EUCLIDES AYRES DE CASTILHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
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- The effectiveness of maternal pertussis vaccination in protecting newborn infants in Brazil: A case-control study(2019) FERNANDES, Eder Gatti; SATO, Ana Paula S.; VAZ-DE-LIMA, Lourdes R. A.; RODRIGUES, Marcela; LEITE, Daniela; BRITO, Cyro A. de; LUNA, Expedito J. A.; CARVALHANAS, Telma Regina M. P.; RAMOS, Maria Ligia Bacciote Nerger; SATO, Helena Keico; CASTILHO, Euclides A. de; SOUZA, Edna M. de; ATOBE, Jane H.; OLIVEIRA, Carmem A. F.; MORAES, Jose Cassio de; GASPAR, Jaqueline Correia; OLIVEIRA, Silvia Silva deIntroduction: In 2014, the Brazilian Ministry of Health (MoH) recommended Tdap to pregnant women in response to a significant increase in the incidence of pertussis among infants. The present study assessed the effectiveness of maternal immunization in preventing pertussis in infants. Methods: An unmatched case-control study was undertaken in Sao Paulo State, Brazil from February 2015 to July 2016. Cases were infants aged <8 weeks at onset of pertussis reported to the Surveillance System and confirmed by real-time polymerase chain reaction or culture. Four to six healthy infants were selected as controls per case from birth certificates in the Information System on Live Births database. General characteristics and mother's vaccination status were compared between cases and controls. The vaccine effectiveness (VE) was calculated as 1 - odds ratio (OR). For the adjusted VE, the OR was calculated using logistic regression analysis. Results: Forty-two cases and 248 controls were enrolled in the study. Mothers of 8 cases (19.1%) and 143 controls (57.4%) were vaccinated during pregnancy, resulting in an unadjusted VE of 82.6% (95% confidence interval [CI], 60.8-92.3%). The VE was unchanged after adjusting for maternal age and monthly household income. Conclusion: Maternal pertussis vaccination during pregnancy was effective in protecting infants aged <8 weeks from pertussis.
- Association between the timing of maternal vaccination and newborns' anti-pertussis toxin antibody levels(2019) VAZ-DE-LIMA, Lourdes R. A.; SATO, Helena Keico; FERNANDES, Eder Gatti; SATO, Ana Paula Sayuri; PAWLOSKI, Lucia C.; TONDELLA, Maria Lucia; BRITO, Cyro A. de; LUNA, Expedito J. A.; CARVALHANAS, Telma Regina M. P.; CASTILHO, Euclides A. de; SOUZA, Edna M. de; ATOBE, Jane H.; OLIVEIRA, Carmem A. F.; LEITE, Daniela; SILVA, Marcela R.; MARIANI-NETO, Corintio; BERSUSA, Ana; CALABRESI, Rita de Cassia S.; SANTOS, Rosemary A. dos; TESSER, Diva T.; RAMOS, Maria Ligia BacciotteBackground: Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil. The objective of this study was to evaluate the effects of Tdap vaccination during pregnancy on the anti-pertussis toxin (PT) IgG response in mothers and their infants at birth. Material and methods: Maternal and cord blood samples were collected from vaccinated (n = 243) and unvaccinated (n = 75) pregnant women, at the time of delivery, from July 2015 to August 2016 in Sao Paulo, Brazil. Anti-PT IgG antibodies were quantified by Enzyme-Linked Immunosorbent Assay (ELISA) and geometric mean concentrations (GMC) were calculated. Relationship between timing of vaccination and antibody concentrations were evaluated. Results: Maternal and cord blood GMCs among the vaccinated group were 5.4 and 5.6 fold higher [66.5 International Units (IU)/mL and 89.8 IU/mL] compared to the unvaccinated group (12.4 IU/mL and 16.1 IU/mL), respectively (p < 0.001). Higher anti-PT IgG GMCs were observed when vaccination occurred >= 60 days before delivery compared to <60 days, suggesting that vaccination early in the third trimester may be more effective than later in pregnancy. Conclusion: Tdap maternal vaccination results in significantly higher anti-FT IgG in newborn infants and supports the current recommendation of the Brazilian Immunization Program.
- Adverse event occurrence following use of tetanus, diphtheria and acellular pertussis adsorbed vaccine - Tdap -, Sao Paulo, SP, Brazil, 2015-2016(2020) GATTAS, Vera Lucia; LUNA, Expedito Jose Albuquerque; SATO, Ana Paula Sayuri; FERNANDES, Eder Gatti; VAZ-DE-LIMA, Lourdes Ra; SATO, Helena Keiko; CASTILHO, Euclides A. deObjective: to describe occurrence of adverse events following immunization (AEFI) with Tdap vaccine during pregnancy. Methods: this was a descriptive study using data from reports by participants in an effectiveness and immunogenicity study conducted in two hospitals in Sao Paulo, SP, Brazil, from 2015 to 2016. Results: of the 201 mothers included in the study, 48 (23.9%) had at least one AEFI; 60 symptoms related to Tdap use were identified - pain (22.4%), swelling (2.5%), fever (1.5%), somnolence (1.0%), redness (0.5%), vomiting (0.5%), headache (0.5%), local reaction (0.5%), and fatigue (0.5%); no rare, very rare, or extremely rare adverse events were reported; all events were considered to be expected, as they are described in the vaccine package insert; outcome of all events was recovery without sequelae. Conclusion: Tdap vaccine in the form adopted by the National Immunization Program is safe; no unexpected adverse events were identified among vaccinated pregnant women.