Vaccination Status Impacts Severity and Duration of Pertussis

Abstract

Research Article| October 01 2014 Vaccination Status Impacts Severity and Duration of Pertussis AAP Grand Rounds (2014) 32 (4): 38. https://doi.org/10.1542/gr.32-4-38 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Vaccination Status Impacts Severity and Duration of Pertussis. AAP Grand Rounds October 2014; 32 (4): 38. https://doi.org/10.1542/gr.32-4-38 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: pertussis, vaccination Source: Barlow RS, Reynolds LE, Cieslak PR, et al. Vaccinated children and adolescents with pertussis infections experience reduced illness severity and duration, Oregon, 2010–2012. Clin Infect Dis. 2014; 58(11): 1523– 1529; doi: https://doi.org/10.1093/cid/ciu156Google Scholar Investigators from multiple institutions analyzed data from an enhanced pertussis surveillance system in the Portland, OR metropolitan area to determine whether vaccination status had an impact on illness severity and cough duration. The study included participants 6 weeks to 18 years of age with confirmed Bordetella pertussis infection and onset between 2010–2012. Data collected included demographics, exposure to antimicrobials, and vaccination status. Information about severity of illness, cough duration, and exposures was obtained from interviews with community health nurses. Cases were considered severe if the infected individuals developed pneumonia, acute encephalopathy, seizures, or were hospitalized with any of these or other pertussis-related conditions. Participants who met the Advisory Committee on Immunization Practices (ACIP) recommended guidelines for their age were classified as up-to-date (UTD). Those who had received pertussis immunization, but did not meet ACIP recommendations for their age, were classified as vaccinated but not up-to-date (NUTD). Participants without documentation of immunization were classified as unvaccinated. Multivariate regression analyses were conducted to assess the independent association between immunization status and both severe disease and duration of cough during the pertussis illness. Among the 753 individuals with confirmed pertussis during the study period, 633 were between 6 weeks and 18 years old; 624 (98.7%) had vaccination history and illness data. The median age was 9 years; 52.5% were female. Among participants, 46% were UTD on pertussis immunization, 26.8% NUTD, and 27.4% were unvaccinated. Antimicrobial therapy was initiated in 74.8% of patients within 20 days of cough onset. Thirty-one (5%) participants were classified as having severe pertussis: 12 were hospitalized, 19 had radiographic evidence of pneumonia, 2 had acute encephalopathy, and 3 had seizures. The median follow-up of study participants was 56 person-days. Four hundred twenty (67%) stopped coughing during the study period and 117 (19%) were lost to follow-up. There were significantly decreased odds of hospitalization in those who were UTD and NUTD when compared to unvaccinated participants (OR = 0.1; 95% CI, .0–.6 for UTD, and OR = 0.1; 95% CI, .0–.9 for NUTD, respectively). After adjusting for age, ever-vaccinated patients (UTD + NUTD) were 5 times less likely to be hospitalized and 2.5 times less likely to develop severe illness than unvaccinated participants, (both results statistically significant). Modeling a 20-day cough duration, UTD patients were significantly more likely to have stopped coughing compared to unvaccinated patients. The authors conclude that in patients with pertussis, those who were previously vaccinated were less likely to develop severe illness compared to unvaccinated patients. In all age groups, vaccinated patients had decreased cough duration. Dr Foxworth has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Pertussis continues to be a problem in the... You do not currently have access to this content.