Association between pertussis vaccination coverage and other sociodemographic factors and pertussis incidence using surveillance data

IF 3 3区 医学 Q2 INFECTIOUS DISEASES
Madhura S. Rane , Jonathan Wakefield , Pejman Rohani , M. Elizabeth Halloran
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引用次数: 0

Abstract

Routine vaccination with pertussis vaccines has been successful in driving down pertussis mortality and morbidity globally. Despite high vaccination coverage, countries such as Australia, USA, and UK have experienced increase in pertussis activity over the last few decades. This may be due to local pockets of low vaccination coverage that result in persistence of pertussis in the population and occasionally lead to large outbreaks. The objective of this study was to characterize the association between pertussis vaccination coverage and sociodemographic factors and pertussis incidence at the school district level in King County, Washington, USA. We used monthly pertussis incidence data for all ages reported to the Public Health Seattle and King County between January 1, 2010 and December 31, 2017 to obtain school district level pertussis incidence. We obtained immunization data from the Washington State Immunization Information System to estimate school-district level vaccination coverage as proportion of 19–35 month old children fully vaccinated with 4 doses of the Diphtheria-Tetanus-acellular-Pertussis (DTaP) vaccine in a school district. We used two methods to quantify the effects of vaccination coverage on pertussis incidence: an ecological vaccine model and an endemic–epidemic model. Even though the effect of vaccination is modeled differently in the two approaches, both models can be used to estimate the association between vaccination coverage and pertussis incidence. Using the ecological vaccine model, we estimated the vaccine effectiveness of 4 doses of Diphtheria-Tetanus-acellular-Pertussis vaccine to be 83% (95% credible interval: 63%, 95%). In the endemic–epidemic model, under-vaccination was statistically significantly associated with epidemic risk of pertussis (adjusted Relative Risk, aRR: 2.76; 95% confidence interval: 1.44, 16.6). Household size and median income were statistically significantly associated with endemic pertussis risk. The endemic–epidemic model suffers from ecological bias, whereas the ecological vaccine model provides less biased and more interpretable estimates of epidemiological parameters, such as DTaP vaccine effectiveness, for each school district.

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百日咳疫苗接种覆盖率和其他社会人口因素与使用监测数据的百日咳发病率之间的关系。
百日咳疫苗常规接种在全球范围内成功降低了百日咳死亡率和发病率。尽管疫苗接种覆盖率很高,但澳大利亚、美国和英国等国的百日咳活动在过去几十年中有所增加。这可能是由于当地疫苗接种覆盖率低,导致百日咳在人群中持续存在,偶尔还会导致大规模爆发。本研究的目的是描述美国华盛顿州金县学区层面的百日咳疫苗接种覆盖率和社会人口因素与百日咳发病率之间的关系。我们使用了2010年1月1日至12月31日期间向西雅图和金县公共卫生局报告的所有年龄段的每月百日咳发病率数据,2017年获得学区级百日咳发病率。我们从华盛顿州免疫信息系统获得了免疫数据,以估计学区一级的疫苗接种覆盖率,即学区内19-35个月大的儿童完全接种≥4剂白喉-破伤风-无细胞百日咳(DTaP)疫苗的比例。我们使用了两种方法来量化疫苗接种覆盖率对百日咳发病率的影响:生态疫苗模型和地方流行病模型。尽管两种方法对疫苗接种效果的建模不同,但这两种模型都可以用于估计疫苗接种覆盖率和百日咳发病率之间的关联。使用生态疫苗模型,我们估计4剂白喉-破伤风无细胞百日咳疫苗的疫苗有效性为83%(95%可信区间:63%,95%)。在地方性流行模型中,疫苗接种不足与百日咳流行风险具有统计学显著相关性(调整后的相对风险,aRR:2.76;95%置信区间:1.44,16.6)。家庭规模和中位收入与地方性百日咳风险具有统计学显着相关性。地方性流行病模型存在生态偏见,而生态疫苗模型对每个学区的流行病学参数(如DTaP疫苗有效性)提供了较少偏见和更可解释的估计。
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来源期刊
Epidemics
Epidemics INFECTIOUS DISEASES-
CiteScore
6.00
自引率
7.90%
发文量
92
审稿时长
140 days
期刊介绍: Epidemics publishes papers on infectious disease dynamics in the broadest sense. Its scope covers both within-host dynamics of infectious agents and dynamics at the population level, particularly the interaction between the two. Areas of emphasis include: spread, transmission, persistence, implications and population dynamics of infectious diseases; population and public health as well as policy aspects of control and prevention; dynamics at the individual level; interaction with the environment, ecology and evolution of infectious diseases, as well as population genetics of infectious agents.
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