CONICET | Buscador de Institutos y Recursos Humanos

AbstractBACKGROUND: Pertussis is a vaccine preventable respiratory disease that may cause death mainly in infants. The schedules for primary pertussis vaccination are set in each country by the local health authorities. Several different schedules meet World Health Organization recommendations, 2-4-6mo, 6-10-14wk, 2-3-4mo, and 3-4-5mo being the most commonly used worldwide. In this work, we analyze the benefits of changing the vaccination schedule to control the disease.METHOD: We used an age-structured deterministic mathematical model for pertussis transmission to compute the incidences for the four above-mentioned schedules. Different vaccination coverages and vaccine effectiveness levels were considered. Immunization data from Argentina and Belgium were used.RESULTS: The highest reduction in incidence was obtained by adopting the 6-10-14wk schedule, reaching about a 36% reduction of 0-1y incidence with respect to the 2-4-6mo schedule. We show the dependence of this reduction on both vaccine effectiveness and coverage. The severe pertussis incidence decreased significantly when the first dose of the 2-4-6mo schedule was accelerated to 6wk. Finally, we estimated that the communication campaign adopted in Flanders (Belgium) to improve compliance with the vaccine schedule could lead to a reduction of 16% in severe pertussis incidence and about 7% in total incidence in infants.CONCLUSIONS: Our work highlights the use of mathematical modeling to quantify the benefits of the existing vaccination schedules and the strategies that could be implemented to improve their compliance. Our results indicated that the 6-10-14wk is the best schedule option and that the Belgium vaccination campaign significantly reduced the incidence of severe cases.

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