Effectiveness of adolescent and adult tetanus, reduced-dose diphtheria, and acellular pertussis vaccine against pertussis.
BACKGROUND Pertussis is among the most poorly controlled bacterial vaccine-preventable diseases in the United States. In 2006, a tetanus, reduced-dose diphtheria, and acellular pertussis (Tdap) booster was recommended for adolescents and adults. Tdap vaccines were licensed on the basis of antibody response without vaccine effectiveness data. METHODS From 30 September 2007 through 19 December 2007, a pertussis outbreak occurred at a nursery through twelfth grade school on St. Croix, US Virgin Islands. We screened all students for cough and collected clinical history, including Tdap receipt. Coughing students were offered diagnostic testing. We defined clinical case patients as students with cough 14 days in duration plus either whoop, paroxysms, or post-tussive vomiting, and we defined confirmed case patients as students with any cough with isolation of Bordetella pertussis or those with clinical cases and polymerase chain reaction or serological evidence of pertussis; other clinical cases were classified as probable. RESULTS There were 51 confirmed or probable cases among 499 students (attack rate, 10%). Disease clustered in grades 6-12, with a peak attack rate of 38% among 10th graders. Of 266 students aged 11 years with complete data, 31 (12%) had received Tdap. Forty-one unvaccinated students (18%) had confirmed or probable pertussis, compared with 2 (6%) of the vaccinated students (relative risk, 2.9); vaccine effectiveness was 65.6% (95% confidence interval, -35.8% to 91.3%; P = .092). CONCLUSIONS This first evaluation of Tdap vaccine effectiveness in the outbreak setting suggests that Tdap provides protection against pertussis. Increased coverage is needed to realize the full benefit of the vaccine program. Serological testing was an important tool for case identification and should be considered for inclusion in the Council of State and Territorial Epidemiologists case definition.
Immunogenicity of a Triple Diphtheria-Tetanus-Whole Cell Pertussis Vaccine in Iranian Preschool Children
Background: Immunization against diphtheria, tetanus and pertussis has been applied in Iran since 1950. WHO suggests periodical evaluation of effectiveness of the triple diphtheria-tetanus-whole cell pertussis (DTwP) vaccine, worldwide. Objectives: To determine the immunogenicity of locally manufactured DTwP vaccine administered to preschool children in a number of health centers of Tehran in 2...متن کامل
BACKGROUND Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DT...متن کامل
The pediatric formulations usually have 3-5 times as much of the diphtheria component than what is in the adult/ adolescent formulation. Similarly, the formulations for adults/adolescents have around one third of acellular pertussis content than pediatric formulations. The amount of tetanus toxoid in each of the products remains almost equivalent. Dose reduction for diphtheria and pertussis is ...متن کامل
Cost-effectiveness analysis of a pertussis vaccination programme for Japan considering intergenerational infection.
OBJECTIVE The incidence of pertussis in adolescence and adulthood has been increasing, and pertussis outbreaks have occurred sporadically in Japan. The risk of intergenerational infection of pertussis is of concern. The aim of this study is to assess the cost-effectiveness of alternative vaccination programmes for replacing the conventional diphtheria-tetanus (DT) vaccine programme administered...متن کامل
OBJECTIVE Data on the effectiveness of the diphtheria-tetanus-acellular pertussis (DTaP) vaccine in the first 4 years of life are sparse. We evaluated the vaccine effectiveness (VE) of 1 and 2 doses of DTaP before 6 months of age and of 3 doses from 6 months of age in Australia, where, since 2003, a fourth dose is not given until 4 years. METHODS We matched reported pertussis cases aged 2 to ...متن کامل