Pertussis antibodies and vaccination coverage among healthcare professionals in Brazil is inadequate: A cross-sectional serological study

Worldwide, tetanus-diphtheria-acellular pertussis (Tdap) vaccination coverage of healthcare professionals (HCPs) is below 40%, but this data is not available for Brazil. We hypothesize that a high number of HCPs are not immune to pertussis in Brazil. Main objective was to determine the seroprevalenc...

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Published in:Vaccine 2023-09, Vol.41 (39), p.5769-5774
Main Authors: Cardona, Rita Soares Barbosa, Weckx, Lily Yin, de Moraes-Pinto, Maria Isabel, Ramos, Bárbara Cristina Ferreira, Dos Santos, Andréia Regina Augusto, Spina, Fernanda Garcia, de Araújo, Beatriz Collaço, Clemens, Ralf, Clemens, Sue Ann Costa
Format: Article
Language:English
Subjects:
Antibodies
Chi-square test
Confidence intervals
Diphtheria
Health care
Hospitals
Immunization
Immunoglobulin G
Immunoglobulins
Infections
Medical personnel
Pertussis
Pertussis toxin
Regression analysis
Serology
Sociodemographics
Statistical analysis
Tetanus
Toxins
Vaccination
Vaccines
Whooping cough
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cited_by cdi_FETCH-LOGICAL-c337t-cd6200312e8745e3737c9a5cd039293936993c10f6132ae57c15d93f7fde6fc33
cites cdi_FETCH-LOGICAL-c337t-cd6200312e8745e3737c9a5cd039293936993c10f6132ae57c15d93f7fde6fc33
container_end_page 5774
container_issue 39
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container_title Vaccine
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creator Cardona, Rita Soares Barbosa
Weckx, Lily Yin
de Moraes-Pinto, Maria Isabel
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de Araújo, Beatriz Collaço
Clemens, Ralf
Clemens, Sue Ann Costa
description Worldwide, tetanus-diphtheria-acellular pertussis (Tdap) vaccination coverage of healthcare professionals (HCPs) is below 40%, but this data is not available for Brazil. We hypothesize that a high number of HCPs are not immune to pertussis in Brazil. Main objective was to determine the seroprevalence of anti-pertussis toxin (anti-PT IgG) among HCPs. Secondary objectives were to evaluate Tdap vaccination coverage, to assess predictive factors associated with anti-PT IgG, and to estimate the decay of anti-PT IgG and time to Tdap vaccination. Observational cross-sectional serological study in 352 HCPs who worked at São Paulo Hospital - Federal University of São Paulo (UNIFESP) in 2020, approved by UNIFESP Ethics Committee. Data collected included sociodemographics, knowledge about Tdap, and vaccination status. Anti-PT IgG were quantified by ELISA: 50 IU/mL high positivity, indicating recent B. pertussis infection or Tdap vaccination, and > 100 IU/mL as acute B. pertussis infection or Tdap vaccination in the previous year. Comparisons were done by Chi-square test, multivariable logistic regression, and Pearsońs correlation, at 5% p-level. 331/352 HCPs were not aware the Brazilian National Immunization Program recommends Tdap for all HCPs and pregnant women. 68/339 HCPs received Tdap (mean 3.1 ± 2.0 years). 55/352 were seronegative for pertussis, all unvaccinated. 56/271 with no history of Tdap vaccination had high positivity. The probability of anti-PT IgG > 50 IU/mL was 11.5 times higher in Tdap vaccinated HCPs than in non-vaccinated (p 
doi_str_mv 10.1016/j.vaccine.2023.08.008
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We hypothesize that a high number of HCPs are not immune to pertussis in Brazil. Main objective was to determine the seroprevalence of anti-pertussis toxin (anti-PT IgG) among HCPs. Secondary objectives were to evaluate Tdap vaccination coverage, to assess predictive factors associated with anti-PT IgG, and to estimate the decay of anti-PT IgG and time to Tdap vaccination. Observational cross-sectional serological study in 352 HCPs who worked at São Paulo Hospital - Federal University of São Paulo (UNIFESP) in 2020, approved by UNIFESP Ethics Committee. Data collected included sociodemographics, knowledge about Tdap, and vaccination status. Anti-PT IgG were quantified by ELISA: &lt;10 IU/mL seronegative and ≥ 10-1000 IU/mL seropositive. Titers ≥ 10-50 IU/mL were classified low positivity, indicating no recent B. pertussis infection or Tdap vaccination; &gt;50 IU/mL high positivity, indicating recent B. pertussis infection or Tdap vaccination, and &gt; 100 IU/mL as acute B. pertussis infection or Tdap vaccination in the previous year. Comparisons were done by Chi-square test, multivariable logistic regression, and Pearsońs correlation, at 5% p-level. 331/352 HCPs were not aware the Brazilian National Immunization Program recommends Tdap for all HCPs and pregnant women. 68/339 HCPs received Tdap (mean 3.1 ± 2.0 years). 55/352 were seronegative for pertussis, all unvaccinated. 56/271 with no history of Tdap vaccination had high positivity. The probability of anti-PT IgG &gt; 50 IU/mL was 11.5 times higher in Tdap vaccinated HCPs than in non-vaccinated (p &lt; 0.001). There was a weak but significant correlation between anti-PT IgG and interval of Tdap vaccination (r = 0.404; p = 0.001). Anti-PT IgG dropped 5 IU/mL/year (p = 0.001). Better education of HCPs on needs and benefits of Tdap vaccination is critical. Goals must be to improve HCPs vaccination coverage.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2023.08.008</identifier><identifier>PMID: 37573201</identifier><language>eng</language><publisher>Netherlands: Elsevier Limited</publisher><subject>Antibodies ; Chi-square test ; Confidence intervals ; Diphtheria ; Health care ; Hospitals ; Immunization ; Immunoglobulin G ; Immunoglobulins ; Infections ; Medical personnel ; Pertussis ; Pertussis toxin ; Regression analysis ; Serology ; Sociodemographics ; Statistical analysis ; Tetanus ; Toxins ; Vaccination ; Vaccines ; Whooping cough</subject><ispartof>Vaccine, 2023-09, Vol.41 (39), p.5769-5774</ispartof><rights>Copyright © 2023 Elsevier Ltd. All rights reserved.</rights><rights>2023. 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Titers ≥ 10-50 IU/mL were classified low positivity, indicating no recent B. pertussis infection or Tdap vaccination; &gt;50 IU/mL high positivity, indicating recent B. pertussis infection or Tdap vaccination, and &gt; 100 IU/mL as acute B. pertussis infection or Tdap vaccination in the previous year. Comparisons were done by Chi-square test, multivariable logistic regression, and Pearsońs correlation, at 5% p-level. 331/352 HCPs were not aware the Brazilian National Immunization Program recommends Tdap for all HCPs and pregnant women. 68/339 HCPs received Tdap (mean 3.1 ± 2.0 years). 55/352 were seronegative for pertussis, all unvaccinated. 56/271 with no history of Tdap vaccination had high positivity. The probability of anti-PT IgG &gt; 50 IU/mL was 11.5 times higher in Tdap vaccinated HCPs than in non-vaccinated (p &lt; 0.001). There was a weak but significant correlation between anti-PT IgG and interval of Tdap vaccination (r = 0.404; p = 0.001). 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source ScienceDirect Journals
subjects Antibodies
Chi-square test
Confidence intervals
Diphtheria
Health care
Hospitals
Immunization
Immunoglobulin G
Immunoglobulins
Infections
Medical personnel
Pertussis
Pertussis toxin
Regression analysis
Serology
Sociodemographics
Statistical analysis
Tetanus
Toxins
Vaccination
Vaccines
Whooping cough
title Pertussis antibodies and vaccination coverage among healthcare professionals in Brazil is inadequate: A cross-sectional serological study
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