Factores que influyen en la adherencia a la vacuna contra la tosferina en mujeres embarazadas en Uruguay / Factors that influence the uptake of pertussis vaccine in pregnant women in Uruguay

Introducción: desde 2015 se ofrece la vacunación contra tosferina de modo universal y gratuito a mujeres embarazadas del Uruguay. Si bien es obligatoria, la cobertura vacunal, aún no es completa. Objetivos: conocer la prevalencia de mujeres embarazadas de dos hospitales públicos de Uruguay que recibieron vacuna dpaT en 2017 y determinar posibles factores que influyen en la adherencia a vacunarse. Métodos: estudio observacional, transversal, descriptivo, mediante encuestas a pacientes cursando puerperio inmediato. Resultados: se analizaron 884 encuestas (edad promedio 25,2 años; 16% adolescentes; la mayoría en pareja y educación secundaria incompleta). Se vacunaron 317 mujeres (36%). Dentro de los factores que se asociaron a la no vacunación se destacan: adolescencia (OR 1,88; IC 95% 1,24-2,85), no tener pareja (OR 1,40; IC 95% 1,04-1,85), no conocer la obligatoriedad de la vacuna (OR 9,44; IC 95% 6,63-13,45), no haber sido informada sobre los beneficios de la vacuna (OR 4; IC 95% 2,43-6,41) y no creer en el beneficio de las vacunas en el embarazo (OR 6,37; IC 95% 4,61-8,78). Discusión: la mayoría de las mujeres embarazadas no recibieron la vacuna dpaT ni tuvieron indicación médica. La falta de información sobre la obligatoriedad y su beneficio, y las creencias con respecto a la vacunación se asociaron a una disminución en la adherencia a la misma. Los profesionales de la salud que atienden mujeres gestantes deben recomendar e informar sobre el beneficio de la vacunación para ellas y el neonato y generar la percepción de riesgo necesaria, como una de las medidas para mejorar la cobertura vacunal.

Background: since 2015, pertussis vaccine has been offered universally and free of charge to pregnant women in Uruguay. Although it is mandatory, vaccination coverage is not yet complete. Aim: to study the pertussis vaccination coverage in 2017 in pregnant women in two state hospitals and to search for barriere for uptaking the vaccine. Methods: we conducted an observational, descriptive and transversal study, using a survey in patients undergoing immediate postpartum period. Results: 884 surveys were analyzed (mean age 25.2 years; 16% teenagers, most of them in a relationship and incomplete high school). 317 women (36%) were vaccinated. Main barriere for uptaking Tdap vaccine were: teenage and being single were associated with a greater risk for the uptake. Not being aware of the vaccine mandatoriness and not being informed about its benefits were associated with 9,44 and 4 higher risks for not uptaking the vaccine (IC 95% 6.63-13.45 and IC 95% 2.43-6.41, respectively). Not believing in the benefits of pertussis vaccine during pregnancy was associated with 6.37 higher risk (OR 6.37; IC 95% 4.61-8.78). Discussion: most pregnant women in this study during 2017 did not uptake pertussis vaccine and did not have medical indication for it. The lack of information about the obligation and benefits, and also patients' beliefs about the vaccination were identified as barriere. Health professionals who treat pregnant women should recommend and inform about the benefits of pertussis vaccine for women and the infant, and create the necessary perception of risk, in order to improve the vaccination coverage.

Factores que influyen en la adherencia a la vacuna contra la tosferina en mujeres embarazadas en Uruguay / Factors that influence the uptake of pertussis vaccine in pregnant women in Uruguay

INTRODUCCIÓN: Desde 2015 se ofrece la vacunación contra tosferina de modo universal y gratuito a mujeres embarazadas del Uruguay. Si bien es obligatoria, la cobertura vacunal, aún no es completa. OBJETIVOS: Conocer la prevalencia de mujeres embarazadas de dos hospitales públicos de Uruguay que recibieron vacuna dpaT en 2017 y determinar posibles factores que influyen en la adherencia a vacunarse. MÉTODOS: Estudio observacional, transversal, descriptivo, mediante encuestas a pacientes cursando puerperio inmediato. RESULTADOS: Se analizaron 884 encuestas (edad promedio 25,2 años; 16% adolescentes; la mayoría en pareja y educación secundaria incompleta). Se vacunaron 317 mujeres (36%). Dentro de los factores que se asociaron a la no vacunación se destacan: adolescencia (OR 1,88; IC 95% 1,24-2,85), no tener pareja (OR 1,40; IC 95% 1,04-1,85), no conocer la obligatoriedad de la vacuna (OR 9,44; IC 95% 6,63-13,45), no haber sido informada sobre los beneficios de la vacuna (OR 4; IC 95% 2,43-6,41) y no creer en el beneficio de las vacunas en el embarazo (OR 6,37; IC 95% 4,61-8,78). DISCUSIÓN: La mayoría de las mujeres embarazadas no recibieron la vacuna dpaT ni tuvieron indicación médica. La falta de información sobre la obligatoriedad y su beneficio, y las creencias con respecto a la vacunación se asociaron a una disminución en la adherencia a la misma. Los profesionales de la salud que atienden mujeres gestantes deben recomendar e informar sobre el beneficio de la vacunación para ellas y el neonato y generar la percepción de riesgo necesaria, como una de las medidas para mejorar la cobertura vacunal.

BACKGROUND: Since 2015, pertussis vaccine has been offered universally and free of charge to pregnant women in Uruguay. Although it is mandatory, vaccination coverage is not yet complete. AIM: To study the pertussis vaccination coverage in 2017 in pregnant women in two state hospitals and to search for barriere for uptaking the vaccine. METHODS: We conducted an observational, descriptive and transversal study, using a survey in patients undergoing immediate postpartum period. RESULTS: 884 surveys were analyzed (mean age 25.2 years; 16% teenagers, most of them in a relationship and incomplete high school). 317 women (36%) were vaccinated. Main barriere for uptaking Tdap vaccine were: teenage and being single were associated with a greater risk for the uptake. Not being aware of the vaccine mandatoriness and not being informed about its benefits were associated with 9,44 and 4 higher risks for not uptaking the vaccine (IC 95% 6.63-13.45 and IC 95% 2.43-6.41, respectively). Not believing in the benefits of pertussis vaccine during pregnancy was associated with 6.37 higher risk (OR 6.37; IC 95% 4.61-8.78). DISCUSSION: Most pregnant women in this study during 2017 did not uptake pertussis vaccine and did not have medical indication for it. The lack of information about the obligation and benefits, and also patients' beliefs about the vaccination were identified as barriere. Health professionals who treat pregnant women should recommend and inform about the benefits of pertussis vaccine for women and the infant, and create the necessary perception of risk, in order to improve the vaccination coverage.

Low tetanus-diphtheria-acellular pertussis (Tdap) vaccine coverage among healthcare workers in a quaternary university hospital in São Paulo, Brazil: need for continuous surveillance and implementation of active strategies

Abstract Introduction: Vaccination with tetanus-diphtheria-acellular pertussis (Tdap) has been recommended for healthcare workers (HCWs) by Brazilian Ministry of Health since November 2014. Objective: To describe the strategies implemented to improve Tdap uptake, cumulative vaccine coverage after each intervention, variables associated to Tdap vaccination, and reasons for non-vaccination among HCWs of the main building of a quaternary hospital attached to the Sao Paulo University Medical School. Methods: A list of HCWs eligible for pertussis vaccination was generated. From April to December 2015, the following interventions were implemented: note on intern journal reminding the importance of pertussis vaccination; email to the head nurses strengthening vaccine recommendations; lectures on pertussis and Tdap for physicians of Obstetrics and Neonatology Clinics; on-site vaccination by mobile teams at the Obstetrics, Neonatology, and Anesthesiology Clinics. Vaccine coverage was accessed at the end of each month. Multivariate Poisson regression model with a robust error variance was used to evaluate variables associated with Tdap vaccination. Reasons for non-vaccination were evaluated from January to May 2017 through phone calls for HCWs who had not received Tdap. Results: The study included 456 HCWs. After the interventions, Tdap coverage raised from 2.8% to 41.2%. In the multivariate analysis, occupation (physician), working place (obstetrics or anesthesiology) and influenza vaccination in 2015 were independently associated to Tdap vaccination. The main reason for non-vaccination was unawareness of Tdap recommendations. Conclusions: Tdap uptake among HCWs was low in our hospital. Providing vaccination at convenient places/times for HCW seems to be the most efficient strategy to increase vaccine uptake.

A survey of the domestic epidemiological characteristics and clinical manifestations of pertussis

PURPOSE: This report describes the results of a survey of the characteristics of pertussis in children from a single institution and compares it to data from the Korea Centers of Disease Control (KCDC). METHODS: We retrospectively evaluated the medical records of 17 and 6 patients diagnosed with pertussis and parapertussis, respectively, at Soonchunhyang University Bucheon Hospital from January 2005 to January 2017. RESULTS: Of the 17 patients with pertussis, 9 were under 1 year of age (52.9%), 3 were aged between 1 and 10 years (17.6%), and 5 were over 10 years of age (29.4%). Seven patients (41.2%) had never received diphtheria-tetanus-acellular pertussis vaccines, of which 5 were infants below 2 months of age and 2 were 10 years old and lived in China. Four patients showed the initial symptoms of cough in China. The sources of infection were the parents (2 cases) and the siblings (8 cases). All patients showed prolonged severe cough and the average duration of cough was 26 days. Severe symptoms, including dyspnea, cyanosis, apnea, and seizures, were observed in the children under 2 months of age. According to the recent 10-year KCDC data, the highest rate of pertussis diagnosis was noted in infants (47.8%), followed by adolescents (18.7%). Six patients with parapertussis also presented with prolonged severe cough without any other severe symptoms. Lymphocytosis was not found, unlike the patients with pertussis. CONCLUSION: The possibility of pertussis and parapertussis should be considered among patients with prolonged severe cough, especially in infants and adolescents.

Systematic review and meta-analysis of pertussis epidemiology in Latin America and the Caribbean: 1980-2015 / Examen sistemático y metanálisis de las características epidemiológicas de la tos ferina en América Latina y el Caribe: 1980-2015 / Revisão sistemática e metanálise da epidemiologia da coqueluche na América Latina e Caribe: 1980 a 2015

Objectives In Latin America and the Caribbean (LAC), pertussis disease incidence has reportedly increased since 2000 despite high vaccine coverage. A systematic review of pertussis literature and a meta-analysis was conducted to understand the burden of disease in LAC. Methods A systematic literature review was completed, using relevant search terms. Original articles describing pertussis epidemiology and vaccine coverage in LAC published between 1980 and 2015 were identified. Applying a Bayesian meta-analysis random-effects model, we calculated pooled estimates and corresponding 95% credible intervals (95% CrIs) for pertussis incidence, case fatality ratio (CFR), pertussis prevalence among contacts, and coverage with three doses of diphtheria, tetanus, and pertussis (DTP) vaccine (DTP3). Results A total of 59 studies meeting our selection criteria were identified, representing 15 countries. Of the 59, 15 of them provided incidence data, with 7 of the 15 reporting a pertussis case definition. The pertussis incidence estimate for the 1980-1999 period was 17.8 cases per 100 000 persons (95% CrI: 5.9-29.7); for the 2000-2015 period, it was 2.5 cases per 100 000 persons (95% CrI: 1.8-3.2). For the 1980-2015 period, the CFR, in 19 studies reviewed, was 3.9% (95% CrI: 2.9%-4.9%); for that same period, in 5 studies reviewed, pertussis prevalence among contacts was 24.9% (95% CrI: 13.7%-36.1%). Pooled DTP3 vaccine coverage estimates, in a total of 20 studies reviewed for the following three time periods, were: 1980-1990, 72.4% (95% CrI: 64.6%-80.2%); 1991-2000, 79.0% (95% CrI: 66.1%-91.9%); and 2001-2015, 90.0% (95% CrI: 87.7%-92.3%). Conclusion A decrease in pertussis incidence and an achievement of moderately high DTP3 vaccine coverage since the early 2000s was observed. The review highlights the need for increased publication of pertussis data at the country level and for LAC as a whole in order to better understand the true burden of the disease. Application of a standardized case definition and use of active case finding would aid in obtaining more accurate estimates of the disease burden in LAC.

RESUMEN Objetivos En América Latina y el Caribe, la incidencia de la tos ferina habría aparentemente aumentado desde el 2000, a pesar de la alta cobertura de vacunación. Se realizó una revisión sistemática de la bibliografía sobre tos ferina y un metanálisis para conocer la carga de esta enfermedad en América Latina y el Caribe. Métodos. La revisión bibliográfica sistemática se realizó utilizando términos de búsqueda pertinentes. Se encontraron artículos originales que describían las características epidemiológicas de la tos ferina y la cobertura de vacunación en América Latina y el Caribe publicados entre 1980 y el 2015. Aplicando un modelo bayesiano de efectos aleatorios para el metanálisis, se obtuvieron estimaciones combinadas y los correspondientes intervalos de credibilidad del 95% (ICr) para la incidencia, la tasa de letalidad y la prevalencia entre contactos de la tos ferina, y la cobertura con tres dosis de vacuna contra la difteria, el tétanos y la tos ferina (DTP3). Resultados Se encontraron en total 59 estudios de 15 países que cumplían con los criterios de selección. De ellos, 15 proporcionaban datos sobre incidencia. Siete de estos 15 contenían una definición de caso de tos ferina. La incidencia estimada de tos ferina para el período 1980-1999 fue de 17,8 casos por 100 000 (ICr 95%: 5,9-29,7) y para el período 2000-2015, de 2,5 casos por 100 000 (ICr 95%: 1,8-3,2). En cuanto a la tasa de letalidad, para el período 1980-2015 en 19 estudios examinados fue de 3,9% (ICr 95%: 2,9%-4,9%); en el mismo período, en 5 estudios examinados la prevalencia de tos ferina entre los contactos fue de 24,9% (ICr 95%: 13,7%-36,1%). Las estimaciones combinadas de cobertura con DTP3 en un total de 21 estudios examinados para los siguientes tres períodos fueron: en 1980-1990, 72,4% (ICr 95%: 64,6%-80,2%); en 1991-2000, 79,0% (ICr 95%: 66,1%-91,9%) y en el 2001-2015, 90,0% (ICr 95%: 87,7%-92,3%). Conclusiones Se observó una disminución de la incidencia de la tos ferina y el logro de una cobertura moderadamente alta con la vacuna DTP3 desde principios del siglo XXI. En el examen se subraya la necesidad de incrementar la publicación de datos sobre la tos ferina en los países y en América Latina y el Caribe en su conjunto, para conocer mejor la verdadera carga de enfermedad. La adopción de una definición de caso normalizada y la búsqueda activa de casos ayudarán a obtener estimaciones más precisas de la carga de enfermedad en América Latina y el Caribe.

RESUMO Objetivos Há relatos de que a incidência de coqueluche na América Latina e Caribe (ALC) tem aumentado desde o ano 2000, apesar da alta cobertura vacinal. Realizamos uma revisão sistemática e metanálise da literatura sobre a coqueluche para compreender a carga da doença na ALC. Métodos. Fizemos uma revisão sistemática da literatura usando termos de pesquisa relevantes. Identificamos artigos originais, publicados entre 1980 e 2015, que descrevessem a epidemiologia da coqueluche e a cobertura vacinal na ALC. Aplicando um modelo Bayesiano de efeitos aleatórios para a metanálise, calculamos estimativas agrupadas e seus correspondentes intervalos de credibilidade de 95% (CrIs 95%) para a incidência de coqueluche, a taxa de letalidade, a prevalência de coqueluche entre os contatos e a cobertura com três doses da vacina combinada para difteria, tétano e coqueluche (DTP3). Resultados Identificamos um total de 59 estudos que cumpriram os nossos critérios de seleção, representando 15 países. Destes 59, 15 apresentaram dados sobre a incidência, e 7 dos 15 apresentaram uma definição de "caso de coqueluche". A incidência estimada da coqueluche no período de 1980 a 1999 foi de 17,8 casos por 100.000 pessoas (CrI 95%: 5,9-29,7); no período de 2000 a 2015, foi de 2,5 casos por 100.000 pessoas (CrI 95%: 1,8-3,2). No período de 1980 a 2015, a taxa de letalidade, em 19 estudos revistos, foi de 3,9% (CrI 95%: 2,9%-4,9%); neste mesmo período, em 5 estudos revistos, a prevalência de coqueluche entre os contatos foi de 24,9% (CrI 95%: 13,7%-36,1%). A cobertura vacinal agrupada com DTP3, em um total de 21 estudos examinados nos seguintes três períodos, foi estimada em: 1980 a 1990, 72,4% (CrI 95%: 64,6%-80,2%); 1991 a 2000, 79,0% (CrI 95%: 66,1%-91,9%); 2001 a 2015, 90,0% (CrI 95%: 87,7%-92,3%). Conclusões Foi observada uma redução na incidência de coqueluche e uma cobertura vacinal com DTP3 relativamente alta desde o início da década de 2000. Esta revisão destaca a necessidade de melhorar a publicação de dados sobre a coqueluche ao nível nacional e na ALC como um todo, a fim de promover uma melhor compreensão sobre a verdadeira carga da doença. O uso de uma definição padronizada de "caso de coqueluche" e a busca ativa de casos ajudaria na obtenção de estimativas mais precisas da carga da doença na ALC.

Tetanus–diphtheria–acellular pertussis vaccination for adults: an update

Although tetanus and diphtheria have become rare in developed countries, pertussis is still endemic in some developed countries. These are vaccine-preventable diseases and vaccination for adults is important to prevent the outbreak of disease. Strategies for tetanus, diphtheria, and pertussis vaccines vary from country to country. Each country needs to monitor consistently epidemiology of the diseases and changes vaccination policies accordingly. Recent studies showed that tetanus–diphtheria–acellular pertussis vaccine for adults is effective and safe to prevent pertussis disease in infants. However, vaccine coverage still remains low than expected and seroprevalence of protective antibodies levels for tetanus, diphtheria, and pertussis decline with aging. The importance of tetanus–diphtheria–acellular pertussis vaccine administration should be emphasized for the protection of young adult and elderly people also, not limited to children.

Avaliação da cobertura vacinal em crianças de um a dois anos pelo Monitoramento Rapido de Cobertura em Vespasiano / Evaluation of vaccination coverage in children one to two year old using the Fast Coverage Monitoring Method in the city of Vespasiano

Introdução:A cobertura vacinal pode ser determinada por três métodos distintos: administrativo, inquérito e o Monitoramento Rápido de Cobertura (MRC). No Brasil, o método mais utilizado é o administrativo. Porém, considerando-se a heterogeneidade nos resultados, o Ministério da Saúde institucionalizou o MRC como a principal ferramenta para verificação rotineira da situação vacinal. Este estudo avaliou se as coberturas para tetravalente, febre amarela e influenza estavam de acordo com o preconizado pelo Programa Nacional de Imunizações a partir da realização de um MRC. Trata-se de um estudo populacional descritivo. Métodos:O cálculo amostral baseou-se no Protocolo de MRC do Ministério da Saúde e constituiu-se de crianças de 1 a 2 anos, residentes em áreas de abrangência de duas unidades de saúde do bairro Célvia, em Vespasiano. Resultados:A cobertura encontrada para febre amarela e tetravalente no Célvia 1 foi de 100% e no Célvia 2 de 96%. Em relação à influenza, a cobertura variou de 68% no Célvia 1 a 75% no Célvia 2. Não houve diferença estatística significativa entre os valores, com p variando de 0,754 a 1,000. Conclusão:As coberturas obtidas pelo Monitoramento Rápido de Cobertura para as vacinas febre amarela e tetravalente em ambas as áreas estudadas corresponderam à meta operacional preconizada pelo PNI (95%). Em relação à vacina Influenza, observou-se cobertura vacinal abaixo do recomendado (80%) nas duas unidades de saúde. Embora não seja possível fazer uma comparação estatística, observou-se diferença entre a cobertura administrativa e o MRC em relação à vacina Influenza.

Introduction:Vaccination coverage can be determined through three different methods: Administrative, Baseline Study and rapid Monitoring of Vaccination Coverage (MVC). From those, Administrative method is the most used in Brazil. However, due to heterogeneity in vaccination coverage results, MVC was recommended by the Ministry of Health as a supervisory tool to verify vaccination status. This population-based descriptive study aimed at evaluating if vaccination coverage for tetravalent, yellow fever and influenza vaccines were in accordance with Brazil's National Immunization Program (NIP) recommendations when MVC was used. Method:Sample calculation, having the MVC Protocol from the Ministry of Health as a basis, included children aged 1 to 2 years old, who lived in areas covered by two different outpatient care units (Célvia 1 and Célvia 2) in Célvia neighborhood, Vespasiano, Brazil. Results:Yellow fever and MMR vaccines coverage was 100% at Célvia 1 and 96% at Célvia 2. Influenza coverage has varied from 68% at Célvia 1 to 75% at Célvia 2. Those values showed no significant statistical difference, with p-value varying from 0.754 to 1.000. Conclusion:Use of MVC at Célvia 1 and Célvia 2 showed that yellow fever and tetravalent vaccines coverage reached NIP target (95%). A different result was shown for influenza vaccine, whose coverage was under the recommended target (80%) in both outpatient care units. A difference between administrative coverage and MVC was found, although a statistical comparison is not possible.

Consenso para el diagnóstico clínico y microbiológico y la prevención de la infección por Bordetella pertussis / Consensus on the clinical and microbiologic diagnosis of Bordetella pertussis, and infection prevention

La tos ferina sigue siendo responsable de una carga de enfermedad importante en el mundo. Aunque la implementación del uso de la vacuna contra esta enfermedad ha disminuido en gran medida el número de casos en la población pediátrica, se ha observado que la inmunidad inducida por la vacuna y por la infeccion natural disminuye con el tiempo lo que hace nuevamente susceptibles a adolescentes y adultos jóvenes que pueden transmitir la enfermedad a lactantes no inmunizados o con esquema de vacunación incompleto. Este documento, resultado de la reunión de un grupo internacional de expertos en la Ciudad de México, ha analizado la información médica reciente para establecer el estado actual de la epidemiología, diagnóstico, vigilancia y, especialmente, el valor de la dosis de refuerzo con dTpa en adolescentes y adultos como estrategia de prevención de tos ferina en México.

Pertussis continues to be responsible for a significant disease burden worldwide. Although immunization practices have reduced the occurrence of the disease among children, waning vaccine- and infection-induced immunity still allows the disease to affect adolescents and adults who, in turn, can transmit the disease to non-immunized or partially immunized infants. This document is the result of a meeting in Mexico City of international experts who analyzed recent medical information in order to establish the current status of the epidemiology, diagnosis and surveillance of pertussis and, especially, the value of the dTpa booster dose in adolescents and adults as a pertussis prevention strategy in Mexico.

Immunogenicity and safety of primary and secondary DTaP booster vaccination

Diphtheria-tetanus-acellular pertussis (DTaP) vaccination must currently be administered three times starting at 2 months of age, at intervals of two months, with the first and second boosters administered at 15 to 8 months and 4 to 6 years of age. A high rate of vaccination is maintained, but studies of the efficiency and safety of booster vaccination are lacking. This study evaluated the immunogenicity and safety of the DTaP booster vaccine. Seventy-two infants who had been vaccinated with the first booster and 78 children who had been vaccinated with the second booster were enrolled in this study. Local and systemic adverse reactions after vaccination were recorded. Sera obtained before and 1 month after booster vaccination were analyzed for antibodies to diphtheria and tetanus toxoid, and anti-pertussis toxin. Diphtheria: The GMT was increased. Tetanus: The geometric mean antibody titer (GMT) was increased. Pertussis: The GMT was increased by 13.72 times and 14.37 times after the first and the second additional vaccination, respectively. Although the seroconversion rate was low prior to the first booster, the average amount of anti-pertussis toxin antibodies before the first additional vaccination was 143.37 EU/mL, which rose to 261.88 EU/mL after the vaccination. The seroconversion rate also increased to 100%. Adverse reactions showed spontaneous resolution within a few days after vaccination. After the second additional vaccination, there was a statistically significant increase in the manifestation of myalgia compared to after the first additional vaccination. In conclusion, DTaP booster vaccination was effective in Korean children, demonstrating that modifications to the current regimen would be unnecessary.

The immunogenicity and safety of three-component DTaP vaccine in Korean infants / 소아과

PURPOSE: We conducted the study to evaluate the immunogenicity and safety of three component DTaP vaccine (Infanrix(R)) in a group of Korean healthy infants on a three-dose primary vaccination. And we compared the immunogenicity of this DTaP vaccine with two component DTaP vaccine which has been widely used in Korea. METHODS: We enrolled one hundred fifty one healthy infants aged 8-9 weeks. These infants were vaccinated at age 2, 4 and 6 months of age with three component DTaP vaccine. Solicited adverse events were actively monitored for 72 hours following each vaccination, and all adverse events after each vaccination were observed for three weeks. Anti-diphtheria toxoid Ab., anti-tetanus toxoid Ab., anti-pertussis toxin Ab., anti-filamentous hemagglutinin Ab., and anti-pertactin Ab. were measured using ELISA for assessing immunogenicity of study vaccine in 60 infants. Immunogenicity analysis of two component DTaP vaccine was performed with same methods in 14 infants as control. RESULTS: The seroconversion rates of anti-diphtheria toxoid Ab, anti-tetanus toxoid Ab. anti- filamentous hemagglutinin Ab. were 100% in both group. Seroconversion rate of anti-pertactin Ab in study group was 100%, but the rate in control group was 50%. However, geometric mean concentration of anti-pertussis toxin Ab. was higher in control group. Mild local and systemic reactions were observed within three days after vaccination, and no serious adverse events related study vaccine were happened during study period. CONCLUSIONS: Our study results suggest that three component DTaP vaccine (Infanrix(R)) is a well- tolerable and high immunogenic vaccine, especially anti-Pertactin Ab. of the study vaccine is very immunogenic. It can be available as routine DTaP vaccination in our infants.