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Recommended or mandatory pertussis vaccination policy in developed countries: does the choice matter?
1University of Nantes, Institut d'Economie et de Management - IAE, LEMNA, Chemin de la Censive du Tertre, BP 52241, 44322 Nantes Cedex 03, France. dorota.girard@univ-nantes.fr
Insights
Universal pertussis vaccination strategies, whether recommended or compulsory, achieve similar high coverage rates in developed countries. Both approaches are equally effective in ensuring children complete their primary pertussis vaccine course.
Area of Science:
- Immunology
- Public Health
- Epidemiology
Background:
- Pertussis (whooping cough) remains a significant public health concern globally.
- Vaccination strategies vary across developed nations, influencing disease control.
- Evaluating the effectiveness of different pertussis vaccination policies is crucial for public health.
Purpose of the Study:
- To compare recommended versus compulsory pertussis vaccination strategies.
- To assess their effectiveness in achieving high infant and child vaccination coverage.
- To analyze factors influencing the choice of vaccination policy.
Main Methods:
- Retrospective analysis of national pertussis surveillance and vaccination data.
- Review of official vaccination recommendations and epidemiological sources.
- Examination of whole-cell and acellular pertussis vaccine use, safety, and efficacy.
Main Results:
- Both mandatory and recommended pertussis vaccination strategies achieve high national coverage rates (over 94%).
- Vaccination legislation type does not significantly impact overall vaccine uptake.
- Recommended and compulsory strategies demonstrate comparable effectiveness.
Conclusions:
- The choice between recommended and compulsory pertussis vaccination depends on national pertussis history and vaccine availability (whole-cell vs. acellular).
- Mandatory policies are often implemented to rapidly increase low vaccination coverage.
- Countries with high voluntary uptake may favor recommended strategies as the most justifiable approach.
Objectives:
To compare universal recommended and compulsory pertussis vaccination strategies in developed countries, and to discuss their effectiveness in terms of the proportion of infants and children who complete their primary course of pertussis vaccine.
Study Design:
Retrospective analysis.
Method:
National pertussis surveillance and vaccination coverage data, official pertussis vaccination recommendations, and medical and epidemiological sources related to the use, safety and efficacy of whole-cell and acellular vaccines were analysed.
Results:
Similar vaccine coverage rates among children (above 94%) can be achieved at national level regardless of the type of vaccination legislation in place. Mandatory and recommended vaccination strategies appear to be equally effective.
Conclusions:
The choice of vaccination strategy is based on the national history of pertussis infection, the safety of available whole-cell vaccines and the willingness of health authorities to introduce acellular vaccines into routine use. The strategies adopted in the UK and the USA are two contrasting examples of immunization policies developed on the basis of different epidemiological backgrounds. They attest to the various associations between the type of pertussis vaccine and the type of universal vaccination strategies that can be undertaken for successful pertussis control. The introduction of a mandatory policy generally takes place during a period of low vaccination coverage, and is vindicated by the need for a rapid increase in immunization uptake. Countries that have already succeeded in implementing sustainable and high rates of uptake with a voluntary approach are expected to recommend pertussis vaccination, considering this to be the most justifiable policy.
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