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Pertussis vaccines: WHO position paper, August
2015†- Recommendations
1. WHO position
The main aim of pertussis vaccination is to reduce the risk of severe pertussis in infants and young children, due to the
high morbidity and mortality caused by the disease in this age group. All children worldwide, including HIV-positive individuals, should be immunized against pertussis.
Every country should seek to achieve early and timely vaccination initiated at 6 weeks and no later than 8 weeks of age, and maintain high coverage (>=90%) with at least 3 doses of assured quality pertussis vaccine at all levels (national and subnational). This will ensure high levels of protection in children in the <5 year age group.
Any reduction in overall coverage can lead to an increase in cases of pertussis.
2. Choice of vaccines
Protection against severe pertussis in infancy and early child-hood can be obtained after a primary series of vaccination with either wP or aP vaccine [1].
Although local and systemic reactogenicity are more commonly associated with wP-containing vaccines, both aP-containing and wP-containing vaccines have excellent safety records [2]. The reac-togenicity of wP vaccines is significantly reduced when given inearly short timeframe schedules. Available evidence indicates that licensed aP and wP vaccines have equivalent initial effectiveness in preventing disease in the first year of life, but that there is more rapid waning of immunity,and possibly a reduced impact on transmission, with aP relative to wP vaccines. When considering a switch from wP to aP vaccines for the primary series, the overall goal of the national immunization programme needs to be considered. Disease-related mortality in the first year of life can be significantly reduced using a primary series of either wP or aP vaccination, whereas reactivation of the protection of older children or adults against symptomatic pertussis require speriodic boosting with the less reactogenic aP vaccines.National programmes currently administering wP vaccination should continue to use wP vaccines for primary vaccination series [3].
References
[1] Grading of scientific evidence—Table 1: efficacy/effectiveness of pertus-sis vaccines in immunocompetent infants and children. Available at:
http://www.who.int/immunization/posi.../pertussisgrad efficacy[accessed October 23, 2015].
[2] Grading of scientific evidence—Table 2: safety of pertussis vaccines inimmunocompetent infants and children. Available at:
http://www.who.int/immunization/posi...ssisgradsafety [accessed October 23,2015].
[3] Grading of scientific evidence—Table 3: evidence to recommendationstable: what is the effect of wP vaccine on clinically important outcomesand harms, compared to aP vaccine? Available at:
http://www.who.int/immunization/position papers/pertussis grad evidence recommendations[accessed October 23, 2015].
P.S.: daca la linkurile de mai sus nu va duc la pagina corespunzatoare, incercati cu google (de ex, la [2] scrieti pe google ultima parte: 'pertussis grad safety who').