Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia

Background: In Latin America, there are few studies of the impact of vaccination against diphtheria, tetanus, and pertussis. We estimate the impact of infant and maternal vaccination on the incidence of these diseases in Colombia. Design and methods: an interrupted time series study analyzing the i...

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Autores principales:	María Cristina Hoyos, Doracelly Hincapié-Palacio, Jesus Ochoa, Alba León
Formato:	article
Lenguaje:	EN
Publicado:	PAGEPress Publications 2021
Materias:	Incidence immunization programs interrupted time series analysis diphtheria-tetanus-pertussis vaccine Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/6e87ec50e1d34affbae9c28ae9340c78
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spelling	oai:doaj.org-article:6e87ec50e1d34affbae9c28ae9340c782021-11-04T08:59:42ZImpact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia10.4081/jphr.2021.25882279-90282279-9036https://doaj.org/article/6e87ec50e1d34affbae9c28ae9340c782021-11-01T00:00:00Zhttps://jphres.org/index.php/jphres/article/view/2588https://doaj.org/toc/2279-9028https://doaj.org/toc/2279-9036 Background: In Latin America, there are few studies of the impact of vaccination against diphtheria, tetanus, and pertussis. We estimate the impact of infant and maternal vaccination on the incidence of these diseases in Colombia. Design and methods: an interrupted time series study analyzing the incidence before and after of vaccination with DwPT (1975-2018) and with Tdap in pregnant women (2008-2018). A segmented regression model with negative binomial distribution estimated the change in level and trend of the predicted incidence ratio after vaccination in relation to the incidence if vaccination had not been started (IRR), using a Prais Winsten regression. Results: The pertussis IRR decreased immediately after the start of childhood vaccination (0.91, p=0.51), but this was only significant (1.01, p<0.001) along with the trend per year, after the start of maternal vaccination (0.98, p<0.001). In the absence of vaccination, the incidence would not have been reduced. Neonatal tetanus had the highest rate of change with significant reduction -1.69 - CI 95%: -2.91, -0.48). The trend after vaccination was the highest with an annual reduction of 19% (0.81, p=0.001). The change in incidence of diphtheria was significant, although slow (-0.02 - CI 95%: -0.04, -0.004). The sustained effect in the post-vaccination period was smaller (0.95, p=0.79). Conclusions: Childhood and maternal vaccination markedly reduced the incidence of pertussis and neonatal tetanus. It is necessary to maintain optimal vaccination coverage and surveillance, within an integrated elimination plan, which prevents the resurgence of these diseases. María Cristina HoyosDoracelly Hincapié-PalacioJesus OchoaAlba León PAGEPress PublicationsarticleIncidenceimmunization programsinterrupted time series analysisdiphtheria-tetanus-pertussis vaccinePublic aspects of medicineRA1-1270ENJournal of Public Health Research (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Incidence immunization programs interrupted time series analysis diphtheria-tetanus-pertussis vaccine Public aspects of medicine RA1-1270
spellingShingle	Incidence immunization programs interrupted time series analysis diphtheria-tetanus-pertussis vaccine Public aspects of medicine RA1-1270 María Cristina Hoyos Doracelly Hincapié-Palacio Jesus Ochoa Alba León Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia
description	Background: In Latin America, there are few studies of the impact of vaccination against diphtheria, tetanus, and pertussis. We estimate the impact of infant and maternal vaccination on the incidence of these diseases in Colombia. Design and methods: an interrupted time series study analyzing the incidence before and after of vaccination with DwPT (1975-2018) and with Tdap in pregnant women (2008-2018). A segmented regression model with negative binomial distribution estimated the change in level and trend of the predicted incidence ratio after vaccination in relation to the incidence if vaccination had not been started (IRR), using a Prais Winsten regression. Results: The pertussis IRR decreased immediately after the start of childhood vaccination (0.91, p=0.51), but this was only significant (1.01, p<0.001) along with the trend per year, after the start of maternal vaccination (0.98, p<0.001). In the absence of vaccination, the incidence would not have been reduced. Neonatal tetanus had the highest rate of change with significant reduction -1.69 - CI 95%: -2.91, -0.48). The trend after vaccination was the highest with an annual reduction of 19% (0.81, p=0.001). The change in incidence of diphtheria was significant, although slow (-0.02 - CI 95%: -0.04, -0.004). The sustained effect in the post-vaccination period was smaller (0.95, p=0.79). Conclusions: Childhood and maternal vaccination markedly reduced the incidence of pertussis and neonatal tetanus. It is necessary to maintain optimal vaccination coverage and surveillance, within an integrated elimination plan, which prevents the resurgence of these diseases.
format	article
author	María Cristina Hoyos Doracelly Hincapié-Palacio Jesus Ochoa Alba León
author_facet	María Cristina Hoyos Doracelly Hincapié-Palacio Jesus Ochoa Alba León
author_sort	María Cristina Hoyos
title	Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia
title_short	Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia
title_full	Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia
title_fullStr	Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia
title_full_unstemmed	Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia
title_sort	impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in colombia
publisher	PAGEPress Publications
publishDate	2021
url	https://doaj.org/article/6e87ec50e1d34affbae9c28ae9340c78
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Impact of childhood and maternal vaccination against diphtheria, tetanus, and pertussis in Colombia

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