Potential Impact of Changes in the Schedule for Primary Diphtheria-Tetanus Toxoids-Pertussis Immunization as Control Strategy for Pertussis

Bergero, Paula Elena; Fabricius, G.; Hozbor, Daniela Flavia; Theeten, Heidi; Hens, Niel

doi:10.1097/inf.0000000000001752

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…10,11 Nuestros resultados sostienen que alcanzar -y mantener-altas coberturas en las dosis primarias y a embarazadas resulta la estrategia principal para evitar casos de pertusis en lactantes. [10][11][12][13] Sin embargo, para mantener las coberturas altas y la confianza de la comunidad en el programa de inmunización, es necesario generar campañas que comuniquen los beneficios y alerten sobre las consecuencias de una vacunación incompleta o retrasada. En este sentido, creemos que este trabajo resulta un aporte, ya que se presentan resultados de un modelo matemático robusto y parametrizado localmente que permiten cuantificar el riesgo, respecto de coqueluche, que conlleva poner en peligro el programa de inmunización obligatoria.…”

Section: Discussionunclassified

“…Para detalles del modelo, véanse las referencias 10 a 12. presentado y validado, y ha sido usado para evaluar diferentes estrategias de control de coqueluche, como el refuerzo a adolescentes, el aumento de cobertura del esquema primario, la corrección de retrasos en la aplicación de dosis y la búsqueda de un calendario óptimo. [10][11][12][13] En la situación epidemiológica referida, se modela y evalúa cuantitativamente el efecto de una caída gradual en las coberturas vacunales sobre la incidencia de coqueluche. La estimación de fallecidos se obtiene a partir de la incidencia calculada en el brote, considerando que son proporcionales a los casos graves y que, en 2011, hubo 76 de un año o menos.…”

Section: Métodosunclassified

“…El efecto de la vacunación materna sobre los lactantes fue modelado considerando que una fracción recibía pasivamente una inmunidad equivalente a una dosis de vacuna que perduraba hasta los 2 meses. 12 La reducción de la fuente de contagio de los lactantes al tener madres inmunizadas no fue incluida aquí, ya que la evidencia en primates sugiere que la vacuna acelular anti coqueluche protegería respecto de la enfermedad, pero no evitaría la colonización ni la transmisión.…”

Section: Métodosunclassified

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La no obligatoriedad de la vacunación y su potencial impacto en la epidemiología de coqueluche

2018

Arch Argent Pediatr

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Comunicaciones breves RESUMEN En este trabajo, se analizan cuantitativamente las consecuencias a corto plazo que tendría sobre coqueluche la sanción del Proyecto de Ley de Consentimiento Informado en Materia de Vacunación presentado en Argentina, en 2017, el cual contempla la no obligatoriedad de la aplicación de las vacunas del Calendario Nacional a los menores de edad. Se utiliza un modelo matemático para la transmisión de pertusis, desarrollado previamente en nuestro grupo. Se considera que la sola presentación del proyecto provoca una disminución en las coberturas por generar desconfianza sobre los beneficios del programa de vacunación. Asumiendo 5 % anual de reducción de las coberturas durante 4 años a partir de 2018, en el siguiente brote, los casos graves en menores del año se incrementarían en más del 100 % respecto del último brote, y se estiman 101 fallecidos. Con una reducción del 10 % anual por 4 años, el siguiente brote superaría al previo en más del 200 %, con 163 decesos.

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Section: Discussionunclassified

Section: Métodosunclassified

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La no obligatoriedad de la vacunación y su potencial impacto en la epidemiología de coqueluche

2018

Arch Argent Pediatr

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“…pertussis management strategies, such as a booster dose for adolescents, an increased coverage with the primary schedule, a correction in dose administration delays, and looking for the optimal schedule. [10][11][12][13] In this epidemiological situation, we modeled and performed a quantitative analysis of the effect of the progressive reduction in immunization coverage on pertussis incidence. The number of deaths was estimated based on the estimated outbreak incidence, considering that they are proportional to severe cases and that there were 76 deaths in infants younger than 1 year in 2011.…”

Section: Schematic Of the Basic Epidemiological Modelmentioning

confidence: 99%

“…The effect of maternal immunization on infants was modeled considering that a fraction of individuals were passively immunized acquiring a protection that was equivalent to a vaccine dose that lasted until 2 months old. 12 The reduction in the source of transmission among infants from having immunized mothers was not included here because the evidence in primates suggests that acellular vaccine confers protection against the disease but does not prevent colonization or transmission.…”

Section: Schematic Of the Basic Epidemiological Modelmentioning

confidence: 99%

Non-mandatory immunization and its potential impact on pertussis epidemiology

Bergero

Fabricius

Hozbor

2018

Arch Argent Pediatr

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In this study, we performed a quantitative analysis of the potential short-term consequences on pertussis of the draft bill on Informed Consent for Immunization proposed in Argentina in 2017, which considers a non-mandatory immunization schedule for minors. We used a mathematical model of pertussis transmission, which had been previously developed by our group. It is considered that the mere presentation of the project causes a reduction in coverage because it creates suspicion on the benefits of immunization. Assuming a 5 % annual reduction in coverage for 4 years as of 2018, in the next outbreak, severe cases in infants younger than 1 year will increase more than 100 % compared to the latest outbreak, with an estimated 101 deaths. With a 10 % annual reduction in the coverages for 4 years, the next outbreak would result in an increase of number of cases of more than 200 %, with 163 deaths.

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Estimating the excess burden of pertussis disease in Australia within the first year of life, that might have been prevented through timely vaccination

Jayasundara

Randall

Sheridan

et al. 2022

International Journal of Epidemiology

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Background Previous Australian studies have shown that delayed vaccination with each of the three primary doses of diphtheria-tetanus-pertussis-containing vaccines (DTP) is up to 50 % in certain subpopulations. We estimated the excess burden of pertussis that might have been prevented if (i) all primary doses and (ii) each dose was given on time. Methods Perinatal, immunization, pertussis notification and death data were probabilistically linked for 1 412 984 infants born in two Australian states in 2000–12. A DTP dose administered >15 days after the recommended age was considered delayed. We used Poisson regression models to compare pertussis notification rates to 1-year of age in infants with ≥1 dose delayed (Aim 1) or any individual dose delayed (Aim 2) versus a propensity weighted counterfactual on-time cohort. Results Of all infants, 42% had ≥1 delayed DTP dose. We estimated that between 39 to 365 days of age, 85 (95% CI: 61–109) cases per 100 000 infants, could have been prevented if all infants with ≥1 delayed dose had received their three doses within the on-time window. Risk of pertussis was higher in the delayed versus the on-time cohort, so crude rates overestimated the excess burden (110 cases per 100 000 infants (95% CI: 95–125)). The estimated dose-specific excess burden per 100 000 infants was 132 for DTP1, 50 for DTP2 and 19 for DTP3. Conclusions We provide robust evidence that improved DTP vaccine timeliness, especially for the first dose, substantially reduces the burden of infant pertussis. Our methodology, using a potential outcomes framework, is applicable to other settings.

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Potential Impact of Changes in the Schedule for Primary Diphtheria-Tetanus Toxoids-Pertussis Immunization as Control Strategy for Pertussis

Cited by 5 publications

References 25 publications

La no obligatoriedad de la vacunación y su potencial impacto en la epidemiología de coqueluche

La no obligatoriedad de la vacunación y su potencial impacto en la epidemiología de coqueluche

Non-mandatory immunization and its potential impact on pertussis epidemiology

Estimating the excess burden of pertussis disease in Australia within the first year of life, that might have been prevented through timely vaccination

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