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Published on: February 22, 2019
Duration of effectiveness of pertussis vaccine: evidence from a 10 year community study
1Department of General Practice, University of Nottingham.
Insights
Pertussis vaccine efficacy wanes significantly within seven years post-immunization, dropping from 100% to 46%. This study highlights the need for updated pertussis vaccination schedules to maintain protection and prevent outbreaks.
Area of Science:
- Immunology
- Epidemiology
- Public Health
Background:
- Whooping cough (pertussis) remains a concern despite widespread vaccination.
- Longitudinal data on pertussis vaccine efficacy over several years is crucial for understanding waning immunity.
Purpose of the Study:
- To longitudinally assess the efficacy of the pertussis vaccine from one to seven years after immunization.
- To evaluate the impact of pertussis vaccine on attack rates during epidemic periods.
Main Methods:
- A 10-year observational study in a general practice community.
- Calculation of pertussis attack rates for immunized and unimmunized children based on known immunization status and birth cohorts.
- Vaccine efficacy calculated as a percentage reduction in attack rate.
Main Results:
- Pertussis vaccine efficacy decreased from 100% in the first year to 46% by the seventh year post-immunization.
- Efficacy was 84% in the fourth year and 52% in the fifth year.
- Highest attack rates were observed during known epidemic periods (1977-9, 1981-3, 1985-7).
Conclusions:
- The current pertussis vaccine and its schedule do not provide sufficient herd immunity to prevent outbreaks.
- Including pertussis vaccination in the preschool immunization program may improve protection and reduce disease incidence.
Abstract:
A 10 year study of whooping cough in a discrete general practice community was performed to assess longitudinally the efficacy of pertussis vaccine from one to seven years after immunisation. Of the 436 cases of whooping cough over 10 years, 326 occurred in children aged 1-7 years. The rate of immunisation was known for each cohort of children born during each year, and the attack rate of whooping cough was thus calculated for those immunised and unimmunized. The attack rates were highest in those cohorts exposed to the epidemics of 1977-9, 1981-3, and 1985-7. The efficacy of the vaccine was calculated as a percentage as (attack rate in unimmunized group--attack rate in immunised group) x 100/attack rate in unimmunized group. It fell from 100% in the first year to 46% in the seventh, being 84% in the fourth and only 52% in the fifth. Thus the pertussis vaccine or its schedule of use does not seem to provide sufficient herd immunity to prevent outbreaks of whooping cough. Matters might be improved if vaccination against pertussis were included in the preschool immunisation programme.
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