Comparison of whole-cell versus acellular pertussis vaccine effectiveness in school clusters of pertussis, France, 2013 - 02/08/20

Doi : 10.1016/j.medmal.2020.07.004

E. Belchior ^a,⁎ , S. Guillot ^b, I. Poujol ^c, A. Thabuis ^c, L. Chouin ^d, M. Martel ^e, E. Delisle ^f, C. Six ^g, N. Guiso ^b, D. Lévy-Bruhl ^a
^a Unité des infections respiratoires et vaccination, direction des maladies infectieuses, santé publique France, Saint-Maurice, France
^b Centre national de référence de la coqueluche et autres bordetelloses, institut Pasteur, Paris, France
^c Cellule Auvergne-Rhône-Alpes, direction des régions (DiRe), santé publique France, Lyon, France
^d Cellule Grand Est, DiRe, santé publique France, Nancy, France
^e Cellule Normandie, DiRe, santé publique France, Rouen, France
^f Cellule Occitanie, DiRe, santé publique France, Montpellier, France
^g Cellule Provence-Alpes-Côte-D’azur et Corse, DiRe, santé publique France, Marseille, France

^⁎Corresponding author at: Unité des infections respiratoires et vaccination (REV), direction des maladies infectieuses (DMI), santé publique France, 12, rue du Val d’Osne, 94415 Saint-Maurice cedex, France.Unité des infections respiratoires et vaccination (REV), direction des maladies infectieuses (DMI), santé publique France12, rue du Val d’OsneSaint-Maurice cedex94415France

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Highlights

•	In 2013, the French national agency for public health (Santé publique France) and its regional units performed a prospective study to compare the effectiveness and protection duration of whole-cell versus acellular pertussis vaccines.
•	Seven investigations of epidemic clusters in a cohort of 305 school children from the 2nd grade to the 6th grade resulted in the identification of 102 clinical cases of pertussis, including 10 cases biologically confirmed by Bordetella pertussis specific PCR.
•	The risk of pertussis when vaccinated with an acellular vaccine alone was 1.6 (RR=1.6; 95% CI=1.1–2.5) times higher than when vaccinated with a whole-cell vaccine or using a combined schedule.
•	The limited duration of protection conferred by the acellular vaccine is in favor of the introduction of the pertussis booster for 6-year-old children in 2013.

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Abstract

Objectives and method

We conducted a prospective study in 2013 to compare the whole-cell versus acellular pertussis vaccines effectiveness and duration of protection, following the occurrence of pertussis clusters.

Results

During seven school outbreaks, we identified 102 clinical pertussis cases, including 10 cases biologically confirmed by Bordetella pertussis specific PCR, among a cohort of 305 children in 2nd to 6th grade. The risk of pertussis when vaccinated with an acellular vaccine alone was 1.6 (RR=1.6; 95% CI=1.1–2.5) times higher than when vaccinated with a whole-cell vaccine or using a combined schedule.