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Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand.
Vaccine. 2017 01 03; 35(1):177-183.V

Abstract

BACKGROUND

Though it is believed the switch from whole cell to acellular pertussis vaccine has contributed to the resurgence of pertussis disease, few studies have evaluated vaccine effectiveness (VE) and duration of protection provided by an acellular vaccine schedule including three primary doses but no toddler-age dose. We assessed this schedule in New Zealand (NZ), a setting with historically high rates of pertussis disease, and low but recently improved immunisation coverage. We further evaluated protection following the preschool-age booster dose.

METHODS

We performed a nested case-control study using national-level healthcare data. Hospitalised and non-hospitalised pertussis was detected among children 6weeks to 7years of age between January 2006 and December 2013. The NZ National Immunisation Register provided vaccination status for cases and controls. Conditional logistic regression was used to calculate dose-specific VE with duration of immunity examined by stratifying VE into ages aligned with the immunisation schedule.

RESULTS

VE against pertussis hospitalisation was 93% (95% confidence interval [CI]: 87, 96) following three doses among infants aged 5-11months who received three compared to zero doses. This protection was sustained through children's fourth birthdays (VE⩾91%). VE against non-hospitalised pertussis was also sustained after three doses, from 86% (95% CI: 80, 90) among 5-11month olds to 84% (95% CI: 80, 88) among 3-year-olds. Following the first booster dose at 4years of age, the protective VE of 93% (95% CI: 90, 95) among 4-year-olds continued through 7years of age (VE⩾91%).

CONCLUSIONS

We found a high level of protection with no reduction in VE following both the primary course and the first booster dose. These findings support a 3-dose primary course of acellular vaccine with no booster dose until 4years of age.

Authors+Show Affiliations

Department of General Practice and Primary Health Care, University of Auckland, New Zealand; Conectus, UniServices, University of Auckland, New Zealand. Electronic address: s.radke@auckland.ac.nz.Department of General Practice and Primary Health Care, University of Auckland, New Zealand.Department of General Practice and Primary Health Care, University of Auckland, New Zealand; Conectus, UniServices, University of Auckland, New Zealand.Conectus, UniServices, University of Auckland, New Zealand.Department of General Practice and Primary Health Care, University of Auckland, New Zealand.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27866766

Citation

Radke, Sarah, et al. "Age-specific Effectiveness Following Each Dose of Acellular Pertussis Vaccine Among Infants and Children in New Zealand." Vaccine, vol. 35, no. 1, 2017, pp. 177-183.
Radke S, Petousis-Harris H, Watson D, et al. Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand. Vaccine. 2017;35(1):177-183.
Radke, S., Petousis-Harris, H., Watson, D., Gentles, D., & Turner, N. (2017). Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand. Vaccine, 35(1), 177-183. https://doi.org/10.1016/j.vaccine.2016.11.004
Radke S, et al. Age-specific Effectiveness Following Each Dose of Acellular Pertussis Vaccine Among Infants and Children in New Zealand. Vaccine. 2017 01 3;35(1):177-183. PubMed PMID: 27866766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand. AU - Radke,Sarah, AU - Petousis-Harris,Helen, AU - Watson,Donna, AU - Gentles,Dudley, AU - Turner,Nikki, Y1 - 2016/11/18/ PY - 2016/08/05/received PY - 2016/10/17/revised PY - 2016/11/01/accepted PY - 2016/11/22/pubmed PY - 2017/12/16/medline PY - 2016/11/22/entrez KW - Effectiveness KW - Immunization KW - Pertussis KW - Vaccine KW - Waning SP - 177 EP - 183 JF - Vaccine JO - Vaccine VL - 35 IS - 1 N2 - BACKGROUND: Though it is believed the switch from whole cell to acellular pertussis vaccine has contributed to the resurgence of pertussis disease, few studies have evaluated vaccine effectiveness (VE) and duration of protection provided by an acellular vaccine schedule including three primary doses but no toddler-age dose. We assessed this schedule in New Zealand (NZ), a setting with historically high rates of pertussis disease, and low but recently improved immunisation coverage. We further evaluated protection following the preschool-age booster dose. METHODS: We performed a nested case-control study using national-level healthcare data. Hospitalised and non-hospitalised pertussis was detected among children 6weeks to 7years of age between January 2006 and December 2013. The NZ National Immunisation Register provided vaccination status for cases and controls. Conditional logistic regression was used to calculate dose-specific VE with duration of immunity examined by stratifying VE into ages aligned with the immunisation schedule. RESULTS: VE against pertussis hospitalisation was 93% (95% confidence interval [CI]: 87, 96) following three doses among infants aged 5-11months who received three compared to zero doses. This protection was sustained through children's fourth birthdays (VE⩾91%). VE against non-hospitalised pertussis was also sustained after three doses, from 86% (95% CI: 80, 90) among 5-11month olds to 84% (95% CI: 80, 88) among 3-year-olds. Following the first booster dose at 4years of age, the protective VE of 93% (95% CI: 90, 95) among 4-year-olds continued through 7years of age (VE⩾91%). CONCLUSIONS: We found a high level of protection with no reduction in VE following both the primary course and the first booster dose. These findings support a 3-dose primary course of acellular vaccine with no booster dose until 4years of age. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/27866766/Age_specific_effectiveness_following_each_dose_of_acellular_pertussis_vaccine_among_infants_and_children_in_New_Zealand_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(16)31029-5 DB - PRIME DP - Unbound Medicine ER -