Pertussis Across the Globe

Tan, Tina Q.; Dalby, Tine; Forsyth, Kevin; Halperin, Scott A.; Heininger, Ulrich; Hozbor, Daniela Flavia; Plotkin, Stanley А.; Ulloa‐Gutiérrez, Rolando; König, Carl Heinz Wirsing von

doi:10.1097/inf.0000000000000795

Cited by 193 publications

(90 citation statements)

References 80 publications

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“…The probabilities of successful vaccination after each dose were calculated such that 53%, 81%, and 85% of vaccine recipients were protected against infection after 1, 2, and 3 doses, respectively, following our previous model [8] and described in the Supplementary Materials. Childhood boosters were not applied in the model due to limited availability and variable uptake in LMICs [2]. …”

Section: Methodsmentioning

confidence: 99%

“…The most recent estimate of deaths from pertussis, largely limited to administrative data, is 60 000 deaths in children <5 years old, the great majority in low- and middle-income countries (LMICs) [1]. Clinical cases of pertussis are grossly underreported in LMICs, due to less developed surveillance systems, reduced access to healthcare services, and limited diagnostic testing [2]. Although estimated worldwide coverage of the primary course of pertussis vaccine was around 86% in 2014 [3], coverage in many LMICs, or regions within them, is much lower [2].…”

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confidence: 99%

“…Clinical cases of pertussis are grossly underreported in LMICs, due to less developed surveillance systems, reduced access to healthcare services, and limited diagnostic testing [2]. Although estimated worldwide coverage of the primary course of pertussis vaccine was around 86% in 2014 [3], coverage in many LMICs, or regions within them, is much lower [2]. While worldwide pertussis vaccination coverage has substantially improved since the inception of the Expanded Programme on Immunization (EPI) [3], later adoption of vaccination in LMICs, with variable coverage due to supply and delivery issues and political instability, is likely to have led to heterogeneity in disease burden [4].…”

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confidence: 99%

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Influence of Population Demography and Immunization History on the Impact of an Antenatal Pertussis Program

et al. 2016

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Background. Antenatal pertussis vaccination is being considered as a means to reduce the burden of infant pertussis in low- and middle-income countries (LMICs), but its likely impact in such settings is yet to be quantified.Methods. An individual-based model was used to simulate the demographic structure and dynamics of a population with characteristics similar to those of LMICs. Transmission of pertussis within this population was simulated to capture the incidence of infection in (1) the absence of vaccination; (2) with a primary course only (three doses of diphtheria, tetanus, and pertussis vaccines [DTP3] commencing in 1985, 1995, or 2005 at 20%, 50%, or 80% coverage); and (3) with the addition of an antenatal pertussis program.Results. Modeled annual incidence averaged over the period 2015–2024 reduced with increasing DTP3 coverage, regardless of the year childhood vaccination commenced. Over the same period, the proportion of infants born with passive protection did not change substantially compared with the prevaccination situation, regardless of DTP3 coverage and start year. We found minimal impact of antenatal vaccination on infection in all infants when mothers were eligible for a single antenatal dose. When mothers were eligible for multiple antenatal doses, incidence in infants aged 0–2 months was reduced by around 30%. This result did not hold for the full 0- to 1-year age group, for whom antenatal vaccination did not reduce infection levels.Conclusions. While antenatal vaccination could potentially reduce infant mortality in LMICs, broader gains at the population level are likely to be achieved by focusing efforts on increasing DTP3 coverage.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Influence of Population Demography and Immunization History on the Impact of an Antenatal Pertussis Program

et al. 2016

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“…In 2012, following the recommendation, uptake was 14.2% [6] for all adults ≥19 years and in 2013 uptake was 17.2% [7]. The recent increases in pertussis cases to more than 28,000 has multiple causes [1], including waning immunity, prevention of infection but not necessarily of transmission by acellular pertussis vaccine, increased reporting, use of better diagnostic tests (i.e., polymerase chain reaction) [8], and modest vaccination coverage [7]. Of these, the modest vaccine coverage is the easiest to address.…”

Section: Introductionmentioning

confidence: 99%

Using the 4 Pillars™ Practice Transformation Program to increase adult Tdap immunization in a randomized controlled cluster trial

Nowalk

Lin

Pavlik

et al. 2016

Vaccine

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Introduction National adult Tdap vaccination rates are low, reinforcing the need to increase vaccination efforts in primary care offices. The 4 Pillars™ Practice Transformation Program is an evidence-based, step-by-step guide to improving primary care adult vaccination with an online implementation tracking dashboard. This study tested the effectiveness of an intervention to increase adult Tdap vaccination that included the Program, provider education, and one-on-one coaching of practice-based immunization champions. Methods 25 primary care practices participated in a randomized controlled cluster trial in Year 1 (6/1/2013–5/31-2014) and a pre-post study in Year 2 (6/1/2014–1/31/2015). Baseline year was 6/1/2012–5/31/2013, with data analyzed in 2016. Demographic and vaccination data were derived from de-identified electronic medical record (EMR) extractions. The primary outcomes were vaccination rates and percentage point (PP) changes/year. Results The cohort consisted of 70,549 patients ≥ 18 years who were seen in the practices ≥ 1 time each year, with a baseline mean age = 55 years; 35% were men; 56% were non-white; 35% were Hispanic and 20% were on Medicare. Baseline vaccination rate averaged 35%. In the Year 1 RCCT, cumulative Tdap vaccination increased significantly in both intervention and control groups; in both cities, the percentage point increases in the intervention groups (7.7 PP in Pittsburgh and 9.9 PP in Houston) were significantly higher (P<0.001) than in the control groups (6.4 PP in Pittsburgh and 7.6 PP in Houston). In the Year 2 pre-post study, in both cities, active intervention groups increased rates significantly more (6.2 PP for both) than maintenance groups (2.2 PP in Pittsburgh and 4.1 PP in Houston; P<0.001). Conclusions An intervention that includes the 4 Pillars™ Practice Transformation Program, staff education and coaching is effective for increasing adult Tdap immunization rates within primary care practices.

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“…In recent years, pertussis control has re-emerged as a prominent public health challenge, with multiple outbreaks observed worldwide (Tan, Dalby & Forsyth, 2015), and with some jurisdictions reporting the highest numbers of cases seen in decades (California Department of Public Health, 2015). In Canada, the last peak in pertussis activity was seen in the mid-1990s, after which incidence rates were gradually declining prior to a 2012 resurgence.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling

Doroshenko

Qian

Osgood

2016

PeerJ

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BackgroundPertussis control remains a challenge due to recently observed effects of waning immunity to acellular vaccine and suboptimal vaccine coverage. Multiple outbreaks have been reported in different ages worldwide. For certain outbreaks, public health authorities can launch an outbreak response immunization (ORI) campaign to control pertussis spread. We investigated effects of an outbreak response immunization targeting young adolescents in averting pertussis cases.MethodsWe developed an agent-based model for pertussis transmission representing disease mechanism, waning immunity, vaccination schedule and pathogen transmission in a spatially-explicit 500,000-person contact network representing a typical Canadian Public Health district. Parameters were derived from literature and calibration. We used published cumulative incidence and dose-specific vaccine coverage to calibrate the model’s epidemiological curves. We endogenized outbreak response by defining thresholds to trigger simulated immunization campaigns in the 10–14 age group offering 80% coverage. We ran paired simulations with and without outbreak response immunization and included those resulting in a single ORI within a 10-year span. We calculated the number of cases averted attributable to outbreak immunization campaign in all ages, in the 10–14 age group and in infants. The count of cases averted were tested using Mann–Whitney U test to determine statistical significance. Numbers needed to vaccinate during immunization campaign to prevent a single case in respective age groups were derived from the model. We varied adult vaccine coverage, waning immunity parameters, immunization campaign eligibility and tested stronger vaccination boosting effect in sensitivity analyses.Results189 qualified paired-runs were analyzed. On average, ORI was triggered every 26 years. On a per-run basis, there were an average of 124, 243 and 429 pertussis cases averted across all age groups within 1, 3 and 10 years of a campaign, respectively. During the same time periods, 53, 96, and 163 cases were averted in the 10–14 age group, and 6, 11, 20 in infants under 1 (p < 0.001, all groups). Numbers needed to vaccinate ranged from 49 to 221, from 130 to 519 and from 1,031 to 4,903 for all ages, the 10–14 age group and for infants, respectively. Most sensitivity analyses resulted in minimal impact on a number of cases averted.DiscussionOur model generated 30 years of longitudinal data to evaluate effects of outbreak response immunization in a controlled study. Immunization campaign implemented as an outbreak response measure among adolescents may confer benefits across all ages accruing over a 10-year period. Our inference is dependent on having an outbreak of significant magnitude affecting predominantly the selected age and achieving a comprehensive vaccine coverage during the campaign. Economic evaluations and comparisons with other control measures can add to conclusions generated by our work.

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Pertussis Across the Globe

Cited by 193 publications

References 80 publications

Influence of Population Demography and Immunization History on the Impact of an Antenatal Pertussis Program

Influence of Population Demography and Immunization History on the Impact of an Antenatal Pertussis Program

Using the 4 Pillars™ Practice Transformation Program to increase adult Tdap immunization in a randomized controlled cluster trial

Evaluation of outbreak response immunization in the control of pertussis using agent-based modeling

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