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Pertussis Vaccination Failure in the New Zealand Pediatric Population: Study Protocol
Hannah Chisholm1, Anna Howe2, Emma Best3
1Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand. h.chisholm@auckland.ac.nz.
Insights
Understanding pertussis vaccination failure is crucial for protecting children. This study identifies risk factors in infants and young children to improve pertussis prevention strategies and vaccine effectiveness.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health
Background:
- Pertussis vaccines significantly reduce disease burden but have limitations, including waning immunity and imperfect protection against carriage and transmission.
- Risk factors for pertussis vaccination failure, especially in infants and young children, are not well understood.
- Identifying these factors is critical for optimizing pediatric pertussis immunization strategies.
Purpose of the Study:
- To investigate risk factors associated with pertussis vaccination failure in two pediatric groups: young infants (0-6 weeks) born to vaccinated mothers and older infants/children (5 months-4 years) post-primary series.
- To generate hypotheses for risk factors using a case series design and test these hypotheses in a subsequent retrospective cohort study.
Main Methods:
- A two-step approach combining a case series study with national administrative data to describe pertussis vaccination failure cases.
- A retrospective cohort study to test hypothesized risk factors identified in the case series, employing pattern analysis.
- Focus on infants born to mothers receiving antenatal pertussis boosters and children after primary immunization.
Main Results:
- Case series analysis will describe characteristics of pertussis vaccination failure.
- Retrospective cohort study will identify and analyze patterns of risk factors associated with vaccine failure.
- Results will inform targeted strategies for enhanced pertussis prevention.
Conclusions:
- Identifying specific risk factors for pertussis vaccine failure in children is essential for improving vaccine effectiveness.
- This research aims to enable targeted interventions, potentially including additional vaccine doses, to better protect pediatric populations from pertussis.
- Understanding failure patterns will enhance public health strategies against pertussis.
Abstract:
Pertussis vaccines have been effective at reducing pertussis-associated morbidity and mortality. However, they have a complex array of limitations, particularly associated with the duration of protection against clinical disease and imperfect immunity (carriage and transmission). Little is known about risk factors for pertussis vaccination failure. Understanding pertussis vaccination failure risk is most important in the paediatric population. This study aims to investigate risk factors for pertussis vaccination failure in (1) infants between birth and six weeks of age born to mothers who received pertussis booster vaccinations during pregnancy and (2) infants after the completion of the primary series (approximately five months old) to four years old. This will be achieved in a two-step process for each study group. Pertussis vaccination failure cases will first be described using a case series study design, relevant case characteristics will be sourced from six national administrative datasets. The case series study results will help select candidate risk factors (hypothesis generating step) to be tested in the retrospective cohort study (hypothesis testing step. Pattern analysis will be used to investigate risk factor patterns in the cohort study. The identification of higher risk groups enables targeting strategies, such as additional doses, to better prevent pertussis disease.
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