1
|
Merdrignac L, Aït El Belghiti F, Pandolfi E, Acosta L, Fabiánová K, Habington A, García Cenoz M, Bøås H, Toubiana J, Tozzi AE, Jordan I, Zavadilová J, O'Sullivan N, Navascués A, Flem E, Croci I, Jané M, Křížová P, Cotter S, Fernandino L, Bekkevold T, Muñoz-Almagro C, Bacci S, Kramarz P, Kissling E, Savulescu C. Effectiveness of one and two doses of acellular pertussis vaccines against laboratory-confirmed pertussis requiring hospitalisation in infants: Results of the PERTINENT sentinel surveillance system in six EU/EEA countries, December 2015 - December 2019. Vaccine 2024; 42:2370-2379. [PMID: 38472070 PMCID: PMC11007387 DOI: 10.1016/j.vaccine.2024.02.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Monitoring effectiveness of pertussis vaccines is necessary to adapt vaccination strategies. PERTINENT, Pertussis in Infants European Network, is an active sentinel surveillance system implemented in 35 hospitals across six EU/EEA countries. We aim to measure pertussis vaccines effectiveness (VE) by dose against hospitalisation in infants aged <1 year. METHODS From December 2015 to December 2019, participating hospitals recruited all infants with pertussis-like symptoms. Cases were vaccine-eligible infants testing positive for Bordetella pertussis by PCR or culture; controls were those testing negative to all Bordetella spp. For each vaccine dose, we defined an infant as vaccinated if she/he received the corresponding dose >14 days before symptoms. Unvaccinated were those who did not receive any dose. We calculated (one-stage model) pooled VE as 100*(1-odds ratio of vaccination) adjusted for country, onset date (in 3-month categories) and age-group (when sample allowed it). RESULTS Of 1,393 infants eligible for vaccination, we included 259 cases and 746 controls. Median age was 16 weeks for cases and 19 weeks for controls (p < 0.001). Median birth weight and gestational age were 3,235 g and week 39 for cases, 3,113 g and week 39 for controls. Among cases, 119 (46 %) were vaccinated: 74 with one dose, 37 two doses, 8 three doses. Among controls, 469 (63 %) were vaccinated: 233 with one dose, 206 two doses, 30 three doses. Adjusted VE after at least one dose was 59 % (95 %CI: 36-73). Adjusted VE was 48 % (95 %CI: 5-71) for dose one (416 eligible infants) and 76 % (95 %CI: 43-90) for dose two (258 eligible infants). Only 42 infants were eligible for the third dose. CONCLUSIONS Our results suggest moderate one-dose and two-dose VE in infants. Larger sample size would allow more precise estimates for dose one, two and three.
Collapse
Affiliation(s)
| | | | - Elisabetta Pandolfi
- Preventive and Predictive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Lesly Acosta
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain; Departament d'Estadística i Investigació Operativa, Universitat Politècnica de Catalunya- BarcelonaTech (UPC), Barcelona, Spain
| | | | | | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Håkon Bøås
- Division of Infection Control, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213 Oslo, Norway
| | - Julie Toubiana
- Biodiversité et Epidémiologie des bactéries et pathogènes, Institut Pasteur, Paris, France; National Reference Center for Whooping Cough and Other Bordetella Infections, Institut Pasteur, Paris, France
| | - Alberto E Tozzi
- Preventive and Predictive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Iolanda Jordan
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | | | | | | | - Elmira Flem
- Division of Infection Control, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213 Oslo, Norway
| | - Ilena Croci
- Preventive and Predictive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Mireia Jané
- Public Health Agency of Catalonia (ASPCAT), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Pavla Křížová
- National Institute of Public Health, Prague, Czech Republic
| | | | - Leticia Fernandino
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Terese Bekkevold
- Division of Infection Control, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213 Oslo, Norway
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sabrina Bacci
- European Centre for Diseases Control and Prevention, Stockholm, Sweden
| | - Piotr Kramarz
- European Centre for Diseases Control and Prevention, Stockholm, Sweden
| | | | | |
Collapse
|
2
|
Merdrignac L, Aït El Belghiti F, Pandolfi E, Jané M, Murphy J, Fabiánová K, García Cenoz M, Flem E, Guillot S, Tozzi AE, Carmona G, Habington A, Zavadilová J, Navasués A, Bøås H, Lévy-Brühl D, Ferretti B, Lanaspa M, O'Sullivan N, Křížová P, Fernandino L, Bekkevold T, Hanslik T, Muñoz-Almagro C, Bacci S, Spiteri G, Valenciano M, Moren A. Incidence and severity of pertussis hospitalisations in infants aged less than 1 year in 37 hospitals of six EU/EEA countries, results of PERTINENT sentinel pilot surveillance system, December 2015 to December 2018. ACTA ACUST UNITED AC 2021; 26. [PMID: 33509338 PMCID: PMC7848786 DOI: 10.2807/1560-7917.es.2021.26.4.1900762] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction PERTINENT is a pilot active surveillance system of infants hospitalised with pertussis in six European Union/European Economic Area countries (37 hospitals, seven sites). Aim This observational study aimed to estimate annual pertussis incidence per site from 2016 to 2018 and respective trends between 2017 and 2018. Pertussis cases were described, including their severity. Methods We developed a generic protocol and laboratory guidelines to harmonise practices across sites. Cases were hospitalised infants testing positive for Bordetella pertussis by PCR or culture. Sites collected demographic, clinical, laboratory data, vaccination status, and risk/protective factors. We estimated sites’ annual incidences by dividing case numbers by the catchment populations. Results From December 2015 to December 2018, we identified 469 cases (247 males; 53%). The median age, birthweight and gestational age were 2.5 months (range: 0–11.6; interquartile range (IQR): 2.5), 3,280 g (range: 700–4,925; IQR: 720) and 39 weeks (range: 25–42; IQR: 2), respectively. Thirty cases (6%) had atypical presentation either with cough or cyanosis only or with absence of pertussis-like symptoms. Of 330 cases with information, 83 (25%) were admitted to intensive care units including five deceased infants too young to be vaccinated. Incidence rate ratios between 2018 and 2017 were 1.43 in Czech Republic (p = 0.468), 0.25 in Catalonia (p = 0.002), 0.71 in France (p = 0.034), 0.14 in Ireland (p = 0.002), 0.63 in Italy (p = 0.053), 0.21 in Navarra (p = 0.148) and zero in Norway. Conclusions Incidence appeared to decrease between 2017 and 2018 in all but one site. Enhanced surveillance of hospitalised pertussis in Europe is essential to monitor pertussis epidemiology and disease burden.
Collapse
Affiliation(s)
| | | | - Elisabetta Pandolfi
- Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital, Rome, Italy
| | - Mireia Jané
- Epidemiological surveillance and response, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jane Murphy
- Research, Temple Street Children's University Hospital, Dublin, Ireland
| | | | - Manuel García Cenoz
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Elmira Flem
- Infectious Disease Epidemiology and Modeling, Norwegian Institute of Public Health, Oslo, Norway
| | - Sophie Guillot
- Biodiversité et Epidémiologie des bactéries et pathogènes, Institut Pasteur, Paris, France
| | - Alberto E Tozzi
- Chief Innovation Unit and Clinical Trials, Bambino Gesù Children Hospital, Rome, Italy
| | - Gloria Carmona
- Epidemiological surveillance and response, Public Health Agency of Catalonia, Barcelona, Spain
| | - Adele Habington
- Microbiology, Our Lady's Children's hospital Crumlin, Dublin, Ireland
| | | | - Ana Navasués
- Clinical Microbiology Service, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Håkon Bøås
- Infectious Disease Epidemiology and Modeling, Norwegian Institute of Public Health, Oslo, Norway
| | - Daniel Lévy-Brühl
- Direction des maladies infectieuses, Santé Publique France, Paris, France
| | - Beatrice Ferretti
- Multifactorial Disease and Complex Phenotype Research Area, Bambino Gesù Children Hospital, Rome, Italy
| | - Miguel Lanaspa
- Instituto de Recerca Pediatrica Hospital Sant Joan de Deu, Barcelona, Spain
| | - Niam O'Sullivan
- Microbiology, Our Lady's Children's hospital Crumlin, Dublin, Ireland
| | - Pavla Křížová
- National Institute of Public Health, Prague, Czech Republic
| | - Leticia Fernandino
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Terese Bekkevold
- Infectious Disease Epidemiology and Modeling, Norwegian Institute of Public Health, Oslo, Norway
| | - Thomas Hanslik
- Sorbonne University, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Carmen Muñoz-Almagro
- CIBER of Epidemiology and Public Health CIBERESP, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain.,Instituto de Recerca Pediatrica Hospital Sant Joan de Deu, Barcelona, Spain
| | - Sabrina Bacci
- European Centre for Diseases Prevention and Control, Stockholm, Sweden
| | | | | | - Alain Moren
- Epidemiology Department, Epiconcept, Paris, France
| | -
- The members of the network are listed at the end of the article
| | | |
Collapse
|
3
|
Castilla J, Navascués A, Casado I, Díaz-González J, Pérez-García A, Fernandino L, Martínez-Baz I, Aguinaga A, Pozo F, Ezpeleta C, Primary Health Care Sentinel Network And The Network For Influenza Surveillance In Hospitals Of Navarre. Combined effectiveness of prior and current season influenza vaccination in northern Spain: 2016/17 mid-season analysis. ACTA ACUST UNITED AC 2017; 22. [PMID: 28230523 PMCID: PMC5322189 DOI: 10.2807/1560-7917.es.2017.22.7.30465] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/16/2017] [Indexed: 12/15/2022]
Abstract
The 2016/17 mid-season vaccine effectiveness estimate against influenza A(H3N2) was 15% (95% confidence interval: −11 to 35) in Navarre. Comparing to individuals unvaccinated in the current and four prior seasons, effectiveness was 24% for current and 3–4 prior doses, 61% for current and 1–2 prior doses, 42% for only current vaccination, and 58% for 3–4 prior doses. This suggests moderate effectiveness for different combinations of vaccination in the current and prior seasons.
Collapse
Affiliation(s)
- Jesús Castilla
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ana Navascués
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Itziar Casado
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jorge Díaz-González
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Alejandra Pérez-García
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Leticia Fernandino
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Aitziber Aguinaga
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | - Francisco Pozo
- Centro Nacional de Microbiología (WHO National Influenza Centre - Madrid), Instituto de Salud Carlos III, Majadahonda, Spain
| | - Carmen Ezpeleta
- Complejo Hospitalario de Navarra, IdiSNA - Navarre Institute for Health Research, Pamplona, Spain
| | | |
Collapse
|