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2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015
BACKGROUND: Despite childhood vaccination coverage rates exceeding 75%, pertussis is still frequently reported in Canada. In Alberta, pertussis incidence ranged from 1.8 to 20.5 cases per 100,000 persons for 2004–2015. Most cases occurred in those aged < 15 years. We investigated pertussis vaccin...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255622/ http://dx.doi.org/10.1093/ofid/ofy210.2107 |
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author | Bell, Christopher A Drews, Steven J Simmonds, Kimberley A Svenson, Lawrence W Crowcroft, Natasha S Schwartz, Kevin Kwong, Jeffrey C Mahmud, Salah Russell, Margaret L |
author_facet | Bell, Christopher A Drews, Steven J Simmonds, Kimberley A Svenson, Lawrence W Crowcroft, Natasha S Schwartz, Kevin Kwong, Jeffrey C Mahmud, Salah Russell, Margaret L |
author_sort | Bell, Christopher A |
collection | PubMed |
description | BACKGROUND: Despite childhood vaccination coverage rates exceeding 75%, pertussis is still frequently reported in Canada. In Alberta, pertussis incidence ranged from 1.8 to 20.5 cases per 100,000 persons for 2004–2015. Most cases occurred in those aged < 15 years. We investigated pertussis vaccine effectiveness (VE) using a test-negative designed (TND) study. METHODS: All individuals who had undergone a real-time PCR laboratory test for Bordetella pertussis between January 1, 2004 and August 31, 2015, in the province of Alberta, Canada were included. Vaccination history was obtained from Alberta’s immunization repository. Vaccination status was classified as complete, incomplete, or not vaccinated, based on the province’s vaccination schedule. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for pertussis infection by time since last vaccination, comparing those with complete or incomplete vaccination to those not vaccinated. We adjusted for age, sex, income, urban/rural status, and the presence of a co-morbid condition. Vaccine effectiveness (VE) was calculated as [(1-aOR)*100]. RESULTS: Of 28,154 individuals tested, 2,297 (12.3%) tested positive for B. pertussis. Among those with complete vs. no vaccination, VE was 88% (95% CI 85–91%) at 1 year, 83% (95% CI 79–86%) at 1 to 3 years, 70% (95% CI 63–76%) at 4 to 6 years, 28% (95% CI 12–42%) at 7 to 9 years, and -4% (95% CI -53 to 29%) at 10 or more years since a last dose of a pertussis vaccine (Figure 1). VE was similar but attenuated in the incompletely vaccinated group, with a comparable waning of immunity. CONCLUSION: Pertussis VE was high in the first year after vaccination, then declined noticeably after 5 years. Our results suggest there is a large number of adolescents and adults susceptible to pertussis. Regular boosters throughout childhood, adolescence, and during pregnancy are critical to protect those at greatest risk of infection and complications. Further validation of the strengths and weaknesses of the TND for assessing pertussis VE is needed. DISCLOSURES: M. L. Russell, Novartis Pharmaceuticals Canada Inc.: Grant Investigator and Unconditional Research Grant, Grant recipient. Merck Frosst Canada Inc.: Grant Investigator and Unconditional Research Grant, Grant recipient. |
format | Online Article Text |
id | pubmed-6255622 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62556222018-11-28 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 Bell, Christopher A Drews, Steven J Simmonds, Kimberley A Svenson, Lawrence W Crowcroft, Natasha S Schwartz, Kevin Kwong, Jeffrey C Mahmud, Salah Russell, Margaret L Open Forum Infect Dis Abstracts BACKGROUND: Despite childhood vaccination coverage rates exceeding 75%, pertussis is still frequently reported in Canada. In Alberta, pertussis incidence ranged from 1.8 to 20.5 cases per 100,000 persons for 2004–2015. Most cases occurred in those aged < 15 years. We investigated pertussis vaccine effectiveness (VE) using a test-negative designed (TND) study. METHODS: All individuals who had undergone a real-time PCR laboratory test for Bordetella pertussis between January 1, 2004 and August 31, 2015, in the province of Alberta, Canada were included. Vaccination history was obtained from Alberta’s immunization repository. Vaccination status was classified as complete, incomplete, or not vaccinated, based on the province’s vaccination schedule. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for pertussis infection by time since last vaccination, comparing those with complete or incomplete vaccination to those not vaccinated. We adjusted for age, sex, income, urban/rural status, and the presence of a co-morbid condition. Vaccine effectiveness (VE) was calculated as [(1-aOR)*100]. RESULTS: Of 28,154 individuals tested, 2,297 (12.3%) tested positive for B. pertussis. Among those with complete vs. no vaccination, VE was 88% (95% CI 85–91%) at 1 year, 83% (95% CI 79–86%) at 1 to 3 years, 70% (95% CI 63–76%) at 4 to 6 years, 28% (95% CI 12–42%) at 7 to 9 years, and -4% (95% CI -53 to 29%) at 10 or more years since a last dose of a pertussis vaccine (Figure 1). VE was similar but attenuated in the incompletely vaccinated group, with a comparable waning of immunity. CONCLUSION: Pertussis VE was high in the first year after vaccination, then declined noticeably after 5 years. Our results suggest there is a large number of adolescents and adults susceptible to pertussis. Regular boosters throughout childhood, adolescence, and during pregnancy are critical to protect those at greatest risk of infection and complications. Further validation of the strengths and weaknesses of the TND for assessing pertussis VE is needed. DISCLOSURES: M. L. Russell, Novartis Pharmaceuticals Canada Inc.: Grant Investigator and Unconditional Research Grant, Grant recipient. Merck Frosst Canada Inc.: Grant Investigator and Unconditional Research Grant, Grant recipient. Oxford University Press 2018-11-26 /pmc/articles/PMC6255622/ http://dx.doi.org/10.1093/ofid/ofy210.2107 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Bell, Christopher A Drews, Steven J Simmonds, Kimberley A Svenson, Lawrence W Crowcroft, Natasha S Schwartz, Kevin Kwong, Jeffrey C Mahmud, Salah Russell, Margaret L 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 |
title | 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 |
title_full | 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 |
title_fullStr | 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 |
title_full_unstemmed | 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 |
title_short | 2454. Pertussis Vaccine Effectiveness and Waning Immunity in Alberta, Canada: 2004–2015 |
title_sort | 2454. pertussis vaccine effectiveness and waning immunity in alberta, canada: 2004–2015 |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255622/ http://dx.doi.org/10.1093/ofid/ofy210.2107 |
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