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Effectiveness of four doses of pertussis vaccine during infancy diminished in elementary school age: A test-negative

Satoko Ohfuji1, Kenji Okada2, Yoko Mouri3

  • 1Department of Public Health, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka-city, Osaka 545-8585, Japan.

Vaccine
|November 24, 2020
PubMed

Insights

The pertussis vaccine is effective in young children, but its protection wanes over time. This study found the 4-dose acellular pertussis vaccine regimen offers little protection for school-aged children.

Area of Science:

  • Immunology
  • Pediatrics
  • Epidemiology

Background:

  • The Japanese national immunization program includes 4 doses of acellular pertussis vaccine for children.
  • Pertussis (whooping cough) cases are increasing among elementary school children (aged 6-12 years).

Purpose of the Study:

  • To assess the effectiveness of the pertussis vaccine program in preventing pertussis in children.
  • To investigate the duration of vaccine effectiveness after the primary immunization series.

Main Methods:

  • A test-negative case-control study was conducted with children aged ≥3 months presenting with pertussis-specific cough.
  • Diagnostic tests identified pertussis cases and controls; vaccination history was collected via parental questionnaires and immunization records.
  • Logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval for laboratory-confirmed pertussis.

Main Results:

  • Vaccine effectiveness (VE) of 4 doses was 70% overall and 90% in children under 6 years.
  • VE was only 8% in school-aged children, indicating minimal protection.
  • The risk of pertussis increased significantly with longer duration since the fourth vaccine dose (P < 0.01).

Conclusions:

  • The effectiveness of the 4-dose pertussis vaccine regimen decreases over time.
  • The current infant immunization schedule does not provide adequate protection against pertussis for school-aged children.
Abstract

Keywords:
EffectivenessJapanPertussis vaccineSchool-aged childrenTest-negative case-control study

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