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Pertussis infant morbidity and mortality trends after universal maternal immunisation in Mexico: An ecological

Adriana Guzman-Holst1, Gerardo Luna-Casas2, Maria Y Cervantes-Apolinar3

  • 1GSK Panama, Research & Development, Ciudad del Saber Edificio 230, Panama City, Panama.

Vaccine
|March 28, 2021
PubMed

Insights

Maternal Tetanus-diphtheria-acellular pertussis (Tdap) vaccination significantly reduced pertussis incidence, hospitalizations, and deaths in infants under two months old in Mexico. This highlights the Tdap program

Area of Science:

  • Public Health
  • Infectious Diseases
  • Vaccinology

Background:

  • Pertussis (whooping cough) is a significant cause of infant mortality in Mexico.
  • The Tetanus-diphtheria-acellular pertussis (Tdap) vaccine was recommended for pregnant women in Mexico in 2013.

Purpose of the Study:

  • To evaluate the impact of maternal Tdap immunization on pertussis morbidity and mortality trends in infants.
  • To analyze pertussis trends in infants aged ≤2 and ≤12 months before and after the implementation of maternal Tdap vaccination.

Main Methods:

  • An ecological retrospective database study was conducted using data from Mexican National and Workers Social Security Institutes (IMSS; ISSSTE).
  • Data included confirmed pertussis cases, hospitalizations, deaths, and vaccination coverage (Tdap, DTPa).
  • Descriptive and regression time-trend analyses were performed for pre- (2010-2012) and post- (2014-2018) maternal Tdap immunization periods.

Main Results:

  • A significant decrease was observed in pertussis incidence (49.9%), hospitalizations (70.0%), and mortality (82.4%) among infants 0-2 months old post-maternal vaccination.
  • In infants 0-12 months old, hospitalizations (28.9%) and mortality (36.2%) decreased, but incidence increased (61.8%).
  • Average primary infant DTPa vaccine coverage was 71.4%-72.7%, while maternal Tdap coverage ranged from 70%-93% since 2013.

Conclusions:

  • The Tdap maternal immunization program has demonstrably reduced the burden of pertussis disease, particularly severe cases, in young infants in Mexico.
  • Observed increases in incidence among 0-12 month olds may be attributed to changes in diagnosis and reporting, and variable vaccination coverage.
  • Findings underscore the critical role of maternal immunization in protecting vulnerable infant populations from pertussis.
Abstract

Keywords:
EpidemiologyImpactMaternal vaccinationMexicoPertussisTdapTrends

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