Eder Gatti Fernandes1, Ana Paula S Sato2, Lourdes R A Vaz-de-Lima3, Marcela Rodrigues4, Daniela Leite5, Cyro A de Brito3, Expedito J A Luna6, Telma Regina M P Carvalhanas4, Maria Lígia Bacciote Nerger Ramos7, Helena Keico Sato8, Euclides A de Castilho9. 1. Divisão de Imunização, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil. Electronic address: edergatti@saude.gov.br. 2. Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - USP, Brazil. 3. Centro de Imunologia, Instituto Adolfo Lutz, São Paulo, Brazil. 4. Divisão de Doenças de Transmissão Respiratória, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil. 5. Centro de Referência Nacional para Coqueluche, Centro de Bacteriologia, Instituto Adolfo Lutz, São Paulo, Brazil. 6. Instituto de Medicina Tropical da Universidade de São Paulo - USP, Brazil. 7. Coordenadoria de Vigilância em Saúde (COVISA), Secretaria Municipal da Saúde de São Paulo, Brazil. 8. Divisão de Imunização, Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac", Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil. 9. Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo - USP, Brazil.
Abstract
INTRODUCTION: In 2014, the Brazilian Ministry of Health (MoH) recommended Tdap to pregnant women in response to a significant increase in the incidence of pertussis among infants. The present study assessed the effectiveness of maternal immunization in preventing pertussis in infants. METHODS: An unmatched case-control study was undertaken in São Paulo State, Brazil from February 2015 to July 2016. Cases were infants aged <8 weeks at onset of pertussis reported to the Surveillance System and confirmed by real-time polymerase chain reaction or culture. Four to six healthy infants were selected as controls per case from birth certificates in the Information System on Live Births database. General characteristics and mother's vaccination status were compared between cases and controls. The vaccine effectiveness (VE) was calculated as 1 - odds ratio (OR). For the adjusted VE, the OR was calculated using logistic regression analysis. RESULTS: Forty-two cases and 248 controls were enrolled in the study. Mothers of 8 cases (19.1%) and 143 controls (57.4%) were vaccinated during pregnancy, resulting in an unadjusted VE of 82.6% (95% confidence interval [CI], 60.8-92.3%). The VE was unchanged after adjusting for maternal age and monthly household income. CONCLUSION: Maternal pertussis vaccination during pregnancy was effective in protecting infants aged <8 weeks from pertussis.
INTRODUCTION: In 2014, the Brazilian Ministry of Health (MoH) recommended Tdap to pregnant women in response to a significant increase in the incidence of pertussis among infants. The present study assessed the effectiveness of maternal immunization in preventing pertussis in infants. METHODS: An unmatched case-control study was undertaken in São Paulo State, Brazil from February 2015 to July 2016. Cases were infants aged <8 weeks at onset of pertussis reported to the Surveillance System and confirmed by real-time polymerase chain reaction or culture. Four to six healthy infants were selected as controls per case from birth certificates in the Information System on Live Births database. General characteristics and mother's vaccination status were compared between cases and controls. The vaccine effectiveness (VE) was calculated as 1 - odds ratio (OR). For the adjusted VE, the OR was calculated using logistic regression analysis. RESULTS: Forty-two cases and 248 controls were enrolled in the study. Mothers of 8 cases (19.1%) and 143 controls (57.4%) were vaccinated during pregnancy, resulting in an unadjusted VE of 82.6% (95% confidence interval [CI], 60.8-92.3%). The VE was unchanged after adjusting for maternal age and monthly household income. CONCLUSION: Maternal pertussis vaccination during pregnancy was effective in protecting infants aged <8 weeks from pertussis.
Authors: Bahaa Abu-Raya; Kirsten Maertens; Kathryn M Edwards; Saad B Omer; Janet A Englund; Katie L Flanagan; Matthew D Snape; Gayatri Amirthalingam; Elke Leuridan; Pierre Van Damme; Vana Papaevangelou; Odile Launay; Ron Dagan; Magda Campins; Anna Franca Cavaliere; Tiziana Frusca; Sofia Guidi; Miguel O'Ryan; Ulrich Heininger; Tina Tan; Ahmed R Alsuwaidi; Marco A Safadi; Luz M Vilca; Nasamon Wanlapakorn; Shabir A Madhi; Michelle L Giles; Roman Prymula; Shamez Ladhani; Federico Martinón-Torres; Litjen Tan; Lessandra Michelin; Giovanni Scambia; Nicola Principi; Susanna Esposito Journal: Front Immunol Date: 2020-06-24 Impact factor: 7.561