Maternal Pertussis Vaccination, Infant Immunization, and Risk of Pertussis
Annette K. Regan,
Hannah C. Moore,
Michael J. Binks
et al.
Abstract:OBJECTIVES:
Following the introduction of jurisdictional maternal pertussis vaccination programs in Australia, we estimated maternal vaccine effectiveness (VE) and whether maternal pertussis vaccination modified the effectiveness of the first 3 primary doses of pertussis-containing vaccines.
METHODS:
We conducted a population-based cohort study of 279 418 mother–infant pairs using probabilistic linkage of administrative healt… Show more
“… 7 Importantly, unvaccinated infants represent the most vulnerable demographic, with 90% of pertussis-related deaths occurring within this group. 8 , 9 Consequently, the current Chinese surveillance system faces challenges in accurately reflecting the true epidemiological situation of Jiangsu Province. Figure 1.…”
This study employed sero-epidemiological methods to estimate the incidence of pertussis within a healthy population located in eastern China. The aim was to gain deeper insights into the epidemiological characteristics and burden of pertussis within the country. Blood samples were collected from healthy individuals in Jiangsu Province between June 2019 and December 2022. The levels of IgG antibodies against pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) in the serum were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). Additionally, pertussis case data reported in Jiangsu Province were collected from the China Information System for Disease Control and Prevention and compared with the results of this study. In 2022, the reported incidence of pertussis stood at 1.0 per 100,000 individuals, marking the highest rate observed in the past two decades. Among 1,909 patients examined, the geometric mean concentration (GMC) of anti-PT IgG antibody was 20.2 (18.5–21.9) IU/ml, while that of anti-FHA IgG antibody was 27.0 (25.4–28.7) IU/ml. The IgG-PT and IgG-FHA seropositivity rate (>20.0 IU/ml) was highest in the 1 ~ 2 y old group and decreased rapidly to the lowest in the 3 ~ 4 y old group and then increased gradually with age. The estimated rate of pertussis infection based on seroprevalence was approximately 25,625‐fold higher than the reported notification rate in the ≥15 year age group. Our findings highlight decreased immunity post-vaccination, stressing the importance of additional booster shots for adolescents and adults to maintain immunity and reduce severe illness. Additionally, they offer vital guidance for policymakers to enhance immunization strategies.
“… 7 Importantly, unvaccinated infants represent the most vulnerable demographic, with 90% of pertussis-related deaths occurring within this group. 8 , 9 Consequently, the current Chinese surveillance system faces challenges in accurately reflecting the true epidemiological situation of Jiangsu Province. Figure 1.…”
This study employed sero-epidemiological methods to estimate the incidence of pertussis within a healthy population located in eastern China. The aim was to gain deeper insights into the epidemiological characteristics and burden of pertussis within the country. Blood samples were collected from healthy individuals in Jiangsu Province between June 2019 and December 2022. The levels of IgG antibodies against pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) in the serum were quantitatively measured using enzyme-linked immunosorbent assay (ELISA). Additionally, pertussis case data reported in Jiangsu Province were collected from the China Information System for Disease Control and Prevention and compared with the results of this study. In 2022, the reported incidence of pertussis stood at 1.0 per 100,000 individuals, marking the highest rate observed in the past two decades. Among 1,909 patients examined, the geometric mean concentration (GMC) of anti-PT IgG antibody was 20.2 (18.5–21.9) IU/ml, while that of anti-FHA IgG antibody was 27.0 (25.4–28.7) IU/ml. The IgG-PT and IgG-FHA seropositivity rate (>20.0 IU/ml) was highest in the 1 ~ 2 y old group and decreased rapidly to the lowest in the 3 ~ 4 y old group and then increased gradually with age. The estimated rate of pertussis infection based on seroprevalence was approximately 25,625‐fold higher than the reported notification rate in the ≥15 year age group. Our findings highlight decreased immunity post-vaccination, stressing the importance of additional booster shots for adolescents and adults to maintain immunity and reduce severe illness. Additionally, they offer vital guidance for policymakers to enhance immunization strategies.
“…While our current focus is on RSV and the platform was built with RSV in mind, the Respiratory Infections Linked Data Platform will provide a valuable resource for wider epidemiological research on other respiratory viruses and infections in the future. Members of our team have longstanding expertise using linked population data in previous analyses, including the evaluation of maternal influenza and pertussis vaccine safety and effectiveness [18,19], and direct and indirect effects of maternal [20][21][22] and childhood [16,23] vaccines, which has aided the design of this platform and will assist with investigations of all respiratory infections. The Respiratory Infections data platform will enable evaluation of the direct and indirect effects of maternal RSV vaccines and/or monoclonal antibodies on RSV and non-RSV hospitalisations.…”
IntroductionThe Western Australia (WA) Respiratory Infections Linked Data Platform is a population-based cohort established to investigate the epidemiology of RSV and other respiratory infections in children aged 0-10 years, incorporating microbiological testing patterns, hospital admissions, emergency department presentations, and socio-demographic data.
MethodsThe cohort was formed through individual linkages between datasets from the WA Department of Health including the Birth and Death Registry, Midwives Notification System (MNS), Hospital Morbidity Data Collection, Emergency Department Data Collection, WA Notifiable Diseases Database, WA Register of Developmental Anomalies, WA Cerebral Palsy Register, WA Antenatal Vaccination Database, WA Family Connections, and PathWest Respiratory Virus Surveillance Data. Hospitalisations and emergency department presentations were temporally linked to routine respiratory viral surveillance data.
ResultsThe cohort consists of 368,830 WA births between 1 January 2010 and 31 December 2020 with accompanying perinatal and demographic data, and with secondary care follow-up to 30 June 2022. Of these births, 24,660 (6.7%) identify as Aboriginal. A total of 4,077 (1.1%) children died from all causes during the study period (2010-2020), and 9.2% (33,818) of children were born preterm (<37 weeks).
ConclusionThe Respiratory Infections Linked Data Platform enables epidemiological investigations, identifying virus-specific risk groups, risk factors, clinical presentation, viral testing patterns, long-term impacts and accurate measures of viral incidence rates in risk and population sub-groups This will not only aid in the calculation of cost-effectiveness estimates of interventions such as immunisations, but also provide guidance for design and implementation of such programs to priority groups. The Respiratory Infections Linked Data Platform will also enable evaluation of the direct and indirect effects of maternal and infant vaccines and new therapeutics. Analyses using this platform will also generate epidemiological data needed for other respiratory viruses on the vaccine pipeline such as parainfluenza virus and human metapneumovirus.
“…The effectiveness of maternal pertussis vaccination for protecting Aboriginal and Torres Strait Islander infants against infection, 2012-2017: a retrospective cohort study Lisa McHugh 1 , Heather A D'Antoine 2 , Mohinder Sarna 3,4 , Michael J Binks 5,6 , Hannah C Moore 6 , Ross M Andrews 7 , Gavin F Pereira 3,8 , Christopher C Blyth 4,9 , Paul Van Buynder 10 , Karin Lust 11 , Annette K Regan 3,12 T he global burden of pertussis is greatest for infants under four months of age. 1 Rates of severe illness (including disease requiring hospitalisation or intensive care) and death are highest for this age group because routine vaccination schedules mean that infants are not fully vaccinated until six months of age.…”
mentioning
confidence: 99%
“…Vaccinating pregnant women against pertussis provides passive protection to infants via maternal antibody transfer. This protection, estimated to prevent 60% 5 to 91% 6 of potential infant pertussis infections, is thought to persist until infants can be protected by childhood vaccination. For this reason, pertussis vaccination programs for pregnant women commenced in August 2014 in Queensland and during April–June 2015 in other Australian states and territories 7 .…”
ObjectivesTo evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age.Study designRetrospective cohort study; analysis of linked administrative health data.Setting, participantsMother–infant cohort (Links2HealthierBubs) including all pregnant women who gave birth to live infants (gestational age ≥ 20 weeks, birthweight ≥ 400 g) in the Northern Territory, Queensland, and Western Australia during 1 January 2012 – 31 December 2017.Main outcome measuresProportions of women vaccinated against pertussis during pregnancy, rates of pertussis infections among infants under seven months of age, and estimated effectiveness of maternal vaccination for protecting infants against pertussis infection, each by Indigenous status.ResultsOf the 19 892 Aboriginal and Torres Strait Islander women who gave birth to live infants during 2012–2017, 7398 (37.2%) received pertussis vaccine doses during their pregnancy, as had 137 034 of 259 526 non‐Indigenous women (52.8%; Indigenous v non‐Indigenous: adjusted odds ratio, 0.66; 95% confidence interval [CI], 0.62–0.70). The annual incidence of notified pertussis infections in non‐Indigenous infants declined from 16.8 (95% CI, 9.9–29) in 2012 to 1.4 (95% CI, 0.3–8.0) cases per 10 000 births in 2017; among Aboriginal and Torres Strait Islander infants, it declined from 47.6 (95% CI, 16.2–139) to 38.6 (95% CI, 10.6–140) cases per 10 000 births. The effectiveness of maternal vaccination for protecting non‐Indigenous infants under seven months of age against pertussis infection during 2014–17 was 68.2% (95% CI, 51.8–79.0%); protection of Aboriginal and Torres Strait Islander infants was not statistically significant (36.1%; 95% CI, –41.3% to 71.1%).ConclusionsDuring 2015–17, maternal pertussis vaccination did not protect Aboriginal and Torres Strait Islander infants in the NT, Queensland, and WA against infection. Increasing the pertussis vaccination rate among pregnant Aboriginal and Torres Strait Islander women requires culturally appropriate, innovative strategies co‐designed in partnership with Indigenous organisations and communities.
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