Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand
Abstract Background Though it is believed the switch from whole cell to acellular pertussis vaccine has contributed to the resurgence of pertussis disease, few studies have evaluated vaccine effectiveness (VE) and duration of protection provided by an acellular vaccine schedule including three prima...
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description | Abstract Background Though it is believed the switch from whole cell to acellular pertussis vaccine has contributed to the resurgence of pertussis disease, few studies have evaluated vaccine effectiveness (VE) and duration of protection provided by an acellular vaccine schedule including three primary doses but no toddler-age dose. We assessed this schedule in New Zealand (NZ), a setting with historically high rates of pertussis disease, and low but recently improved immunisation coverage. We further evaluated protection following the preschool-age booster dose. Methods We performed a nested case-control study using national-level healthcare data. Hospitalised and non-hospitalised pertussis was detected among children 6 weeks to 7 years of age between January 2006 and December 2013. The NZ National Immunisation Register provided vaccination status for cases and controls. Conditional logistic regression was used to calculate dose-specific VE with duration of immunity examined by stratifying VE into ages aligned with the immunisation schedule. Results VE against pertussis hospitalisation was 93% (95% confidence interval [CI]: 87, 96) following three doses among infants aged 5–11 months who received three compared to zero doses. This protection was sustained through children’s fourth birthdays (VE ⩾ 91%). VE against non-hospitalised pertussis was also sustained after three doses, from 86% (95% CI: 80, 90) among 5–11 month olds to 84% (95% CI: 80, 88) among 3-year-olds. Following the first booster dose at 4 years of age, the protective VE of 93% (95% CI: 90, 95) among 4-year-olds continued through 7 years of age (VE ⩾ 91%). Conclusions We found a high level of protection with no reduction in VE following both the primary course and the first booster dose. These findings support a 3-dose primary course of acellular vaccine with no booster dose until 4 years of age. |
doi_str_mv | 10.1016/j.vaccine.2016.11.004 |
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We assessed this schedule in New Zealand (NZ), a setting with historically high rates of pertussis disease, and low but recently improved immunisation coverage. We further evaluated protection following the preschool-age booster dose. Methods We performed a nested case-control study using national-level healthcare data. Hospitalised and non-hospitalised pertussis was detected among children 6 weeks to 7 years of age between January 2006 and December 2013. The NZ National Immunisation Register provided vaccination status for cases and controls. Conditional logistic regression was used to calculate dose-specific VE with duration of immunity examined by stratifying VE into ages aligned with the immunisation schedule. Results VE against pertussis hospitalisation was 93% (95% confidence interval [CI]: 87, 96) following three doses among infants aged 5–11 months who received three compared to zero doses. This protection was sustained through children’s fourth birthdays (VE ⩾ 91%). VE against non-hospitalised pertussis was also sustained after three doses, from 86% (95% CI: 80, 90) among 5–11 month olds to 84% (95% CI: 80, 88) among 3-year-olds. Following the first booster dose at 4 years of age, the protective VE of 93% (95% CI: 90, 95) among 4-year-olds continued through 7 years of age (VE ⩾ 91%). Conclusions We found a high level of protection with no reduction in VE following both the primary course and the first booster dose. These findings support a 3-dose primary course of acellular vaccine with no booster dose until 4 years of age.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2016.11.004</identifier><identifier>PMID: 27866766</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Age ; Age Factors ; Allergy and Immunology ; Case-Control Studies ; Child ; Child, Preschool ; Children & youth ; Diphtheria ; Disease ; Effectiveness ; Female ; Hospitalization ; Humans ; Immunization ; Infant ; Infants ; Laboratories ; Male ; Mortality ; New Zealand - epidemiology ; Pertussis ; Pertussis Vaccine - administration & dosage ; Pertussis Vaccine - immunology ; Schedules ; Studies ; Tetanus ; Treatment Outcome ; Vaccine ; Vaccines ; Vaccines, Acellular - administration & dosage ; Vaccines, Acellular - immunology ; Waning ; Whooping cough ; Whooping Cough - epidemiology ; Whooping Cough - prevention & control</subject><ispartof>Vaccine, 2017-01, Vol.35 (1), p.177-183</ispartof><rights>The Authors</rights><rights>2016 The Authors</rights><rights>Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 3, 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-2134a78bd46bedae7779813e1609ffcf005b3eddee715fc5afb1a43dd6f6031e3</citedby><cites>FETCH-LOGICAL-c528t-2134a78bd46bedae7779813e1609ffcf005b3eddee715fc5afb1a43dd6f6031e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1846812955?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27866766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Radke, Sarah, MSPH, PhD</creatorcontrib><creatorcontrib>Petousis-Harris, Helen, BSc, PhD</creatorcontrib><creatorcontrib>Watson, Donna, MA</creatorcontrib><creatorcontrib>Gentles, Dudley, MSc</creatorcontrib><creatorcontrib>Turner, Nikki, MBChB, MPH, MD</creatorcontrib><title>Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>Abstract Background Though it is believed the switch from whole cell to acellular pertussis vaccine has contributed to the resurgence of pertussis disease, few studies have evaluated vaccine effectiveness (VE) and duration of protection provided by an acellular vaccine schedule including three primary doses but no toddler-age dose. We assessed this schedule in New Zealand (NZ), a setting with historically high rates of pertussis disease, and low but recently improved immunisation coverage. We further evaluated protection following the preschool-age booster dose. Methods We performed a nested case-control study using national-level healthcare data. Hospitalised and non-hospitalised pertussis was detected among children 6 weeks to 7 years of age between January 2006 and December 2013. The NZ National Immunisation Register provided vaccination status for cases and controls. Conditional logistic regression was used to calculate dose-specific VE with duration of immunity examined by stratifying VE into ages aligned with the immunisation schedule. Results VE against pertussis hospitalisation was 93% (95% confidence interval [CI]: 87, 96) following three doses among infants aged 5–11 months who received three compared to zero doses. This protection was sustained through children’s fourth birthdays (VE ⩾ 91%). VE against non-hospitalised pertussis was also sustained after three doses, from 86% (95% CI: 80, 90) among 5–11 month olds to 84% (95% CI: 80, 88) among 3-year-olds. Following the first booster dose at 4 years of age, the protective VE of 93% (95% CI: 90, 95) among 4-year-olds continued through 7 years of age (VE ⩾ 91%). Conclusions We found a high level of protection with no reduction in VE following both the primary course and the first booster dose. These findings support a 3-dose primary course of acellular vaccine with no booster dose until 4 years of age.</description><subject>Age</subject><subject>Age Factors</subject><subject>Allergy and Immunology</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Diphtheria</subject><subject>Disease</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Immunization</subject><subject>Infant</subject><subject>Infants</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mortality</subject><subject>New Zealand - epidemiology</subject><subject>Pertussis</subject><subject>Pertussis Vaccine - administration & dosage</subject><subject>Pertussis Vaccine - immunology</subject><subject>Schedules</subject><subject>Studies</subject><subject>Tetanus</subject><subject>Treatment Outcome</subject><subject>Vaccine</subject><subject>Vaccines</subject><subject>Vaccines, Acellular - administration & dosage</subject><subject>Vaccines, Acellular - immunology</subject><subject>Waning</subject><subject>Whooping cough</subject><subject>Whooping Cough - epidemiology</subject><subject>Whooping Cough - prevention & control</subject><issn>0264-410X</issn><issn>1873-2518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk-LFDEQxRtR3HH1IygBL166TXU66fRFWRb_waIHFcRLyCSV3Yw9yZh0z7Df3jQzKuxlTyHFr17y6lVVPQfaAAXxetPstTE-YNOWawPQUNo9qFYge1a3HOTDakVb0dUd0B9n1ZOcN5RSzmB4XJ21vRSiF2JVHS6usc47NN55Q9A5NJPfY8CciYvjGA8-XBPU5obYmJFER7TBcZxHncgO0zTn7DM5_YXobSy4D06HKRMdLDE3frQJQymSz3ggP1GPpf60euT0mPHZ6Tyvvr9_9-3yY3315cOny4ur2vBWTnULrNO9XNtOrNFq7Pt-kMAQBB2cM644WjO0FrEH7gzXbg26Y9YKJygDZOfVq6PuLsXfM-ZJbX1eDOiAcc4KBio6Pkgp7kdl1_Kul3xBX95BN3FOoRhZKCGhHTgvFD9SJsWcEzq1S36r060CqpYQ1UadBqeWEBWAKiGWvhcn9Xm9Rfuv629qBXh7BLBMbu8xqWw8BoPWp5KfstHf-8SbOwpm9MEbPf7CW8z_3ajcKqq-Lpu0LBIIBrSYY38AnmvGSA</recordid><startdate>20170103</startdate><enddate>20170103</enddate><creator>Radke, Sarah, MSPH, PhD</creator><creator>Petousis-Harris, Helen, BSc, PhD</creator><creator>Watson, Donna, MA</creator><creator>Gentles, Dudley, MSc</creator><creator>Turner, Nikki, MBChB, MPH, MD</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T2</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U2</scope></search><sort><creationdate>20170103</creationdate><title>Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand</title><author>Radke, Sarah, MSPH, PhD ; Petousis-Harris, Helen, BSc, PhD ; Watson, Donna, MA ; Gentles, Dudley, MSc ; Turner, Nikki, MBChB, MPH, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-2134a78bd46bedae7779813e1609ffcf005b3eddee715fc5afb1a43dd6f6031e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Age Factors</topic><topic>Allergy and Immunology</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Diphtheria</topic><topic>Disease</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Immunization</topic><topic>Infant</topic><topic>Infants</topic><topic>Laboratories</topic><topic>Male</topic><topic>Mortality</topic><topic>New Zealand - epidemiology</topic><topic>Pertussis</topic><topic>Pertussis Vaccine - administration & dosage</topic><topic>Pertussis Vaccine - immunology</topic><topic>Schedules</topic><topic>Studies</topic><topic>Tetanus</topic><topic>Treatment Outcome</topic><topic>Vaccine</topic><topic>Vaccines</topic><topic>Vaccines, Acellular - administration & dosage</topic><topic>Vaccines, Acellular - immunology</topic><topic>Waning</topic><topic>Whooping cough</topic><topic>Whooping Cough - epidemiology</topic><topic>Whooping Cough - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Radke, Sarah, MSPH, PhD</creatorcontrib><creatorcontrib>Petousis-Harris, Helen, BSc, PhD</creatorcontrib><creatorcontrib>Watson, Donna, MA</creatorcontrib><creatorcontrib>Gentles, Dudley, MSc</creatorcontrib><creatorcontrib>Turner, Nikki, MBChB, MPH, MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Safety Science and Risk</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Radke, Sarah, MSPH, PhD</au><au>Petousis-Harris, Helen, BSc, PhD</au><au>Watson, Donna, MA</au><au>Gentles, Dudley, MSc</au><au>Turner, Nikki, MBChB, MPH, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2017-01-03</date><risdate>2017</risdate><volume>35</volume><issue>1</issue><spage>177</spage><epage>183</epage><pages>177-183</pages><issn>0264-410X</issn><eissn>1873-2518</eissn><abstract>Abstract Background Though it is believed the switch from whole cell to acellular pertussis vaccine has contributed to the resurgence of pertussis disease, few studies have evaluated vaccine effectiveness (VE) and duration of protection provided by an acellular vaccine schedule including three primary doses but no toddler-age dose. We assessed this schedule in New Zealand (NZ), a setting with historically high rates of pertussis disease, and low but recently improved immunisation coverage. We further evaluated protection following the preschool-age booster dose. Methods We performed a nested case-control study using national-level healthcare data. Hospitalised and non-hospitalised pertussis was detected among children 6 weeks to 7 years of age between January 2006 and December 2013. The NZ National Immunisation Register provided vaccination status for cases and controls. Conditional logistic regression was used to calculate dose-specific VE with duration of immunity examined by stratifying VE into ages aligned with the immunisation schedule. Results VE against pertussis hospitalisation was 93% (95% confidence interval [CI]: 87, 96) following three doses among infants aged 5–11 months who received three compared to zero doses. This protection was sustained through children’s fourth birthdays (VE ⩾ 91%). VE against non-hospitalised pertussis was also sustained after three doses, from 86% (95% CI: 80, 90) among 5–11 month olds to 84% (95% CI: 80, 88) among 3-year-olds. Following the first booster dose at 4 years of age, the protective VE of 93% (95% CI: 90, 95) among 4-year-olds continued through 7 years of age (VE ⩾ 91%). Conclusions We found a high level of protection with no reduction in VE following both the primary course and the first booster dose. These findings support a 3-dose primary course of acellular vaccine with no booster dose until 4 years of age.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>27866766</pmid><doi>10.1016/j.vaccine.2016.11.004</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Age Age Factors Allergy and Immunology Case-Control Studies Child Child, Preschool Children & youth Diphtheria Disease Effectiveness Female Hospitalization Humans Immunization Infant Infants Laboratories Male Mortality New Zealand - epidemiology Pertussis Pertussis Vaccine - administration & dosage Pertussis Vaccine - immunology Schedules Studies Tetanus Treatment Outcome Vaccine Vaccines Vaccines, Acellular - administration & dosage Vaccines, Acellular - immunology Waning Whooping cough Whooping Cough - epidemiology Whooping Cough - prevention & control |
title | Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand |
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