Format

Send to

Choose Destination
Vaccine. 2019 Jul 9;37(30):4140-4146. doi: 10.1016/j.vaccine.2019.05.067. Epub 2019 Jun 1.

Acellular pertussis vaccine effectiveness and waning immunity in Alberta, Canada: 2010-2015, a Canadian Immunization Research Network (CIRN) study.

Author information

1
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 3Z6, Canada.
2
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 3Z6, Canada. Electronic address: mlrussel@ucalgary.ca.
3
Diagnostic Virology, ProvLab Alberta, Alberta Health Services, 2B1.03 WMC, University of Alberta Hospital, 8440-112 St, Edmonton, AB T6G 2J2, Canada; Department of Laboratory Medicine and Pathology, 4B1.19 WMC, University of Alberta, 8440-112 St, Edmonton, AB T6G 2J2, Canada.
4
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 3Z6, Canada; Alberta Ministry of Health, 10025 Jasper Avenue, Edmonton, AB T5J 1S6, Canada.
5
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 3Z6, Canada; Alberta Ministry of Health, 10025 Jasper Avenue, Edmonton, AB T5J 1S6, Canada; Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, 5-22F University Terrace, 8303 112 ST NW, Edmonton, AB T6G 2T4, Canada; School of Public Health, University of Alberta, 3-300 Edmonton Clinical Health Academy, 11405 87 AVE NE, Edmonton, Alberta T6G 1C9, Canada.
6
Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, Ontario M5T 3M7, Canada; Public Health Ontario, 480 University Ave., Suite 300, Toronto, Ontario M5G 1V2, Canada; ICES, 2075 Bayview Ave, Room G1-06, Toronto, Ontario M4N 3M5, Canada.
7
Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, Ontario M5T 3M7, Canada; Public Health Ontario, 480 University Ave., Suite 300, Toronto, Ontario M5G 1V2, Canada; ICES, 2075 Bayview Ave, Room G1-06, Toronto, Ontario M4N 3M5, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, ON M5G 1V7, Canada.
8
Vaccine and Drug Evaluation Centre, Faculty of Health Sciences, Room S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
9
Dalla Lana School of Public Health, University of Toronto, 155 College St., 6th Floor, Toronto, Ontario M5T 3M7, Canada; Public Health Ontario, 480 University Ave., Suite 300, Toronto, Ontario M5G 1V2, Canada; ICES, 2075 Bayview Ave, Room G1-06, Toronto, Ontario M4N 3M5, Canada; Laboratory Medicine and Pathobiology, University of Toronto, 1 King's College Circle, 6th Floor, Toronto, Ontario M5S 1A8, Canada.

Abstract

BACKGROUND:

Pertussis is still frequently reported in Canada. In Alberta, pertussis incidence ranged from 1.8 to 20.5 cases per 100,000 persons for 2004-2015. Most cases occurred in those aged <15 years. In Alberta, acellular formulations replaced whole-cell in 1997. We investigated pertussis vaccine effectiveness (VE) using a test-negative design (TND) study.

METHODS:

We included all persons who had a real-time PCR laboratory test for Bordetella pertussis between January 1, 2010 and August 31, 2015, in the province of Alberta, Canada. Vaccination history was obtained from Alberta's immunization repository. Vaccination status was classified as complete, incomplete, or unvaccinated, based on the province's vaccination schedule. Persons who had received ≥one dose of whole cell vaccine were excluded from analysis. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for pertussis infection by time since last vaccination. We adjusted for vaccination status, age, sex, neighbourhood income, urban/rural status, and the presence of a co-morbid condition. VE was calculated as [(1 - aOR) * 100].

RESULTS:

Of the 12,149 tests available, 936 (7.7%) were positive for Bordetella pertussis. Among the full cohort, VE was 90% (95% CI 87-92%) at 1 year, 81% (95% CI 77-85%) at 1-3 years, 76% (95% CI 68-82%) at 4-7 years, and 37% (95% CI 11-56%) at 8 or more years since a last dose of acellular pertussis vaccine.

CONCLUSIONS:

Pertussis VE was highest in the first year after vaccination, then declined noticeably as years since a last vaccination increased. Our results suggest that a large number of adolescents and adults are susceptible to infection with Bordetella pertussis. Regular boosters throughout childhood, adolescence, and during pregnancy may be needed.

KEYWORDS:

Acellular pertussis vaccine; Canada; Epidemiology; Vaccine effectiveness; Waning immunity; Whooping cough

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center