Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Hum Vaccin Immunother. 2021 Apr 3;17(4):1136-1141. doi: 10.1080/21645515.2020.1806673. Epub 2020 Oct 29.
Whooping cough continues to be an important public health issue despite high levels of vaccination coverage with acellular pertussis vaccine. Young unimmunized infants represent the most vulnerable group with the highest rates of complications and death. As infant-specific pertussis epidemiologic data, especially among neonates, in Italy were limited, a retrospective observational study of hospitalizations for whooping cough in Italian infants aged <12 months between 2007 and 2018 was conducted to address this knowledge gap. The temporal trend of rates, also stratified for age classes according to the expected age for the administration of vaccine doses, were analyzed by the slope of the regression line. The mean age at the time of admission was 92 d (±64). A clear seasonal pattern in the occurrence of pertussis hospitalizations with a summer peak was observed. Infants younger than 3 months old had the highest hospitalization rates (169 x 100000 infants on average), with a significant rising trend of 9 x 100000 infants on average per year. Limiting the analysis to -related hospitalizations such trend was even more evident. In the other age classes, hospitalization rates were considerably lower and gradually decreased with increasing age. This study demonstrated that pediatric populations, too young to be protected by vaccination, had a greater risk of contracting pertussis. Thus, it is necessary to promote additional immunization strategies besides one booster dose in adolescents, including vaccination during pregnancy.
尽管使用无细胞百日咳疫苗进行了高覆盖率的接种，百日咳仍是一个重要的公共卫生问题。未接种疫苗的年轻婴儿是最脆弱的群体，并发症和死亡率最高。由于意大利针对婴儿的百日咳流行病学数据（尤其是针对新生儿的）有限，因此进行了一项回顾性观察研究，以研究意大利<12 个月龄婴儿因百日咳住院的情况，以填补这一知识空白。根据疫苗接种剂量预期年龄对年龄组进行分层，通过回归线的斜率分析了发病率的时间趋势。入院时的平均年龄为 92 天（±64 天）。观察到百日咳住院的发生呈明显的季节性模式，夏季高峰明显。3 个月以下的婴儿住院率最高（平均每 10 万名婴儿中有 169 例），平均每年有 9 例的显著上升趋势。将分析仅限于与百日咳相关的住院病例，这种趋势更加明显。在其他年龄组中，住院率较低，并且随着年龄的增长逐渐降低。这项研究表明，尚未接种疫苗的幼儿群体罹患百日咳的风险更高。因此，除了青少年加强针之外，还需要制定其他免疫接种策略，包括在妊娠期间接种疫苗。
