons were performed in all infants <12 months.
From 2005 to 2016, 2315 laboratory or clinically-confirmed pertussis cases were reported in infants <12 months of age (278 cases in young infants aged ≤6 weeks); 55 pertussis deaths were reported in children aged <12 months. No pertussis deaths were reported in the 2014-2016 period. Since maternal Tdap introduction in 2013, a consistent decline in pertussis incidence and mortality was observed. In the time-series analysis, incidence declined from 209.4/100,000 persons (2005-2012) to 49.1/100,000 persons (2014-2016) in all children <12 months; a 87.5% (95%CI: 77.2-93.2%) reduction. For these same period's incidence in young infants ≤6 weeks declined from 196.7 to 89.6/100,000 person-years (an 54.4% [95% CI: 35.4-67.9%] reduction). Greater incidence reductions were observed in older infants; 73.4% (95% CI: 68.4-77.6%) in those aged 7-<28 weeks, and 100% in those aged 28-52 weeks. A 100% reduction in Pertussis mortality in infants <12 months was observed. Since Tdap introduction, maternal vaccine coverage rose from <60% in 2013-2015 to 80% in 2016.
Implementation of maternal immunization in Bogotá may have contributed to the reduction in pertussis incidence and mortality among infants <12 months of age (ClinicalTrials.gov: NCT02569879). An Audio Summary linked to this article that can be found on Figshare https://doi.org/10.6084/m9.figshare.12943316.
孕妇接种破伤风、白喉和无细胞百日咳（Tdap）疫苗可为幼儿提供保护。我们旨在描述在哥伦比亚波哥大引入孕妇Tdap免疫前后，12个月以下儿童百日咳发病率及相关死亡率的趋势。
收集了2005 - 2016年期间，12个月以下婴儿百日咳相关病例/死亡的数据，这些数据来自SIVIGILA，并比较了疫苗引入前（2005 - 2012年）和孕妇接种Tdap疫苗后（2014 - 2016年）12个月以下婴儿以及三个不同年龄组（≤6周、7 - <28周、28 - 52周）的发病率。对所有12个月以下婴儿进行了死亡率比较。
2005年至2016年期间，12个月以下婴儿报告了2315例实验室确诊或临床确诊的百日咳病例（≤6周的幼儿中有278例）；12个月以下儿童报告了55例百日咳死亡病例。2014 - 2016年期间未报告百日咳死亡病例。自2013年引入孕妇Tdap疫苗后，观察到百日咳发病率和死亡率持续下降。在时间序列分析中，所有12个月以下儿童的发病率从2005 - 2012年的209.4/100,000人下降至2014 - 2016年的49.1/100,000人；下降了87.5%（95%CI：77.2 - 93.2%）。同期，≤6周幼儿的发病率从196.7/100,000人年降至89.6/100,000人年（下降了54.4% [95%CI：35.4 - 67.9%]）。年龄较大的婴儿发病率下降幅度更大；7 - <28周龄婴儿下降了73.4%（95%CI：68.4 - 77.6%），28 - 52周龄婴儿下降了100%。12个月以下婴儿的百日咳死亡率下降了100%。自引入Tdap疫苗以来，孕妇疫苗接种覆盖率从2013 - 2015年的<60%升至2016年的80%。
在波哥大实施孕妇免疫可能有助于降低12个月以下婴儿的百日咳发病率和死亡率（ClinicalTrials.gov：NCT02569879）。可在Figshare上找到与本文相关的音频摘要，链接为https://doi.org/10.6084/m9.figshare.12943316。
