title: Effectiveness of acellular pertussis vaccine in a routine immunization program: a multicenter, case-control study in Japan.
abstract: In 2008, the number of pertussis cases increased substantially among Japanese adolescents, despite high coverage with acellular pertussis vaccine (DTaP). This study examined the effectiveness of DTaP vaccine in the routine immunization program in Japan. Between April 2009 and October 2012, we conducted a multicenter, case-control study, and compared the history of DTaP vaccination between 55 newly diagnosed pertussis cases and 90 age- and sex-matched controls. DTaP vaccine history was obtained by a self-administered questionnaire completed by their parents or guardians. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for development of pertussis. DTaP vaccination of ≥1 dose revealed a significantly lower OR for pertussis (OR=0.20, 95%CI, 0.04-0.97), and the OR of complete vaccination (4 doses) was 0.22 (0.04-1.05). Even after limiting subjects to those whose vaccination status could be confirmed by the immunization records, the negative associations were observed. The decreasing ORs of 4-dose vaccinees remained, even among subjects who had received the fourth dose ≥9.2 years earlier (OR=0.11, 95%CI, 0.01-1.02). In conclusion, DTaP vaccination had a preventive effect for pertussis. Effectiveness was observed even 9 or more years after the final dose.
authors.affiliation: Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. Electronic address: satop@med.osaka-cu.ac.jp.
authors.forename: Satoko
authors.initials: S
authors.lastname: Ohfuji
authors.affiliation: Section of Pediatrics, Department of Medicine, Fukuoka Dental College, 2-15-1, Tamura, Sawara-ku, Fukuoka 814-0193, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Okada
authors.affiliation: Department of Pediatrics, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Field Epidemiology Training Program, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Preventive Medicine, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Hara
authors.affiliation: Sotobo Children's Clinic, Medical Corporation Shigyo-no-kai, 1880-4, Izumi, Misaki-cho, Isumi 299-4503, Chiba, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Kuroki
authors.affiliation: Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan; Clinical Epidemiology Research Center, Medical Co. LTA, 6-18, Ten-ya-machi, Hakata-ku, Fukuoka 812-0025, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hirota
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D010567:Pertussis Vaccine / Q000276:immunology*; D012307:Risk Factors; D014611:Vaccination; D014917:Whooping Cough / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D010567:Pertussis Vaccine
keywords: Case-control study; DTaP vaccine; Effectiveness; Pertussis; Risk factors