First Pertussis Vaccine Dose and Prevention of Infant Mortality

Tiwari, Tejpratap; Baughman, Andrew L.; Clark, Thomas A.

doi:10.1542/peds.2014-2291

Cited by 46 publications

(31 citation statements)

References 43 publications

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“…A recent US study provides detailed age distribution by week of age for 258 deaths identified through national case surveillance data rather than death certificates between 1991 and 2008 [29]. In the prevaccine period, 67% of deaths occurred by 12 months of age, but <5% were identified in the first month of life and around 15% by 2 months [24], in contrast to the US experience in 1991–2008, where almost 50% of deaths had occurred by age 1 month and 85% by 2 months [29].…”

Section: Resultsmentioning

confidence: 99%

“…In the prevaccine period, 67% of deaths occurred by 12 months of age, but <5% were identified in the first month of life and around 15% by 2 months [24], in contrast to the US experience in 1991–2008, where almost 50% of deaths had occurred by age 1 month and 85% by 2 months [29]. …”

Section: Resultsmentioning

confidence: 99%

“…

Figure 4.Age distribution of pertussis deaths in children <12 months of age in the United States in the pre- and postvaccine eras. *Sako et al [24]; ^Tiwari et al [29]. …”

Section: Discussionmentioning

confidence: 99%

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Global Childhood Deaths From Pertussis: A Historical Review

Chow¹,

Khandaker

McIntyre

2016

Clin Infect Dis.

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Impact of pertussis vaccines on mortality is a key World Health Organization indicator, and trends in mortality rates and age distribution can inform maternal immunization strategies. We systematically reviewed studies reporting pertussis mortality rates (PMRs) per million population, identifying 19 eligible studies. During a prevaccine observation period of ≥50 years in high-income countries (HICs), PMRs reduced in both infants and 1- to 4-year-olds by >80%, along with improvements in living conditions. In studies in low- and middle-income countries (LMICs), PMRs resembled highest prevaccine HIC rates. Postvaccine in HICs, significant further reduction in deaths (>98%) occurred, but with a large left shift in age of onset among residual deaths. Postvaccine in LMICs, limited data also show large and rapid decreases in PMRs, first in older infants and children, but long-term data fully enumerating residual deaths are lacking. In Sweden, large increases in the prevalence of undetectable pertussis antibodies were found at 10 years after high childhood coverage of acellular pertussis vaccines. Such data are not available from LMICs using whole-cell vaccines in a primary schedule without boosters. Data on residual infant deaths and maternal seroprevalence would be valuable inputs into consideration of pertussis vaccination in pregnancy in LMIC settings, especially if more precise immune correlates of infant protection against death from pertussis were known.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Global Childhood Deaths From Pertussis: A Historical Review

Chow¹,

Khandaker

McIntyre

2016

Clin Infect Dis.

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“…81 Another Australian study, also using the screening method to investigate VE of acellular vaccines against laboratory-confirmed notifications, found VE point estimates to be between 78.2% to 91.7% for children aged one to less than four years (three vaccine doses), between 64.7% and 87.4% for children aged five to less than eight years (four doses), and between 43.3% and 78.1% for children aged eight to less than 12 years (five doses). 82 Infant pertussis vaccination has been demonstrated to reduce the rate of hospitalisation, even after a single dose, [83][84][85][86] however to date, few studies have specifically assessed the effectiveness of acellular pertussis vaccines against severe infection. 82,85,87,88 Rendi-Wagner et al (2006), using the screening method, estimated that the VE for preventing hospitalisation in children aged younger than 15 years, after 3 doses, was 79%…”

Section: Vaccinesmentioning

confidence: 99%

“…4,21 The primary aim of pertussis immunisation is to protect young infants against severe Despite the well-established pertussis immunisation programs in Australia and overseas, infants younger than six months of age continue to be at highest risk of severe outcomes. 10,86,89,[103][104][105][106] In the future, new pertussis vaccines may be able to provide earlier and longer lasting protection by utilising live attenuated B. pertussis strains, novel soluble or micro-particle vaccine formulations, improved adjuvants, or mucosal delivery, [107][108][109] however as these novel vaccines may still be many years away, other strategies need to be considered to protect young infants. 10,61,103,105 The "cocoon" strategy, which attempts to protect newborn infants by immunising their close contacts, such as parents and other caregivers, has been proposed as a possible solution.…”

Section: Immunisation Strategies and Coveragementioning

confidence: 99%

The diagnosis and epidemiology of pertussis in Australia

Kaczmarek¹

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Pertussis, more commonly known as whooping cough, is one of the most common vaccine-preventable infections reported in Australia. In the last decade, pertussis incidence has increased in Australia and overseas, with large sustained epidemics occurring most notably in developed countries. Australia had a pertussis epidemic between 2009 and 2012, which peaked during 2011 with 38,602 notified cases. The role of improved diagnostic methods, particularly the use of polymerase chain reaction (PCR) testing, has been hypothesised to have led to improved case ascertainment and superior detection of disease activity. This Thesis is comprised of five distinct studies contributing to the investigation of this hypothesis.In Australia, the incidence of pertussis is predominantly monitored using notification data, with the case definition for notifications heavily reliant on laboratory confirmation. By analysing pertussis notifications between 1991 and 2013 by diagnostic test method, I was able to demonstrate that PCR quickly replaced all other laboratory methods for pertussis diagnosis from 2005 onwards, with the exception of persisting serology use in a proportion of adolescents and adults. In addition, a change in the age distribution of notifications was observed over time, with increasing pertussis incidence among older children and adolescents.As notification data can be biased by changes in testing practices, awareness, and definitions, my next study investigated pertussis testing trends in the general practice (GP, primary care) setting between 2000 and 2011 using data from the Bettering the Evaluation And Care of Health (BEACH) program. Among a stable set of GP encounters for respiratory illness, it was observed that the likelihood of individuals being tested for pertussis in 2010-2011 was seven times higher compared to ten years earlier. These findings, at least in part, suggest that notifications have been amplified due to increased testing.To gather more information about the contribution of increased testing to the pertussis epidemic, the incidence of severe pertussis cases admitted to intensive care units (ICUs) was reviewed, as the ICU setting is less likely to be biased by changes in diagnostic This Thesis makes an important and original contribution to understanding the recent resurgence of pertussis in Australia and overseas by addressing gaps in knowledge about changes in diagnostic testing. Although a true increase in pertussis incidence occurred in Australia, increasing PCR diagnosis allowed better case detection across all age groups and healthcare settings. Greater understanding of pertussis epidemiology as a result of PCR diagnosis should ultimately improve pertussis immunisation and control programs, through better identification of at-risk groups.iv

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