RESUMEN
This study investigates the incidence of Class B respiratory infectious diseases (RIDs) in China under the Coronavirus disease 2019 (COVID-19) epidemic and examines variations post-epidemic, following the relaxation of non-pharmaceutical interventions (NPIs). Two-stage evaluation was used in our study. In the first stage evaluation, we established counterfactual models for the pre-COVID-19 period to estimate expected incidences of Class B RIDs without the onset of the epidemic. In the second stage evaluation, we constructed seasonal autoregressive integrated moving average intervention (SARIMA-Intervention) models to evaluate the impact on the Class B RIDs after NPIs aimed at COVID-19 pandemic were relaxed. The counterfactual model in the first stage evaluation suggested average annual increases of 10.015%, 78.019%, 70.439%, and 67.799% for tuberculosis, scarlet fever, measles, and pertussis respectively, had the epidemic not occurred. In the second stage evaluation, the total relative reduction in 2023 of tuberculosis, scarlet fever, measles and pertussis were - 35.209%, - 59.184%, - 4.481%, and - 9.943% respectively. The actual incidence declined significantly in the first stage evaluation. However, the results of the second stage evaluation indicated that a rebound occurred in four Class B RIDs after the relaxation of NPIs; all of these showed a negative total relative reduction rate.
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COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/transmisión , COVID-19/prevención & control , China/epidemiología , Incidencia , SARS-CoV-2/aislamiento & purificación , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/transmisión , Infecciones del Sistema Respiratorio/virología , Infecciones del Sistema Respiratorio/prevención & control , Escarlatina/epidemiología , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Tos Ferina/transmisión , Sarampión/epidemiología , Sarampión/transmisión , Sarampión/prevención & control , Pandemias/prevención & control , Tuberculosis/epidemiología , Tuberculosis/transmisión , Tuberculosis/prevención & controlAsunto(s)
Vacuna contra la Tos Ferina , Tos Ferina , Humanos , Tos Ferina/prevención & control , Vacuna contra la Tos Ferina/administración & dosificación , Niño , Preescolar , Bordetella pertussis/inmunología , Bordetella pertussis/aislamiento & purificación , Vacunas Acelulares/administración & dosificación , Vacunas Acelulares/inmunología , Lactante , Vacunación/estadística & datos numéricos , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Masculino , FemeninoRESUMEN
This phase 1 trial assessed the safety and immunogenicity of an investigational tetanus/diphtheria/acellular pertussis vaccine combined with CpG 1018 adjuvant 1500 µg (Tdap-1018 1500 µg) or 3000 µg (Tdap-1018 3000 µg) in adults and adolescents. In this randomized, active-controlled, multicenter, dose-escalation trial, healthy participants aged 10 to 22 years received 1 dose of Tdap-1018 1500 µg, Tdap-1018 3000 µg, or Boostrix. Geometric mean concentrations (GMCs) and booster response rates (BRRs) for antibodies against pertussis (pertussis toxin, filamentous hemagglutinin, pertactin), tetanus, and diphtheria antigens, and neutralizing antibodies against pertussis toxin were assessed 4 weeks after vaccination. Safety and tolerability were assessed for solicited post-injection reactions within 7 days after vaccination and unsolicited adverse events up to 12 weeks after vaccination. Of 117 enrolled participants, 80 adults (92%) and 30 adolescents (100%) completed the study. Both Tdap-1018 formulations were generally well tolerated, with no vaccine-related serious adverse events. Frequency and severity in post-injection reactions after Tdap-1018 administration were similar to Boostrix except for higher proportions of moderate pain for Tdap-1018. In adults at week 4, ratio of GMCs and BRRs for all antigens in the 3000-µg group were similar to or higher than Boostrix, with significantly higher GMC ratios for anti-pertussis toxin (2.1 [1.5-3.0]) and anti-tetanus (1.8 [1.1-2.9]) and significantly higher BRRs for anti-pertussis toxin (difference [95% CI]: 34.5% [13.4-54.6]), anti-pertactin (19.2% [4.4-38.1]), and anti-tetanus (30.0% [3.6-52.7]) antibodies. For adolescents, in the 3000-µg group, ratio of GMCs and BRRs were similar to or higher than Boostrix for all antigens. Both Tdap-1018 formulations showed acceptable safety and tolerability profiles. Tdap-1018 3000 µg induced similar or higher immune responses than Boostrix. ACTRN12620001177943 (Australian New Zealand Clinical Trials Registry; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=ACTRN12620001177943p).
Asunto(s)
Adyuvantes Inmunológicos , Anticuerpos Antibacterianos , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular , Inmunización Secundaria , Oligodesoxirribonucleótidos , Tos Ferina , Humanos , Adolescente , Femenino , Masculino , Anticuerpos Antibacterianos/sangre , Inmunización Secundaria/métodos , Adulto , Adulto Joven , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/inmunología , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/efectos adversos , Adyuvantes Inmunológicos/administración & dosificación , Adyuvantes Inmunológicos/efectos adversos , Niño , Oligodesoxirribonucleótidos/administración & dosificación , Oligodesoxirribonucleótidos/inmunología , Tos Ferina/prevención & control , Tos Ferina/inmunología , Anticuerpos Neutralizantes/sangre , Vacuna contra Difteria, Tétanos y Tos Ferina/inmunología , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Vacuna contra Difteria, Tétanos y Tos Ferina/efectos adversos , Tétanos/prevención & control , Tétanos/inmunología , Voluntarios Sanos , Inmunogenicidad VacunalRESUMEN
BACKGROUND: Bordetella pertussis is the causative agent of whooping cough or pertussis. Although both acellular (aP) and whole-cell pertussis (wP) vaccines protect against disease, the wP vaccine, which is highly reactogenic, is better at preventing colonization and transmission. Reactogenicity is mainly attributed to the lipid A moiety of B. pertussis lipooligosaccharide (LOS). Within LOS, lipid A acts as a hydrophobic anchor, engaging with TLR4-MD2 on host immune cells to initiate both MyD88-dependent and TRIF-dependent pathways, thereby influencing adaptive immune responses. Lipid A variants, such as monophosphoryl lipid A (MPLA) can also act as adjuvants. Adjuvants may overcome the shortcomings of aP vaccines. RESULTS: This work used lipid A modifying enzymes from other bacteria to produce an MPLA-like adjuvant strain in B. pertussis. We created B. pertussis strains with distinct lipid A modifications, which were validated using MALDI-TOF. We engineered a hexa-acylated monophosphorylated lipid A that markedly decreased human TLR4 activation and activated the TRIF pathway. The modified lipooligosaccharide (LOS) promoted IRF3 phosphorylation and type I interferon production, similar to MPLA responses. We generated three other variants with increased adjuvanticity properties and reduced endotoxicity. Pyrogenicity studies using the Monocyte Activation Test (MAT) revealed that these four lipid A variants significantly decreased the IL-6, a marker for fever, response in peripheral blood mononuclear cells (PBMCs). CONCLUSION: These findings pave the way for developing wP vaccines that are possibly less reactogenic and designing adaptable adjuvants for current vaccine formulations, advancing more effective immunization strategies against pertussis.
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Adyuvantes Inmunológicos , Bordetella pertussis , Lípido A , Receptor Toll-Like 4 , Lípido A/análogos & derivados , Lípido A/inmunología , Bordetella pertussis/inmunología , Humanos , Receptor Toll-Like 4/metabolismo , Receptor Toll-Like 4/inmunología , Adyuvantes Inmunológicos/farmacología , Proteínas Adaptadoras del Transporte Vesicular/metabolismo , Proteínas Adaptadoras del Transporte Vesicular/inmunología , Vacuna contra la Tos Ferina/inmunología , Lipopolisacáridos , Factor 3 Regulador del Interferón/metabolismo , Tos Ferina/prevención & control , Tos Ferina/inmunología , Interleucina-6/metabolismo , Interleucina-6/inmunologíaRESUMEN
Pertussis has reemerged globally, with rising incidence in China. Controlling this disease remains a significant public health challenge worldwide. This study applies bibliometric methods to analyze global and Chinese research on pertussis, assessing current trends, identifying hot topics, predicting future research directions, and providing guidance for scientific research and clinical practice. Pertussis-related articles from 2000 to 2023 were retrieved from four major Chinese databases and three English databases. COOC and CiteSpace software were used to analyze publication trends, geographic distribution, institutions, disciplines, and keywords, to visualize through network maps. The study analyzed 2,580 Chinese and 5,311 foreign articles and reviews. Pertussis research publications have increased globally, with foreign research peaking earlier than in China. The United States leads in publication volume, while China showed the highest burst of activity from 2019 to 2023. Research mainly focuses on animal experiments, vaccine development and safety, clinical characteristics and treatment, and pertussis toxin. Pertussis research is thriving globally and in China. Future research should emphasize interdisciplinary collaboration across molecular biology, immunology, and epidemiology to innovate vaccines and control strategies. Additionally, continued development of treatment drugs remains crucial as current vaccines do not fully control pertussis.
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Bibliometría , Vacuna contra la Tos Ferina , Tos Ferina , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Humanos , China/epidemiología , Vacuna contra la Tos Ferina/administración & dosificación , Vacuna contra la Tos Ferina/inmunología , Salud Global , Animales , Investigación Biomédica/tendencias , Investigación Biomédica/estadística & datos numéricos , Desarrollo de VacunasRESUMEN
BACKGROUND: Pregnant women, fetuses, and neonates are particularly vulnerable to vaccine-preventable diseases (VPDs). These VPDs are associated with high morbidity and mortality among expectant mothers and their fetuses and neonates. Vaccination during pregnancy can protect the expectant mother from VPDs to which she may be especially vulnerable while pregnant. In addition, the passive transfer of maternal neutralizing immunoglobulin G (IgG) and secretory immunoglobulin A (IgA) also protects the fetus against congenital infections and may further protect the neonate from infection during the first few months of life. Despite this, coverage of recommended maternal vaccines remains suboptimal globally, especially in resource-constrained settings. Determinants of vaccine acceptance and uptake are frequently understudied in low- and middle-income countries (LMICs) and among specific groups such as pregnant and postpartum women. This proposed systematic review will assess the acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in LMICs. METHODS: A Boolean search strategy employing common and medical subject heading (MeSH) terms for tetanus, influenza, pertussis, and COVID-19 vaccines, as well as vaccine acceptance, hesitancy, together with uptake, pregnancy, and postpartum, will be used to search electronic databases for relevant literature published between 2009 and 2024. Only studies conducted in LMICs that investigated determinants of acceptance, hesitancy, and uptake of tetanus, influenza, pertussis, and COVID-19 vaccines among pregnant and postpartum women will be eligible for inclusion in the review. The quality and the risk of bias of all eligible full-text articles will be assessed using the Joanna Briggs Institute's (JBI) critical appraisal tools. DISCUSSION: This protocol proposes a systematic review and meta-analysis that aims to assess the uptake of maternal vaccines and to systematically appraise and quantify determinants of the acceptance and uptake of recommended vaccines during pregnancy and postpartum in LMICs. A better understanding of these factors and how they influence maternal vaccine decision-making will enable public health practitioners as well as global and national policymakers to design more effective interventions as we look towards expanding the scope and reach of maternal immunization programs.
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COVID-19 , Países en Desarrollo , Gripe Humana , Metaanálisis como Asunto , SARS-CoV-2 , Revisiones Sistemáticas como Asunto , Tétanos , Tos Ferina , Humanos , Femenino , Embarazo , COVID-19/prevención & control , Gripe Humana/prevención & control , Tétanos/prevención & control , SARS-CoV-2/inmunología , Tos Ferina/prevención & control , Periodo Posparto , Complicaciones Infecciosas del Embarazo/prevención & control , Vacunación/psicología , Vacunas contra la COVID-19 , Aceptación de la Atención de Salud , Vacunas contra la InfluenzaRESUMEN
BACKGROUND: Healthcare professionals (HCPs) play a significant role in the decision-making process of pregnant women on maternal vaccinations. Whereas a high proportion of HCPs discuss maternal vaccinations with pregnant women, confidence in discussing maternal vaccinations is lacking and HCPs experience inadequate training to discuss maternal vaccinations with pregnant women. Furthermore, different practical barriers might influence the consultation process, such as lack of time. More studies on the barriers, as well as facilitators, to discussing maternal vaccinations is needed and will help us to better understand and support HCPs in discussing maternal vaccinations. METHODS: This qualitative study involved semi-structured interviews with fourteen HCPs working as midwives or gynaecologists in the Netherlands. An integrated theoretical approach was used to inform data collection and analysis. Thematic analysis was conducted using inductive and deductive approaches. This study followed the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. RESULTS: The thematic analysis of the data pointed to the following five themes of HCP counselling: the consultation process, attitude, perceived norm, perceived control and improvement ideas. Most HCPs follow a similar approach in maternal pertussis vaccination consultations, beginning by assessing clients' understanding, providing basic information, and addressing questions. However, consultation timing and prioritization vary among HCPs. Challenges in consultations include client requests for clear advice, with HCPs trained to remain neutral, emphasizing client autonomy in decision-making. Most HCPs acknowledge the importance of their consultations in informing pregnant women about maternal pertussis vaccination. CONCLUSIONS: This study offers a confirmation of the awareness of the pivotal role of HCPs in informing pregnant women about the maternal pertussis vaccination. HCPs stress the importance of neutral counselling, enabling pregnant women to make well-informed decisions independently. Because of upcoming vaccine hesitancy nowadays, HCPs must be equipped with the knowledge and confidence to navigate difficult conversations. Continuous education and training might help to increase HCPs' confidence in handling difficult consultations. Additionally, making the information materials for pregnant women available in multiple languages and incorporating more visuals to enhance comprehension could support HCPs in reaching a broader group of pregnant women.
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Consejo , Ginecología , Partería , Investigación Cualitativa , Vacunación , Humanos , Femenino , Países Bajos , Embarazo , Vacunación/psicología , Adulto , Actitud del Personal de Salud , Tos Ferina/prevención & control , Vacuna contra la Tos Ferina/administración & dosificación , Mujeres Embarazadas/psicología , Personal de Salud/psicología , Persona de Mediana Edad , Conocimientos, Actitudes y Práctica en Salud , MasculinoRESUMEN
Pertussis vaccination is recommended during pregnancy to protect the baby. Pertussis vaccination was initially free to pregnant people through general practice and hospitals in New Zealand, but uptake was suboptimal. In one district funding of maternal pertussis vaccination was widened to community pharmacies in 2016. Eighteen months later promotion to pharmacies, midwives and pregnant people took place. In 2020 and 2021, COVID-19 lockdowns occurred. AIM: To explore the effects of promotion and COVID-19 lockdowns on uptake of funded maternal pertussis vaccination in pharmacy, and awareness, use and opinions of promotional elements. METHODS: Five years of pharmacy claims data were analysed and 12 pharmacists, 18 people eligible/recently eligible for maternal pertussis vaccination and 11 midwives were interviewed. RESULTS: Provision of maternal pertussis vaccination increased during and after promotion. Qualitative data showed that pharmacists valued phone calls with information about maternal pertussis vaccination and recommendations for increasing uptake. Prompted by these calls, some pharmacists contacted midwives to inform them of funded maternal pertussis vaccination in the pharmacy (which midwives appreciated) and recommended pertussis vaccination to pregnant clients. Pharmacy staff reportedly were motivated to recommend this vaccination by being informed about it and having posters displayed in the pharmacy. Pregnant people valued healthcare professionals' conversations about maternal pertussis vaccination, but appeared to be uninfluenced by posters and promotional social media posts about this vaccination. During COVID-19, maternal pertussis uptake in pharmacies increased 31% March to May 2020 (before and during the first COVID-19 lockdown) versus the same time the previous year, then declined. CONCLUSION: Promotion appeared to have a sustained effect on uptake of maternal pertussis vaccination in pharmacies. Pregnant people were most influenced by discussions with healthcare professionals. Pharmacists and pharmacy staff increased proactivity with maternal vaccinations after promotion to them. Promotion may need to be repeated over time.
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COVID-19 , Vacuna contra la Tos Ferina , Farmacéuticos , Vacunación , Tos Ferina , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Femenino , Embarazo , Tos Ferina/prevención & control , Vacunación/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Farmacias , Adulto , Nueva Zelanda , SARS-CoV-2 , ParteríaRESUMEN
Refugees usually face a disproportionate burden of infectious diseases. Recently, Brazil has experienced an influx of refugees which demands the need for scaling up public health efforts to address the challenges. The research sought to study the burden and risk factors associated with infectious diseases among refugees received in the city of Porto Alegre. This was a cross-sectional study of 261 newly arrived refugees. The study sample was predominantly composed of Venezuelans (50.6%) and Haitians (44%), male (146: 56.7%), single (30.7%), with an average age of 33.38 (± 7.30) years. The average schooling was 10.42 (± 2.09) years. Diseases with the highest prevalence were influenza, whooping cough, diphtheria, and tuberculosis. There was significant association between the country of origin and presence of symptoms for infectious and contagious diseases, which warrants targeted interventions for reducing the incidence of these diseases among refugees in Brazil.
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Enfermedades Transmisibles , Difteria , Gripe Humana , Refugiados , Humanos , Estudios Transversales , Masculino , Refugiados/estadística & datos numéricos , Adulto , Femenino , Brasil/epidemiología , Factores de Riesgo , Enfermedades Transmisibles/epidemiología , Gripe Humana/epidemiología , Difteria/epidemiología , Adulto Joven , Tuberculosis/epidemiología , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Prevalencia , Campos de Refugiados , Persona de Mediana Edad , Haití/epidemiología , Haití/etnología , Costo de Enfermedad , AdolescenteRESUMEN
BACKGROUND: Pertussis vaccination in pregnancy has been introduced in an increasing number of countries to better protect infants against the disease in their first weeks of life. The optimal timing of pertussis vaccination in pregnancy is however still under debate. METHODS: We systematically reviewed published literature on safety, immunogenicity and effectiveness of pertussis vaccination in pregnancy related to timing of vaccination. The search was conducted using PubMed, MEDLINE and Web of Science and yielded 1623 articles, thereof 777 duplicates. Screening resulted in the inclusion of 45 publications reporting on safety (n = 11), immunogenicity (n = 26) and/or effectiveness (n = 9). We also mapped pertussis recommendations in pregnancy by government institutions globally according to the recommended timing of vaccination. RESULTS: Overall, the selected publications did not indicate increased safety concerns associated with timing of pertussis vaccination in pregnancy. Immunogenicity studies often suggested optimal protection at birth after early third trimester vaccination. Few studies investigated qualitative antibody characteristics, and none investigated antibody titers in breastmilk or cellular-mediated immunity related to timing of vaccination. Effectiveness studies showed decreased vaccine effectiveness of late third trimester pertussis vaccination compared to vaccination earlier in pregnancy. Worldwide, a general recommendation for pertussis vaccination in pregnancy was found for 58 countries, with as many as 22 different recommended timings registered. CONCLUSION: The timing of pertussis vaccination in pregnancy seems to impact immunogenicity and vaccine effectiveness, with optimal immune responses at birth suggested following early third trimester vaccination and reduced vaccine effectiveness of late third trimester pertussis vaccination suggested compared to vaccination earlier in pregnancy. However, inconsistent and lacking data are reflected in the divergent national recommendations for pertussis vaccination in pregnancy worldwide. SUMMARY: Pertussis vaccination in pregnancy aims to protect infants in their first weeks of life. Our review suggests that immunogenicity and vaccine effectiveness are impacted by the timing of vaccination in pregnancy. National recommendations for pertussis vaccination in pregnancy vary widely worldwide.
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Vacuna contra la Tos Ferina , Vacunación , Tos Ferina , Humanos , Embarazo , Femenino , Tos Ferina/prevención & control , Tos Ferina/inmunología , Vacuna contra la Tos Ferina/administración & dosificación , Vacuna contra la Tos Ferina/inmunología , Vacunación/métodos , Esquemas de Inmunización , Eficacia de las Vacunas , Factores de TiempoRESUMEN
BACKGROUND: The reported number of pertussis cases declined after the implementation of COVID-19 prevention and control measures, however, the burden of pertussis among adults in China remains largely unknown. Additionally, the waning of natural antibody level has also rarely been assessed. METHODS: A total of 762 healthcare workers (HCWs) who had underwent the health examinations in 2021 and 2022 were included. Serum anti-PT IgG and IgA levels were determined by ELISA. Recent B. pertussis infection was defined as anti-PT IgG ≥100 IU/ml and/or anti-PT IgA ≥10 IU/ml. RESULTS: In 2021, the seroprevalence of recent B. pertussis infection was 10.1 %, and those HCWs in outpatient department had a higher percentage (18.6 %), and geometric mean concentration (GMC) (6.3 IU/ml) than those in other departments. This seroprevalence decreased to 2.4 % in 2022, although the difference remained significant. In the 77 subjects with recent B. pertussis infection in 2021, anti-PT IgG was undetectable in 18 cases the following year. Majority (68/76) of the subjects with anti-PT IgA ≥10 IU/ml in 2021 no longer had detected this antibody in 2022. Among 95 pertussis cases, approximately 60.0 % of cases reported no history of cough. Among those with a documented cough history, 36 cases with suspected pertussis courses who had never been diagnosed. Prolonged cough with nocturnal exacerbation (29/38) was the most commonly reported clinical symptom, and whoop was confirmed in six cases. Uroclepsia and syncopes during the cough attacks were reported by three and one subjects, respectively. One case presented with subconjunctival hemorrhage and tensionic purpura during the course. CONCLUSIONS: The results suggested a high prevalence of B. pertussis infection among HCWs. The presence of unrecognized adult pertussis cases and the rapid waning of antibody indicate the need to improve clinical management for suspected pertussis in adults, and to updated immunization schedule after childhood program.
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Anticuerpos Antibacterianos , Bordetella pertussis , COVID-19 , Personal de Salud , Inmunoglobulina G , Tos Ferina , Humanos , Estudios Seroepidemiológicos , Personal de Salud/estadística & datos numéricos , COVID-19/epidemiología , COVID-19/inmunología , China/epidemiología , Tos Ferina/epidemiología , Tos Ferina/inmunología , Tos Ferina/prevención & control , Adulto , Femenino , Masculino , Anticuerpos Antibacterianos/sangre , Inmunoglobulina G/sangre , Bordetella pertussis/inmunología , Persona de Mediana Edad , Inmunoglobulina A/sangre , SARS-CoV-2/inmunología , Adulto JovenRESUMEN
Continued circulation of the whooping cough pathogen, even in countries with high vaccine coverage, can be related to persistence of Bordetella pertussis biofilms in the respiratory tract. The films differ from planktonic cells by increased resistance to the host immune system and antibacterial drugs. The available acellular pertussis vaccines (aPV) containing antigens isolated from planktonic cultures of B. pertussis protect from severe forms of whooping cough, but do not effectively influence circulation of virulent strains in the subclinical forms of the disease and asymptomatic carriage. It is promising to create new generation aPV based on antigens isolated from biofilm cultures of B. pertussis capable of more effectively controlling the entire infectious cycle of whooping cough, including colonization, persistence, and transmission of the pathogen. From antigenic complexes isolated from the culture medium of biofilm and planktonic cultures of the strain B. pertussis No. 317 (serotype 1.2.3), experimental aPV were made: aPV-B and aPV-P, respectively. In intracerebral infection of mice with a virulent strain of B. pertussis, aPV-B demonstrated 2.5-fold higher protective activity than aPV-P and also more effectively reduced colonization of the lungs by B. pertussis cells in mice after intranasal infection with a virulent strain. Both vaccine preparations were safe and did not cause death in mice after administration of histamine.
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Biopelículas , Bordetella pertussis , Vacuna contra la Tos Ferina , Vacunas Acelulares , Tos Ferina , Bordetella pertussis/inmunología , Bordetella pertussis/patogenicidad , Vacuna contra la Tos Ferina/inmunología , Animales , Biopelículas/efectos de los fármacos , Biopelículas/crecimiento & desarrollo , Tos Ferina/prevención & control , Tos Ferina/microbiología , Tos Ferina/inmunología , Ratones , Vacunas Acelulares/inmunología , Plancton/efectos de los fármacos , Plancton/inmunología , Antígenos Bacterianos/inmunología , Femenino , Ratones Endogámicos BALB C , Administración IntranasalRESUMEN
In France, the goal of the pertussis vaccination program is to protect newborns. All infants are vaccinated under the program and then given booster shots up to the age of 25 years. Pregnant women are likewise vaccinated, with the cocooning strategy reserved for infants born to unvaccinated mothers. Real-world data shows (i) inadequate coverage among adolescents and adults under 25; (ii) improper use of the tetanus, diphtheria, and polio (Td/IPV) vaccine in children under six years, adolescents, and young adults; and (iii) underdiagnosis of pertussis in adults. Older patients or those with specific chronic medical conditions are at risk of developing severe disease. Improving the diagnosis and surveillance of pertussis in adults and seniors would be one of the first steps in the right direction. Aligning pertussis vaccination in adults with the Td/IPV program (boosters at 45, 65 years of age, and then every 10 years) would make the vaccination schedule simpler, easier to understand, and easier to implement. Large-scale awareness campaigns targeting this population would increase coverage, thereby boosting the effectiveness of the other measures.
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Vacuna contra la Tos Ferina , Vacunación , Tos Ferina , Humanos , Tos Ferina/prevención & control , Tos Ferina/epidemiología , Francia , Adulto , Vacuna contra la Tos Ferina/administración & dosificación , Vacunación/métodos , Femenino , Programas de Inmunización/métodos , Embarazo , Adolescente , Adulto Joven , Inmunización Secundaria , Esquemas de Inmunización , Anciano , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Persona de Mediana Edad , Cobertura de Vacunación/estadística & datos numéricosAsunto(s)
Vacuna contra la Tos Ferina , Tos Ferina , Humanos , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Hungría/epidemiología , Femenino , Vacuna contra la Tos Ferina/administración & dosificación , Embarazo , Incidencia , Recién Nacido , Lactante , Masculino , Vacunación/estadística & datos numéricosRESUMEN
Pertussis, an acute respiratory infection caused by Bordetella pertussis, has recently experienced a dramatic increase in incidence and associated deaths in China, drawing significant clinical attention. This article retrospectively analyzes national data on pertussis incidence and mortality from 2010 to 2024, exploring potential factors contributing to this trend. It also discusses strategies for enhancing vaccination programs, improving early diagnosis and treatment, and optimizing the clinical management of high-risk infants, with the aim of addressing the challenges posed by the current pertussis epidemic.
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Bordetella pertussis , Tos Ferina , Humanos , Tos Ferina/epidemiología , Tos Ferina/mortalidad , Tos Ferina/prevención & control , China/epidemiología , Estudios Retrospectivos , Incidencia , Lactante , Bordetella pertussis/genética , Preescolar , Vacuna contra la Tos Ferina/administración & dosificación , Vacuna contra la Tos Ferina/inmunología , Vacunación , Recién Nacido , Femenino , Niño , Programas de Inmunización , MasculinoRESUMEN
Despite high pediatric vaccination coverage rates (VCRs), pertussis incidence has increased worldwide, including in several countries in Latin America in the last two decades. Given the few vaccine effectiveness (VE) studies in Latin American countries, this retrospective, observational, cohort study estimated the effectiveness of hexavalent acellular (aP) primary and booster vaccination (wP) against pertussis in infants (6.5-18.5 months) and children (18.5-48.5 and 48.5-72.5 months) in Panama. Age-specific incidence rates (IRs) were calculated for the vaccine's pre-initiation (2001-2013), initiation (2014), and post-initiation (2015-2019) periods. VCRs and trends were determined, and VE was analyzed using a case coverage or screening method to compare proportions of vaccinated cases and vaccinated individuals in the population. Between 2001-2019, 868 confirmed pertussis cases were reported in Panama; 712 (82.0%; 54.8 cases/year) during the pre-initiation period, 19 (2.2%; 19 cases/year) during the initiation period, and 137 (15.8%; 27.4 cases/year) during the post-initiation period. Panama underwent cyclical increases in IRs, which varied between age groups. VCRs increased for primary and booster doses. Between 2015 and 2019, third-dose yearly vaccine coverage increased, on average, 3.3%. Specifically, during the post-initiation period, 109/137 (79.6%) of cases were unvaccinated. Relative VE was estimated at 96.2% [95% CI: 86.5%, 98.9%] with three doses; 100% with 4 and 5 booster doses. Absolute VE was estimated at 99.3% with three doses only. These results show that vaccination played an important role in maintaining a low number of pertussis cases in Panama, affirming the need for sustained investment and commitment to vaccination programs.
Asunto(s)
Esquemas de Inmunización , Inmunización Secundaria , Cobertura de Vacunación , Tos Ferina , Humanos , Panamá , Lactante , Tos Ferina/prevención & control , Tos Ferina/epidemiología , Estudios Retrospectivos , Preescolar , Masculino , Niño , Femenino , Cobertura de Vacunación/estadística & datos numéricos , Incidencia , Vacuna contra la Tos Ferina/administración & dosificación , Vacuna contra la Tos Ferina/inmunología , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/inmunología , Vacunación/estadística & datos numéricos , Vacunación/métodosRESUMEN
Recent months have seen an increase in pertussis cases in several countries across the Northern and Southern hemispheres. The lack of immune stimulation during the COVID-19 pandemic due to the reduced circulation of Bordetella pertussis, the pathogen responsible for pertussis, is likely to have led to increased population susceptibility which has been magnified the typical three to five yearly cyclical peaks in activity. Maternal immunization for pertussis proves highly effective in protecting infants under three months of age. It's also critical for immunizers and parents to maintain high and timely immunization uptake to ensure infants receive maximum early protection when they are most at risk of severe disease.