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Pertussis epidemiology in Australia over the decade 1995-2005--trends by region and age group
Helen E Quinn1, Peter B McIntyre
1National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, University of Sydney, New South Wales. helenq@chw.edu.au
Insights
Changes in the National Immunisation Program for pertussis, including new acellular vaccines and booster doses, increased vaccine coverage. Pertussis remains a concern in infants and adults, necessitating targeted protection strategies.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- The National Immunisation Program for pertussis underwent significant modifications between 1995 and 2005.
- These changes included adopting acellular pertussis vaccines for all doses and adjusting booster schedules.
Purpose of the Study:
- To analyze the impact of National Immunisation Program changes on pertussis epidemiology in Australia.
- To evaluate trends in pertussis notifications and vaccine coverage during 1995-2005.
Main Methods:
- Analysis of Australian Bureau of Statistics surveys and the Australian Childhood Immunisation Register data.
- Review of national pertussis notifications from 1995 to 2005.
Main Results:
- Pertussis vaccine coverage at 12 and 24 months substantially increased.
- While overall national notifications remained stable, age distribution shifted, with high rates in adolescents and adults (20-59 years).
- Pertussis remains well-controlled in young children (1-9 years) but continues to affect infants under 6 months.
Conclusions:
- The updated immunisation program has improved pertussis control in certain age groups.
- Focus is needed on protecting unvaccinated infants and understanding pertussis burden in the elderly.
- Further strategies are required to address pertussis incidence in adolescents and adults.
Abstract:
Important changes have occurred in the National Immunisation Program for pertussis during the decade 1995-2005, including the introduction of acellular pertussis vaccine for all doses, removal from the schedule of the booster dose at 18 months, and the introduction of a booster dose for adolescents. In addition, the coverage of pertussis vaccine at 12 and 24 months has substantially increased as recorded by Australian Bureau of Statistics surveys and the Australian Childhood Immunisation Register. There were 75,458 notifications nationally between 1995 and 2005, with little change in the annual number of notifications at the national level but with periodic and dramatic changes in the age distribution of notified cases. Pertussis is well controlled in the 1-4 and 5-9 year age groups, and the highest annual notification rates continue to be in infants under 6 months of age. Adolescents aged 10-19 years had high notification rates in all states and territories, over this period, but 63% of notifications are now in the 20-59 year age range. Following the introduction of a fifth dose for adolescents, the current focus should be on protecting infants too young to be vaccinated and further defining the true morbidity of the disease in the elderly population.
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