McHugh Lisa, D'Antoine Heather A, Sarna Mohinder, Binks Michael J, Moore Hannah C, Andrews Ross M, Pereira Gavin F, Blyth Christopher C, Van Buynder Paul, Lust Karin, Regan Annette K
The University of Queensland, Brisbane, QLD.
National Aboriginal and Torres Strait Islander Research Network, University of Queensland, Brisbane, QLD.
Med J Aust. 2024 Mar 4;220(4):196-201. doi: 10.5694/mja2.52220. Epub 2024 Feb 14.
To evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age.
Retrospective cohort study; analysis of linked administrative health data.
SETTING, PARTICIPANTS: Mother-infant cohort (Links2HealthierBubs) including all pregnant women who gave birth to live infants (gestational age ≥ 20 weeks, birthweight ≥ 400 g) in the Northern Territory, Queensland, and Western Australia during 1 January 2012 - 31 December 2017.
Proportions of women vaccinated against pertussis during pregnancy, rates of pertussis infections among infants under seven months of age, and estimated effectiveness of maternal vaccination for protecting infants against pertussis infection, each by Indigenous status.
Of the 19 892 Aboriginal and Torres Strait Islander women who gave birth to live infants during 2012-2017, 7398 (37.2%) received pertussis vaccine doses during their pregnancy, as had 137 034 of 259 526 non-Indigenous women (52.8%; Indigenous v non-Indigenous: adjusted odds ratio, 0.66; 95% confidence interval [CI], 0.62-0.70). The annual incidence of notified pertussis infections in non-Indigenous infants declined from 16.8 (95% CI, 9.9-29) in 2012 to 1.4 (95% CI, 0.3-8.0) cases per 10 000 births in 2017; among Aboriginal and Torres Strait Islander infants, it declined from 47.6 (95% CI, 16.2-139) to 38.6 (95% CI, 10.6-140) cases per 10 000 births. The effectiveness of maternal vaccination for protecting non-Indigenous infants under seven months of age against pertussis infection during 2014-17 was 68.2% (95% CI, 51.8-79.0%); protection of Aboriginal and Torres Strait Islander infants was not statistically significant (36.1%; 95% CI, -41.3% to 71.1%).
During 2015-17, maternal pertussis vaccination did not protect Aboriginal and Torres Strait Islander infants in the NT, Queensland, and WA against infection. Increasing the pertussis vaccination rate among pregnant Aboriginal and Torres Strait Islander women requires culturally appropriate, innovative strategies co-designed in partnership with Indigenous organisations and communities.
评估孕妇百日咳疫苗接种对预防7个月以下原住民及托雷斯海峡岛民婴儿百日咳感染的有效性。
回顾性队列研究；对相关行政卫生数据进行分析。
研究地点、参与者：母婴队列（Links2HealthierBubs），包括2012年1月1日至2017年12月31日期间在北领地、昆士兰州和西澳大利亚州分娩活产婴儿（孕周≥20周，出生体重≥400g）的所有孕妇。
孕期接种百日咳疫苗的女性比例、7个月以下婴儿的百日咳感染率，以及按原住民身份划分的孕妇接种疫苗对保护婴儿免受百日咳感染的估计有效性。
在2012 - 2017年期间分娩活产婴儿的19892名原住民及托雷斯海峡岛民女性中，7398名（37.2%）在孕期接种了百日咳疫苗；在259526名非原住民女性中，有137034名（52.8%）接种了该疫苗（原住民与非原住民相比：校正优势比为0.66；95%置信区间[CI]为0.62 - 0.70）。非原住民婴儿中百日咳感染的年报告发病率从2012年的每10000例出生16.8例（95%CI为9.9 - 29）降至2017年的每10000例出生1.4例（95%CI为0.3 - 8.0）；在原住民及托雷斯海峡岛民婴儿中，该发病率从每10000例出生47.6例（95%CI为16.2 - 139）降至38.6例（95%CI为10.6 - 140）。2014 - 2017年期间，孕妇接种疫苗对保护7个月以下非原住民婴儿免受百日咳感染的有效性为68.2%（95%CI为51.8 - 79.0%）；对原住民及托雷斯海峡岛民婴儿的保护作用无统计学意义（36.1%；95%CI为 - 41.3%至71.1%）。
在2015 - 2017年期间，孕妇百日咳疫苗接种未能保护北领地、昆士兰州和西澳大利亚州的原住民及托雷斯海峡岛民婴儿免受感染。提高原住民及托雷斯海峡岛民孕妇的百日咳疫苗接种率需要与原住民组织和社区合作共同设计的具有文化适宜性的创新策略。
