Undervaccination with diphtheria, tetanus, and pertussis vaccine: National trends and association with pertussis risk in young children

Hum Vaccin Immunother. 2017 Apr 3;13(4):757-761. doi: 10.1080/21645515.2016.1249552. Epub 2016 Nov 18.

Abstract

Background: The high coverage for ≥3 pertussis vaccine doses among Taiwanese children might not imply timely vaccination. Recently, resurgence of pertussis and challenges with availability of DTaP-IPV-Hib prompted this study.

Methods: In the 1996-2012 national birth cohort, we calculated the prevalence and days of undervaccination against pertussis by age 36 months. We also compared the odds of undervaccination in each laboratory-confirmed pertussis patient at ages 3-35 months with sex-, residence-, and age-matched controls from the general population, using conditional logistic regression.

Results: The prevalence of undervaccination was 60.6% (median 16 days) and decreasing (p < 0.0001). Among 145 cases and 2,900 controls, 58 (40.0%) and 721 (24.9%) were undervaccinated (OR 2.28, 95% CI 1.57-3.31). The attributable risk percent was 22.5% (95% CI 14.5-27.9).

Conclusions: Undervaccination was decreasing. Approximately up to one-fifth pertussis cases in children aged 3-35 months could have been prevented with on-time vaccination.

Keywords: Immunization schedules; Taiwan; pertussis; timeliness; undervaccination; vaccine shortage.

MeSH terms

  • Child, Preschool
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage*
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / immunology*
  • Female
  • Humans
  • Immunization / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Risk Factors
  • Taiwan / epidemiology
  • Whooping Cough / epidemiology*
  • Whooping Cough / prevention & control*

Substances

  • Diphtheria-Tetanus-acellular Pertussis Vaccines