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Published on: February 23, 2014
Insights
In 1982-83 New Zealand pertussis outbreaks, the childhood immunization program showed mixed results. While some children were protected, many remained vulnerable, especially infants under six months.
Area of Science:
- Public Health
- Epidemiology
- Immunization Programs
Background:
- Pertussis (whooping cough) posed a significant public health challenge in New Zealand during 1982-1983.
- The existing pertussis immunization schedule involved two doses of adsorbed triple vaccine at three and five months of age.
Purpose of the Study:
- To analyze the effectiveness of the pertussis immunization program in New Zealand during the 1982-1983 outbreaks.
- To assess the impact of vaccination on disease severity and transmission within families.
Main Methods:
- Retrospective study of 187 primary pertussis cases and 231 unvaccinated family contacts aged 11 and under.
- Inclusion criteria required laboratory confirmation of pertussis or contact with a laboratory-confirmed case within the family.
- Analysis focused on immunization status, disease occurrence, and clinical severity.
Main Results:
- A significant proportion of vaccinated children remained susceptible to pertussis infection.
- Vaccination appeared to reduce the clinical severity of pertussis when infection did occur.
- Infants aged six months and under were largely unvaccinated and unprotected during the study period.
Conclusions:
- The pertussis immunization program demonstrated incomplete protection against infection.
- The findings highlight the vulnerability of unvaccinated infants to pertussis.
- The study suggests a need to reconsider and potentially modify the current pertussis immunization strategy.
Abstract:
Pertussis was prevalent in many parts of New Zealand in 1982 and early 1983. Details of 187 primary family cases and spread within 231 family contacts all aged 11 or under were studied. During the lifetime of these children the pertussis immunisation programme has been two injections of adsorbed triple vaccine at three and five months of age. All primary family cases were either laboratory confirmed or were contacts of a case within that family who had been laboratory confirmed. Results reveal that, whilst a significant number of children were protected by immunisation, a substantial number were not. Where infection did occur the clinical condition was likely to be less severe. However, almost all infants of six months of age or under in the study were not immunised and received no protection. Various options to vary the pertussis immunisation programme are discussed.
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