Background Pertussis is a contagious respiratory disease. Maternal tetanus–diphtheria–acellular pertussis vaccination during pregnancy has been recommended by the United States Centres for Disease Control (US CDC) Advisory Committee on Immunization Practices (ACIP) for unvaccinated pregnant women since October 2011 to prevent infection among infants; in 2012, ACIP extended this recommendation to every pregnancy, regardless of previous vaccination status. The population-level effect of these recommendations on infant pertussis is unknown. This study aimed to examine the impact of the 2011/2012 ACIP pertussis recommendation on pertussis incidence and mortality among US infants. Methods We used monthly data on pertussis deaths among infants aged <1 year between January 2005 and December 2017 in the CDC Death Data and yearly infant pertussis incidence data from the CDC National Notifiable Disease Surveillance System to perform an interrupted time series analysis, accounting for the passage of the Affordable Care Act. Results This study included 156 months of data. A potential decline in trend in infant pertussis incidence was noted during the post-recommendations period. No appreciable differences in trend were found in population-level infant pertussis mortality after the guideline changes in both adjusted and unadjusted models. Results were similar for all mortality sensitivity analyses. Conclusions The 2011/2012 ACIP maternal pertussis vaccination recommendations were not associated with a population-level change in the trend in mortality, but were potentially associated with a decrease in incidence in the USA between 2005 and 2017.

中文翻译：

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美国孕产妇百日咳疫苗接种建议对婴儿百日咳发病率和死亡率的影响：间断时间序列分析

背景 百日咳是一种传染性呼吸道疾病。自 2011 年 10 月起，美国疾病控制中心 (US CDC) 免疫实践咨询委员会 (ACIP) 建议未接种疫苗的孕妇在怀孕期间接种破伤风-白喉-无细胞百日咳疫苗，以预防婴儿感染；2012 年，ACIP 将这一建议扩展到每次怀孕，无论之前的疫苗接种情况如何。这些建议对婴儿百日咳的人群影响尚不清楚。本研究旨在探讨 2011/2012 ACIP 百日咳建议对美国婴儿百日咳发病率和死亡率的影响。方法 我们使用 CDC 死亡数据中 2005 年 1 月至 2017 年 12 月期间 1 岁以下婴儿百日咳死亡的月度数据和 CDC 国家法定疾病监测系统的年度婴儿百日咳发病率数据进行中断时间序列分析，考虑了《平价医疗法案》的通过。结果 本研究包含 156 个月的数据。在建议后期间，婴儿百日咳发病率趋势可能下降。在调整和未调整模型中指南发生变化后，人群水平的婴儿百日咳死亡率没有发现明显的趋势差异。所有死亡率敏感性分析的结果相似。结论 2011/2012 年 ACIP 孕产妇百日咳疫苗接种建议与死亡率趋势的人口水平变化无关，但可能与 2005 年至 2017 年美国发病率下降有关。