• Medientyp: E-Artikel
  • Titel: Comparative Effectiveness of Acellular Versus Whole-Cell Pertussis Vaccines in Teenagers
  • Beteiligte: Klein, Nicola P.; Bartlett, Joan; Fireman, Bruce; Rowhani-Rahbar, Ali; Baxter, Roger
  • Erschienen: American Academy of Pediatrics (AAP), 2013
  • Erschienen in: Pediatrics, 131 (2013) 6, Seite e1716-e1722
  • Sprache: Englisch
  • DOI: 10.1542/peds.2012-3836
  • ISSN: 0031-4005; 1098-4275
  • Schlagwörter: Pediatrics, Perinatology and Child Health
  • Entstehung:
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  • Beschreibung: <jats:sec><jats:title>BACKGROUND:</jats:title><jats:p>During the 1990s, the United States switched from combined diphtheria, tetanus toxoids, whole-cell pertussis (DTwP) vaccines to combined acellular pertussis (DTaP) vaccines because of safety concerns. After a 2010–2011 pertussis outbreak, we sought to evaluate whether disease risk in 10 to 17 year olds differed between those who previously received DTwP from those who received DTaP.</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>A case-control study among individuals born from 1994 to 1999 who received 4 pertussis-containing vaccines during the first 2 years of life at Kaiser Permanente Northern California (KPNC). We separately compared pertussis polymerase chain reaction (PCR)-positive cases with PCR-negative and KPNC-matched controls. We assessed risk of pertussis relative to vaccine type in early childhood (4 DTwPs, mixed DTwP/DTaP, or 4 DTaPs) by using conditional logistic regression stratified for calendar time and adjusted for gender, race, medical clinic, and receipt of reduced antigen content acellular pertussis (Tdap) vaccine.</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>We compared 138 PCR-positive cases with 899 PCR-negative and 54 339 KPNC-matched controls. Teenagers who had received 4 DTwPs were much less likely to be pertussis PCR-positive than those who had received 4 DTaPs (odds ratio 5.63, 95% confidence interval 2.55–12.46) or mixed DTwP/DTaP vaccines (odds ratio 3.77, 95% confidence interval 1.57–9.07). Decreasing number of DTwP doses was significantly associated with increased pertussis risk (P &amp;lt; .0001).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p>Teenagers who received DTwP vaccines in childhood were more protected during a pertussis outbreak than were those who received DTaP vaccines.</jats:p></jats:sec>