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Evaluation of immunisation strategies for pertussis vaccines in Jinan, China – an interrupted time-series study
- Source :
- Epidemiology and Infection
- Publication Year :
- 2020
- Publisher :
- Cambridge University Press (CUP), 2020.
-
Abstract
- Studies in countries with high immunisation coverage suggest that the re-emergence of pertussis may be caused by a decreased duration of protection resulting from the replacement of whole-cell pertussis vaccine (WPV) with the acellular pertussis vaccine (APV). In China, WPV was introduced in 1978. The pertussis vaccination schedule advanced from an all-WPV schedule (1978–2007), to a mixed WPV/APV schedule (2008–2009), then to an all-APV schedule (2010–2016). Increases in the incidence of pertussis have been reported in recent years in Jinan and other cities in China. However, there have been few Chinese-population-based studies focused on the impact of schedule changes. We obtained annual pertussis incidences from 1956 to 2016 from the Jinan Notifiable Conditions Database. We used interrupted time series and segmented regression analyses to assess changes in pertussis incidence at the beginning of each year, and average annual changes during the intervention. Pertussis incidence decreased by 1.11 cases per 100 000 population (P= 0.743) immediately following WPV introduction in 1978 and declined significantly by 1.21 cases per 100 000 population per year (P< 0.0001) between 1978 and 2001. Immediately after APV replaced the fourth dose of WPV in 2008, the second and third doses in 2009, then replaced all four doses in 2010, pertussis incidence declined by 1.98, 1.98 and 1.08 cases per 100 000 population, respectively. However, the results were not statistically significant. There were significant increasing trends in pertussis incidence after APV replacements: 1.63, 1.77 and 1.78 cases/year in 2008–2016, 2009–2016 and 2010–2016, respectively. Our study shows that the impact of an all-WPV schedule may be less than the impacts of the sequential WPV/APV schedules. The short-term impact of APV was better than that of WPV; however, the duration of APV-induced protection was not ideal. The impact and duration of protective immunity resulting from APVs produced in China need further evaluation. Further research on the effectiveness of pertussis vaccination programme in Jinan, China is also necessary.
- Subjects :
- Male
Pediatrics
Whooping Cough
Epidemiology
0302 clinical medicine
segmented regression analysis
Medicine
Pertussis vaccination
Longitudinal Studies
030212 general & internal medicine
Child
Pertussis Vaccine
reported incidence
education.field_of_study
Incidence
pertussis
Incidence (epidemiology)
Middle Aged
Treatment Outcome
Infectious Diseases
Child, Preschool
Female
Acellular pertussis
medicine.drug
Adult
China
medicine.medical_specialty
Protective immunity
Adolescent
Interrupted time series
Population
Young Adult
03 medical and health sciences
Vaccines, Acellular
030225 pediatrics
Humans
Cities
education
Immunization Schedule
Original Paper
vaccination policy evaluation
business.industry
Infant, Newborn
Infant
Interrupted Time Series Analysis
nervous system
Vaccines, Inactivated
Pertussis vaccine
business
Subjects
Details
- ISSN :
- 14694409 and 09502688
- Volume :
- 148
- Database :
- OpenAIRE
- Journal :
- Epidemiology and Infection
- Accession number :
- edsair.doi.dedup.....0fc637ef20167394a1c0deebdab4272f