White J M, Fairley C K, Owen D, Matthews R C, Miller E
Immunisation Division, PHLS Communicable Disease Surveillance Centre.
Commun Dis Rep CDR Rev. 1996 May 24;6(6):R86-91.
Notifications of pertussis in England and Wales have fallen dramatically from 65 810 during the epidemic year of 1982 to 3963 cases during the epidemic year of 1994, as vaccine coverage has risen. The incidence of pertussis has declined in all ages, including babies under 3 months of age who would have been at risk of disease from older siblings vaccinated under the accelerated schedule introduced in 1990 if immunity induced as result of this schedule had been short lived. To document the efficacy of the current whole cell vaccine under the accelerated schedule an enhanced surveillance scheme based on laboratory confirmed cases of pertussis was set up in 1994. Three deaths occurred in infants with confirmed pertussis, all of whom were under 8 weeks of age and unvaccinated. The overall vaccine efficacy for those over 6 months and under 5 years of age was 94%. This estimate may be inflated, as a number of biases could lead to the underascertainment of cases in vaccinated children, but it is similar to previous estimates obtained for children of the same age vaccinated under the 3, 5, and 10 month schedule. Vaccine efficacy was 89% for children aged over 5 and under 15 years. The enhanced surveillance scheme will enable us to monitor the duration of protection under the accelerated schedule and evaluate the continuing impact of pertussis infection.
在英格兰和威尔士，随着疫苗接种覆盖率的上升，百日咳报告病例数已从1982年疫情年的65810例大幅降至1994年疫情年的3963例。百日咳发病率在各年龄段均有所下降，包括3个月以下的婴儿，这些婴儿如果因1990年引入的加速接种计划而产生的免疫力短暂，原本会因接种该计划的年长兄弟姐妹而面临患病风险。为了记录当前全细胞疫苗在加速接种计划下的效果，1994年建立了一个基于实验室确诊百日咳病例的强化监测方案。确诊百日咳的婴儿中有3例死亡，所有死亡婴儿均未满8周且未接种疫苗。6个月以上至5岁以下儿童的总体疫苗效力为94%。由于一些偏差可能导致接种疫苗儿童的病例报告不足，这个估计值可能偏高，但与之前按照3个月、5个月和10个月接种计划为同年龄儿童接种疫苗所获得的估计值相似。5岁以上至15岁儿童的疫苗效力为89%。强化监测方案将使我们能够监测加速接种计划下的保护持续时间，并评估百日咳感染的持续影响。
