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      Pertussis epidemiological pattern and disease burden in Brazil: an analysis of national public health surveillance data

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          ABSTRACT

          Objective: We described pertussis epidemiological trends in Brazil between 2010 and 2015. We also assessed tetanus, diphtheria and acellular pertussis (Tdap) vaccine coverage among pregnant women from 2014, the year of the introduction of Tdap maternal immunization recommendation in Brazil, to 2016.

          Methods: Epidemiological data for incidence, prevalence, hospitalization, mortality, and maternal vaccination coverage were calculated based on the Brazilian public surveillance databases.

          Results: The epidemiological data analysis results showed that the pertussis average incidence rate (IR) was 2.19/100,000 inhabitants for all ages, with a peak in 2014 (4.03/100,000 inhabitants) and highest incidence in <1-year-old children (IR = 175.20/100,000). 97.6% of pertussis deaths (405/415) were in <1-year-old children. Maternal immunization coverage was 9.2% in 2014, 40.4% in 2015, and 33.8% in 2016.

          Conclusions: Pertussis incidence and pertussis-related deaths increased in Brazil from 2010 to 2014 and decreased in 2015. In the two years, 2015 and 2016 that followed the NIP recommendation, Tdap vaccination coverage of pregnant women was low and varying from region to region. More efforts and national plans would help increase awareness and maternal immunization coverage.

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          Most cited references43

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          Duration of immunity against pertussis after natural infection or vaccination.

          Despite decades of high vaccination coverage, pertussis has remained endemic and reemerged as a public health problem in many countries in the past 2 decades. Waning of vaccine-induced immunity has been cited as one of the reasons for the observed epidemiologic trend. A review of the published data on duration of immunity reveals estimates that infection-acquired immunity against pertussis disease wanes after 4-20 years and protective immunity after vaccination wanes after 4-12 years. Further research into the rate of waning of vaccine-acquired immunity will help determine the optimal timing and frequency of booster immunizations and their role in pertussis control.
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            A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012-2013.

            Infants with pertussis infection are at risk of severe clinical illness and death. Several countries, including the United Kingdom, have introduced maternal pertussis vaccination during pregnancy to protect infants from infection following national increases in pertussis notifications. The objective of this study was to estimate the effectiveness of maternal pertussis vaccination in protecting infants against laboratory-confirmed pertussis infection.
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              Sustained Effectiveness of the Maternal Pertussis Immunization Program in England 3 Years Following Introduction

              The effectiveness of maternal immunization in preventing infant pertussis was first demonstrated in England, 1 year after the program using diphtheria–tetanus–5-component acellular pertussis–inactivated polio vaccine (dT5aP-IPV) was introduced in 2012. Vaccine effectiveness against laboratory-confirmed pertussis has been sustained >90% in the 3 years following its introduction, despite changing to another acellular vaccine with different antigen composition. Consistent with this, disease incidence in infants <3 months of age has remained low despite high activity persisting in those aged 1 year and older. Vaccine effectiveness against infant deaths was estimated at 95% (95% confidence interval, 79%–100%). Additional protection from maternal immunization is retained in infants who received their first dose of the primary series. There is no longer evidence of additional protection from maternal vaccination after the third infant dose. Although numbers are small and ongoing assessment is required, there is no evidence of increased risk of disease after primary immunization in infants whose mothers received maternal vaccination.
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                Author and article information

                Journal
                Hum Vaccin Immunother
                Hum Vaccin Immunother
                KHVI
                khvi20
                Human Vaccines & Immunotherapeutics
                Taylor & Francis
                2164-5515
                2164-554X
                2020
                24 July 2019
                24 July 2019
                : 16
                : 1
                : 61-69
                Affiliations
                [a ]GSK , Rio de Janeiro, RJ, Brazil
                [b ]Ribeirão Preto Medical School, University of São Paulo , Brazil
                [c ]Shift Gestão de Serviços , Rio de Janeiro, RJ, Brazil
                [d ]GSK , Wavre, Belgium
                Author notes
                CONTACT Ariane Abreu ariane.j.abreu@ 123456gsk.com GSK , Estrada Dos Bandeirantes 8464, Jacarepaguá, Rio de janeiro 22783110

                PREVIOUS CONGRESS ACTIVITIES:

                XVII Congreso Latinoamericano de Infectología Pediátrica - SLIPE 2017 - 8-11 Nov 2017 - Cancún, Mexico

                CLINICAL TRIAL REGISTRATION:

                Not applicable

                Author information
                http://orcid.org/0000-0002-5599-0991
                http://orcid.org/0000-0003-3491-3396
                Article
                1634991
                10.1080/21645515.2019.1634991
                7012156
                31242082
                8384d79d-0c9b-4272-859e-7c033377bcd8
                © 2019 GlaxoSmithKline Biologicals SA. Published with license by Taylor & Francis Group, LLC.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 January 2019
                : 3 June 2019
                : 16 June 2019
                Page count
                Figures: 5, Tables: 2, References: 63, Pages: 9
                Funding
                Funded by: (GSK study identifier HO-16-17848) and all costs related to the development of related publications
                GlaxoSmithKline Biologicals S.A. funded this study (GSK study identifier HO-16-17848) and all costs related to the development of related publications.
                Categories
                Research Paper

                Molecular medicine
                brazil,epidemiology,vaccination,bordetella pertussis,tdap
                Molecular medicine
                brazil, epidemiology, vaccination, bordetella pertussis, tdap

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