Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness
Abstract Background Pertussis causes severe disease in young unvaccinated infants, with preterms potentially at highest risk. We studied pertussis in hospitalized infants as related to gestational age (GA) and vaccination history. Methods Medical record data of 0-2y old patients hospitalized for per...
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| Format: | Article |
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BMC
2019-10-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4563-5 |
| _version_ | 1818347695670034432 |
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| author | Nicoline A. T. van der Maas Elisabeth A. M. Sanders Florens G. A. Versteegh Albertine Baauw Anneke Westerhof Hester E. de Melker |
| author_facet | Nicoline A. T. van der Maas Elisabeth A. M. Sanders Florens G. A. Versteegh Albertine Baauw Anneke Westerhof Hester E. de Melker |
| author_sort | Nicoline A. T. van der Maas |
| collection | DOAJ |
| description | Abstract Background Pertussis causes severe disease in young unvaccinated infants, with preterms potentially at highest risk. We studied pertussis in hospitalized infants as related to gestational age (GA) and vaccination history. Methods Medical record data of 0-2y old patients hospitalized for pertussis during 2005–2014 were linked to vaccination data. Multivariable logistic regression was used to study the association between GA and vaccination history on the clinical disease course. We compared vaccine effectiveness (VE) against hospitalization for pertussis between term and preterm infants (i.e., <37w GA) using the screening method as developed by Farrington. Results Of 1187 records, medical data from 676 were retrieved. Of these, 12% concerned preterms, whereas they are 8% of Dutch birth cohorts. Median age at admission was 3 m for preterms and 2 m for terms (p < 0.001). Preterms more often had received pertussis vaccination (62% vs 44%; p = 0.01) and more often had coinfections (37% vs 21%; p = 0.01). Preterms tended more often to have complications, to require artificial respiration or to need admittance to the intensive care unit (ICU). Preterms had longer ICU stays (15d vs 9d; p = 0.004). Vaccinated preterms and terms had a lower median length of hospital stay and lower crude risks of apneas and the need for artificial respiration, additional oxygen, and ICU admittance than those not vaccinated. After adjustment for presence of coinfections and age at admittance, these differences were not significant, except the lower need of oxygen treatment in vaccinated terms. Effectiveness of the first vaccination against pertussis hospitalizations was 95% (95% CI 93–96%) and 73% (95% CI 20–91%) in terms and preterms, respectively. Effectiveness of the second dose of the primary vaccination series was comparable in both groups (86 and 99%, respectively). Conclusions Infants hospitalized for pertussis suffer from severe disease. Preterms were overrepresented, with higher need for intensive treatment and less VE of first vaccination. These findings stress the need for alternative prevention, in particular prenatal vaccination of mothers, to reduce pertussis in both groups. |
| first_indexed | 2024-12-13T17:38:15Z |
| format | Article |
| id | doaj.art-d7dd186056e749568a5c35b71adc0edc |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T17:38:15Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-d7dd186056e749568a5c35b71adc0edc2022-12-21T23:36:51ZengBMCBMC Infectious Diseases1471-23342019-10-0119111110.1186/s12879-019-4563-5Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectivenessNicoline A. T. van der Maas0Elisabeth A. M. Sanders1Florens G. A. Versteegh2Albertine Baauw3Anneke Westerhof4Hester E. de Melker5Centre for Infectious Disease Control, National Institute for Public Health and the EnvironmentDepartment of Paediatric Immunology and Infectious Diseases, University Medical Hospital UtrechtUniversity of Groningen, University Medical Centre Groningen/Beatrix Children’s HospitalDepartment of Paediatrics, Rijnstate HospitalCentre for Infectious Disease Control, National Institute for Public Health and the EnvironmentCentre for Infectious Disease Control, National Institute for Public Health and the EnvironmentAbstract Background Pertussis causes severe disease in young unvaccinated infants, with preterms potentially at highest risk. We studied pertussis in hospitalized infants as related to gestational age (GA) and vaccination history. Methods Medical record data of 0-2y old patients hospitalized for pertussis during 2005–2014 were linked to vaccination data. Multivariable logistic regression was used to study the association between GA and vaccination history on the clinical disease course. We compared vaccine effectiveness (VE) against hospitalization for pertussis between term and preterm infants (i.e., <37w GA) using the screening method as developed by Farrington. Results Of 1187 records, medical data from 676 were retrieved. Of these, 12% concerned preterms, whereas they are 8% of Dutch birth cohorts. Median age at admission was 3 m for preterms and 2 m for terms (p < 0.001). Preterms more often had received pertussis vaccination (62% vs 44%; p = 0.01) and more often had coinfections (37% vs 21%; p = 0.01). Preterms tended more often to have complications, to require artificial respiration or to need admittance to the intensive care unit (ICU). Preterms had longer ICU stays (15d vs 9d; p = 0.004). Vaccinated preterms and terms had a lower median length of hospital stay and lower crude risks of apneas and the need for artificial respiration, additional oxygen, and ICU admittance than those not vaccinated. After adjustment for presence of coinfections and age at admittance, these differences were not significant, except the lower need of oxygen treatment in vaccinated terms. Effectiveness of the first vaccination against pertussis hospitalizations was 95% (95% CI 93–96%) and 73% (95% CI 20–91%) in terms and preterms, respectively. Effectiveness of the second dose of the primary vaccination series was comparable in both groups (86 and 99%, respectively). Conclusions Infants hospitalized for pertussis suffer from severe disease. Preterms were overrepresented, with higher need for intensive treatment and less VE of first vaccination. These findings stress the need for alternative prevention, in particular prenatal vaccination of mothers, to reduce pertussis in both groups.http://link.springer.com/article/10.1186/s12879-019-4563-5PertussisPretermsInfantsHospitalizationVaccine effectivenessVaccination |
| spellingShingle | Nicoline A. T. van der Maas Elisabeth A. M. Sanders Florens G. A. Versteegh Albertine Baauw Anneke Westerhof Hester E. de Melker Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness BMC Infectious Diseases Pertussis Preterms Infants Hospitalization Vaccine effectiveness Vaccination |
| title | Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness |
| title_full | Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness |
| title_fullStr | Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness |
| title_full_unstemmed | Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness |
| title_short | Pertussis hospitalizations among term and preterm infants: clinical course and vaccine effectiveness |
| title_sort | pertussis hospitalizations among term and preterm infants clinical course and vaccine effectiveness |
| topic | Pertussis Preterms Infants Hospitalization Vaccine effectiveness Vaccination |
| url | http://link.springer.com/article/10.1186/s12879-019-4563-5 |
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