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Acellular pertussis vaccine effectiveness for children during the 2009-2010 pertussis epidemic in Queensland
Sarah L Sheridan1, Bradley J McCall2, Craig A Davis3
1Queensland Children's Medical Research Institute, University of Queensland, Brisbane, QLD, Australia. s.sheridan@uq.edu.au.
Insights
Acellular pertussis vaccine offers good protection in young children, but its effectiveness wanes with age. Increased testing identified milder pertussis cases, potentially lowering vaccine effectiveness estimates.
Area of Science:
- Immunization
- Pediatric Infectious Diseases
- Public Health
Background:
- Pertussis (whooping cough) remains a concern in young children.
- Acellular pertussis vaccines are widely used but their long-term effectiveness requires ongoing evaluation.
Purpose of the Study:
- To assess the effectiveness of acellular pertussis vaccine doses against pertussis notification and hospitalization in children.
- To evaluate vaccine effectiveness (VE) across different age groups (1-4 years and 5-12 years) and vaccination schedules.
Main Methods:
- A population-based retrospective study in Queensland, Australia (2009-2010).
- Utilized routinely collected data on pertussis notifications, hospitalizations, testing (including PCR), and vaccinations.
- Employed the screening method to calculate vaccine effectiveness.
Main Results:
- Vaccine effectiveness against pertussis notification and hospitalization in 1-4 year olds was high (83.5%-89.4%).
- Effectiveness against notification in 5-12 year olds varied significantly by year (71.2%-87.7% in 2009, 34.7%-70.3% in 2010).
- Increased use of PCR testing coincided with higher notification rates and potentially milder disease detection.
Conclusions:
- Acellular pertussis vaccine provides robust protection in the initial years post-vaccination.
- Vaccine effectiveness appears to decrease as children age.
- Changes in diagnostic practices, particularly increased PCR testing, may influence pertussis notification rates and VE estimates.
Unlabelled:
OBJECTIVES To assess the effectiveness of three, four and five doses of acellular pertussis vaccine against pertussis notification for children aged 1 - < 4 years and 5 - < 12 years, and the effectiveness of three doses of acellular pertussis vaccine against pertussis hospitalisation for children aged 1 - < 4 years.
Design, Setting And Participants:
A population-based retrospective study of children aged 1 - < 12 years residing in Queensland, Australia, during 2009 and 2010. Routinely collected notification, hospitalisation, testing and vaccination data were used to describe notification rates and testing patterns and to assess vaccine effectiveness (VE) by the screening method.
Main Outcome Measures:
VE against pertussis notification for children aged 1 - < 4 years and 5 - < 12 years, by birth year, and VE against pertussis hospitalisation for children aged 1 - < 4 years.
Results:
1961 notifications and 29 hospitalisations were included in the VE calculations. VE point estimates against pertussis notification and hospitalisation in children aged 1 - < 4 years were similar in 2009 and 2010, and ranged between 83.5% and 89.4%. VE point estimates against notification among children aged 5 - < 12 years were between 71.2% and 87.7% in 2009, and between 34.7% and 70.3% in 2010. The numbers of pertussis tests performed for children, particularly polymerase chain reaction (PCR) tests, increased between 2009 and 2010.
Conclusions:
Acellular pertussis vaccine provided good protection within the first years of priming, but this waned as age increased. Changes in pertussis testing behaviour, because of increases in PCR use and awareness, may have contributed to increased pertussis notification rates and lower estimates of VE against notification owing to identification of milder disease.
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