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Acellular pertussis vaccine effectiveness for children during the 2009–2010 pertussis epidemic in Queensland

Sarah L Sheridan, Bradley J McCall, Craig A Davis, Jennifer M B Robson, Brynley P Hull, Christine E Selvey, Robert S Ware, Keith Grimwood and Stephen B Lambert
Med J Aust 2014; 200 (6): 334-338. || doi: 10.5694/mja13.11069

Summary

Objectives: To assess the effectiveness of three, four and five doses of acellular pertussis vaccine against pertussis notification for children aged 1 – < 4 years and 5 – < 12 years, and the effectiveness of three doses of acellular pertussis vaccine against pertussis hospitalisation for children aged 1 – < 4 years.

Design, setting and participants: A population-based retrospective study of children aged 1 – < 12 years residing in Queensland, Australia, during 2009 and 2010. Routinely collected notification, hospitalisation, testing and vaccination data were used to describe notification rates and testing patterns and to assess vaccine effectiveness (VE) by the screening method.

Main outcome measures: VE against pertussis notification for children aged 1 – < 4 years and 5 – < 12 years, by birth year, and VE against pertussis hospitalisation for children aged 1 – < 4 years.

Results: 1961 notifications and 29 hospitalisations were included in the VE calculations. VE point estimates against pertussis notification and hospitalisation in children aged 1 – < 4 years were similar in 2009 and 2010, and ranged between 83.5% and 89.4%. VE point estimates against notification among children aged 5 – < 12 years were between 71.2% and 87.7% in 2009, and between 34.7% and 70.3% in 2010. The numbers of pertussis tests performed for children, particularly polymerase chain reaction (PCR) tests, increased between 2009 and 2010.

Conclusions: Acellular pertussis vaccine provided good protection within the first years of priming, but this waned as age increased. Changes in pertussis testing behaviour, because of increases in PCR use and awareness, may have contributed to increased pertussis notification rates and lower estimates of VE against notification owing to identification of milder disease.

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  • Sarah L Sheridan1,2
  • Bradley J McCall3
  • Craig A Davis4
  • Jennifer M B Robson5
  • Brynley P Hull6
  • Christine E Selvey7
  • Robert S Ware1,2
  • Keith Grimwood1
  • Stephen B Lambert1,4

  • 1 Queensland Children’s Medical Research Institute, University of Queensland, Brisbane, QLD.
  • 2 School of Population Health, University of Queensland, Brisbane, QLD.
  • 3 Metro South Public Health Unit, Brisbane, QLD.
  • 4 Communicable Diseases Unit, Queensland Health, Brisbane, QLD.
  • 5 Microbiology Department, Sullivan Nicolaides Pathology, Brisbane, QLD.
  • 6 National Centre for Immunisation Research and Surveillance, Sydney, NSW.
  • 7 Health Protection NSW, NSW Health, Sydney, NSW.

Correspondence: s.sheridan@uq.edu.au

Acknowledgements: 

We thank Angela Wakefield and Nancy Tran, of the Communicable Diseases Unit, Queensland Health, and Jason Christiansen, of Metro South Public Health Unit, for their assistance in data extraction; and Karen Peterson and Vicki Bryant, of the Queensland Health Immunisation Program, for describing the vaccination program, schedule and register. Sarah Sheridan is supported by a National Health and Medical Research Council (NHMRC) postgraduate scholarship and a Children’s Health Foundation (CHF) clinical PhD scholarship. Stephen Lambert is supported by an NHMRC early career fellowship and a CHF People Support Fellowship, which helped support the study. Keith Grimwood receives funding from the NHMRC.

Competing interests:

Keith Grimwood has served on the GlaxoSmithKline advisory board for pneumococcal conjugate vaccines.

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