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Tdap vaccine effectiveness in adolescents during the 2012 Washington State pertussis epidemic.
Pediatrics. 2015 Jun; 135(6):981-9.Ped

Abstract

BACKGROUND

Acellular pertussis vaccines replaced whole-cell vaccines for the 5-dose childhood vaccination series in 1997. A sixth dose of pertussis-containing vaccine, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed (Tdap), was recommended in 2005 for adolescents and adults. Studies examining Tdap vaccine effectiveness (VE) among adolescents who have received all acellular vaccines are limited.

METHODS

To assess Tdap VE and duration of protection, we conducted a matched case-control study during the 2012 pertussis epidemic in Washington among adolescents born during 1993-2000. All pertussis cases reported from January 1 through June 30, 2012, in 7 counties were included; 3 controls were matched by primary provider clinic and birth year to each case. Vaccination histories were obtained through medical records, the state immunization registry, and parent interviews. Participants were classified by type of pertussis vaccine received on the basis of birth year: a mix of whole-cell and acellular vaccines (1993-1997) or all acellular vaccines (1998-2000). We used conditional logistic regression to calculate odds ratios comparing Tdap receipt between cases and controls.

RESULTS

Among adolescents who received all acellular vaccines (450 cases, 1246 controls), overall Tdap VE was 63.9% (95% confidence interval [CI]: 50% to 74%). VE within 1 year of vaccination was 73% (95% CI: 60% to 82%). At 2 to 4 years postvaccination, VE declined to 34% (95% CI: -0.03% to 58%).

CONCLUSIONS

Tdap protection wanes within 2 to 4 years. Lack of long-term protection after vaccination is likely contributing to increases in pertussis among adolescents.

Authors+Show Affiliations

Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Meningitis and Vaccine Preventable Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, and amacosta@cdc.gov.Communicable Disease Epidemiology, Washington State Department of Health, Shoreline, Washington.Communicable Disease Epidemiology, Washington State Department of Health, Shoreline, Washington.Biostatistics Office, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and.Communicable Disease Epidemiology, Washington State Department of Health, Shoreline, Washington.Meningitis and Vaccine Preventable Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, and.Meningitis and Vaccine Preventable Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, and.Meningitis and Vaccine Preventable Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, and.Meningitis and Vaccine Preventable Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, and.Meningitis and Vaccine Preventable Disease Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, and.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

25941309

Citation

Acosta, Anna M., et al. "Tdap Vaccine Effectiveness in Adolescents During the 2012 Washington State Pertussis Epidemic." Pediatrics, vol. 135, no. 6, 2015, pp. 981-9.
Acosta AM, DeBolt C, Tasslimi A, et al. Tdap vaccine effectiveness in adolescents during the 2012 Washington State pertussis epidemic. Pediatrics. 2015;135(6):981-9.
Acosta, A. M., DeBolt, C., Tasslimi, A., Lewis, M., Stewart, L. K., Misegades, L. K., Messonnier, N. E., Clark, T. A., Martin, S. W., & Patel, M. (2015). Tdap vaccine effectiveness in adolescents during the 2012 Washington State pertussis epidemic. Pediatrics, 135(6), 981-9. https://doi.org/10.1542/peds.2014-3358
Acosta AM, et al. Tdap Vaccine Effectiveness in Adolescents During the 2012 Washington State Pertussis Epidemic. Pediatrics. 2015;135(6):981-9. PubMed PMID: 25941309.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tdap vaccine effectiveness in adolescents during the 2012 Washington State pertussis epidemic. AU - Acosta,Anna M, AU - DeBolt,Chas, AU - Tasslimi,Azadeh, AU - Lewis,Melissa, AU - Stewart,Laurie K, AU - Misegades,Lara K, AU - Messonnier,Nancy E, AU - Clark,Thomas A, AU - Martin,Stacey W, AU - Patel,Manisha, Y1 - 2015/05/04/ PY - 2015/03/16/accepted PY - 2015/5/6/entrez PY - 2015/5/6/pubmed PY - 2015/8/21/medline KW - adolescent KW - diphtheria-tetanus-acellular pertussis vaccine KW - diphtheria-tetanus-pertussis vaccine KW - whooping cough SP - 981 EP - 9 JF - Pediatrics JO - Pediatrics VL - 135 IS - 6 N2 - BACKGROUND: Acellular pertussis vaccines replaced whole-cell vaccines for the 5-dose childhood vaccination series in 1997. A sixth dose of pertussis-containing vaccine, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed (Tdap), was recommended in 2005 for adolescents and adults. Studies examining Tdap vaccine effectiveness (VE) among adolescents who have received all acellular vaccines are limited. METHODS: To assess Tdap VE and duration of protection, we conducted a matched case-control study during the 2012 pertussis epidemic in Washington among adolescents born during 1993-2000. All pertussis cases reported from January 1 through June 30, 2012, in 7 counties were included; 3 controls were matched by primary provider clinic and birth year to each case. Vaccination histories were obtained through medical records, the state immunization registry, and parent interviews. Participants were classified by type of pertussis vaccine received on the basis of birth year: a mix of whole-cell and acellular vaccines (1993-1997) or all acellular vaccines (1998-2000). We used conditional logistic regression to calculate odds ratios comparing Tdap receipt between cases and controls. RESULTS: Among adolescents who received all acellular vaccines (450 cases, 1246 controls), overall Tdap VE was 63.9% (95% confidence interval [CI]: 50% to 74%). VE within 1 year of vaccination was 73% (95% CI: 60% to 82%). At 2 to 4 years postvaccination, VE declined to 34% (95% CI: -0.03% to 58%). CONCLUSIONS: Tdap protection wanes within 2 to 4 years. Lack of long-term protection after vaccination is likely contributing to increases in pertussis among adolescents. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/25941309/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=25941309 DB - PRIME DP - Unbound Medicine ER -