College of Public Health, University of South Florida, Panama Program at City of Knowledge, Tampa, FL, USA.
Gorgas Memorial Institute for Health Studies, Panama City, Panama.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2389577. doi: 10.1080/21645515.2024.2389577. Epub 2024 Aug 20.
Despite high pediatric vaccination coverage rates (VCRs), pertussis incidence has increased worldwide, including in several countries in Latin America in the last two decades. Given the few vaccine effectiveness (VE) studies in Latin American countries, this retrospective, observational, cohort study estimated the effectiveness of hexavalent acellular (aP) primary and booster vaccination (wP) against pertussis in infants (6.5-18.5 months) and children (18.5-48.5 and 48.5-72.5 months) in Panama. Age-specific incidence rates (IRs) were calculated for the vaccine's pre-initiation (2001-2013), initiation (2014), and post-initiation (2015-2019) periods. VCRs and trends were determined, and VE was analyzed using a case coverage or screening method to compare proportions of vaccinated cases and vaccinated individuals in the population. Between 2001-2019, 868 confirmed pertussis cases were reported in Panama; 712 (82.0%; 54.8 cases/year) during the pre-initiation period, 19 (2.2%; 19 cases/year) during the initiation period, and 137 (15.8%; 27.4 cases/year) during the post-initiation period. Panama underwent cyclical increases in IRs, which varied between age groups. VCRs increased for primary and booster doses. Between 2015 and 2019, third-dose yearly vaccine coverage increased, on average, 3.3%. Specifically, during the post-initiation period, 109/137 (79.6%) of cases were unvaccinated. Relative VE was estimated at 96.2% [95% CI: 86.5%, 98.9%] with three doses; 100% with 4 and 5 booster doses. Absolute VE was estimated at 99.3% with three doses only. These results show that vaccination played an important role in maintaining a low number of pertussis cases in Panama, affirming the need for sustained investment and commitment to vaccination programs.
尽管儿童疫苗接种覆盖率（VCR）很高，但百日咳的发病率在全球范围内有所增加，包括拉丁美洲的几个国家在过去二十年中也是如此。鉴于拉丁美洲国家进行的疫苗效力（VE）研究较少，本回顾性、观察性队列研究估计了六价无细胞（aP）基础和加强疫苗接种（wP）在巴拿马婴儿（6.5-18.5 个月）和儿童（18.5-48.5 和 48.5-72.5 个月）中的有效性。计算了疫苗接种前（2001-2013 年）、启动后（2014 年）和启动后（2015-2019 年）期间的年龄特异性发病率（IR）。确定了 VCR 及其趋势，并使用病例覆盖或筛选方法分析 VE，以比较接种人群中接种病例和接种个体的比例。2001-2019 年间，巴拿马报告了 868 例确诊百日咳病例；前启动期 712 例（82.0%；54.8 例/年），启动期 19 例（2.2%；19 例/年），启动后 137 例（15.8%；27.4 例/年）。巴拿马的 IR 呈周期性增加，且在不同年龄组之间有所不同。基础和加强剂量的 VCR 有所增加。2015 年至 2019 年间，第三剂年疫苗覆盖率平均增加了 3.3%。具体而言，在启动后期间，137 例病例中有 109 例（79.6%）未接种疫苗。估计相对 VE 为 96.2%[95%CI：86.5%，98.9%]，接种三剂；接种 4 剂和 5 剂的保护率为 100%。仅接种三剂的绝对 VE 估计为 99.3%。这些结果表明，疫苗接种在巴拿马维持低百日咳病例数方面发挥了重要作用，证实了持续投资和承诺疫苗接种计划的必要性。
