The effectiveness of maternal pertussis vaccination for protecting Aboriginal and Torres Strait Islander infants against infection, 2012–2017: A retrospective cohort study

Lisa McHugh, Heather A. D’Antoine, Mohinder Sarna, Michael J. Binks, Hannah C. Moore, Ross M. Andrews, Gavin F Pereira, Christopher C. Blyth, Paul Van Buynder, Karin Lust, Annette K. Regan

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    Abstract

    Objectives: To evaluate the effectiveness of maternal pertussis vaccination for preventing pertussis infections in Aboriginal and Torres Strait Islander infants under seven months of age. 

    Study design: Retrospective cohort study; analysis of linked administrative health data. 

    Setting, participants: Mother–infant cohort (Links2HealthierBubs) including all pregnant women who gave birth to live infants (gestational age ≥ 20 weeks, birthweight ≥ 400 g) in the Northern Territory, Queensland, and Western Australia during 1 January 2012 – 31 December 2017. 

    Main outcome measures: Proportions of women vaccinated against pertussis during pregnancy, rates of pertussis infections among infants under seven months of age, and estimated effectiveness of maternal vaccination for protecting infants against pertussis infection, each by Indigenous status. 

    Results: Of the 19 892 Aboriginal and Torres Strait Islander women who gave birth to live infants during 2012–2017, 7398 (37.2%) received pertussis vaccine doses during their pregnancy, as had 137 034 of 259 526 non-Indigenous women (52.8%; Indigenous v non-Indigenous: adjusted odds ratio, 0.66; 95% confidence interval [CI], 0.62–0.70). The annual incidence of notified pertussis infections in non-Indigenous infants declined from 16.8 (95% CI, 9.9–29) in 2012 to 1.4 (95% CI, 0.3–8.0) cases per 10 000 births in 2017; among Aboriginal and Torres Strait Islander infants, it declined from 47.6 (95% CI, 16.2–139) to 38.6 (95% CI, 10.6–140) cases per 10 000 births. The effectiveness of maternal vaccination for protecting non-Indigenous infants under seven months of age against pertussis infection during 2014–17 was 68.2% (95% CI, 51.8–79.0%); protection of Aboriginal and Torres Strait Islander infants was not statistically significant (36.1%; 95% CI, –41.3% to 71.1%). 

    Conclusions: During 2015–17, maternal pertussis vaccination did not protect Aboriginal and Torres Strait Islander infants in the NT, Queensland, and WA against infection. Increasing the pertussis vaccination rate among pregnant Aboriginal and Torres Strait Islander women requires culturally appropriate, innovative strategies co-designed in partnership with Indigenous organisations and communities.

    Original languageEnglish
    Pages (from-to)196-201
    Number of pages6
    JournalMedical Journal of Australia
    Volume220
    Issue number4
    Early online date2024
    DOIs
    Publication statusPublished - 4 Mar 2024

    Bibliographical note

    Funding Information:
    This investigation was supported by a National Health and Medical Research Council (NHMRC) Project Grant (GNT1141510) and operational funds provided by the Western Australia Department of Health. Lisa McHugh is supported by an NHMRC EL1 Investigator Grant (GNT2016407) at the University of Queensland. Annette K Regan was supported by an NHMRC Early Career Fellowship (GNT1138425). Hannah C Moore was supported by a Stan Perron Charitable Foundation People Fellowship. Christopher C Blyth was supported by an NHMRC Career Development Fellowship (GNT1111596) and NHMRC Investigator award (APP1173163). Michael J Binks was supported by an NHMRC Early Career Fellowship (GNT1088733) and an NHMRC‐funded Hot North (Improving Health Outcomes in the Tropical North) Fellowship (1131932). Gavin F Pereira was supported by NHMRC Project (GNT1099655) and Investigator Grants (GNT1173991), and by the Research Council of Norway through its Centres of Excellence funding scheme (GNT262700). The funding sources had no role in the planning, study design, data collection, analysis or interpretation, reporting or publication.

    Funding Information:
    This investigation was supported by a National Health and Medical Research Council (NHMRC) Project Grant (GNT1141510) and operational funds provided by the Western Australia Department of Health. Lisa McHugh is supported by an NHMRC EL1 Investigator Grant (GNT2016407) at the University of Queensland. Annette K Regan was supported by an NHMRC Early Career Fellowship (GNT1138425). Hannah C Moore was supported by a Stan Perron Charitable Foundation People Fellowship. Christopher C Blyth was supported by an NHMRC Career Development Fellowship (GNT1111596) and NHMRC Investigator award (APP1173163). Michael J Binks was supported by an NHMRC Early Career Fellowship (GNT1088733) and an NHMRC-funded Hot North (Improving Health Outcomes in the Tropical North) Fellowship (1131932). Gavin F Pereira was supported by NHMRC Project (GNT1099655) and Investigator Grants (GNT1173991), and by the Research Council of Norway through its Centres of Excellence funding scheme (GNT262700). The funding sources had no role in the planning, study design, data collection, analysis or interpretation, reporting or publication. We thank the Linkages Services Branch of Queensland Health and the data custodians of the Perinatal, Notifications and Other Communicable Infectious Diseases, and Immunisation Data collections; the Linkage and Client Services Teams at the Data Linkage Branch of the Western Australia Department of Health and the data custodians of the Midwives Notification System, the WA Antenatal Vaccination Database, and the WA Notifiable Infectious Diseases Database; and SA-NT DataLink and the NT Centre for Disease Control, and the data custodians of the NT Perinatal Trends, Communicable Infectious Diseases, and Immunisation Databases.

    Publisher Copyright:
    © 2024 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

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