A new analysis of CDC data shows the whooping cough vaccine and its adolescent booster TDap have been associated with waning immunity against pertussis in children and adolescents.

Following the introduction of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (TDaP) vaccine in 2005, there was a steep decline in rates of pertussis associated with youth, ages 11 to 18 years (P<0.001). However, by 2010, rate of disease increased among teenagers at a much faster rate than other age groups (P<0.001), reported Tami H. Skoff, and Stacey W. Martin, of the CDC in Atlanta.

Notably, in 2011-2012, there was a 265.7% increase in the incidence of pertussis among youth (ages 11 to 18 years), and a 156.8% increase among children (ages 1 to 10 years), they wrote in JAMA Pediatrics.

In a second study in the journal, researchers assessed whether a priming dose of whole-cell pertussis (wP) vaccine was cost-effective at reducing pertussis infection in infants. Their model “predicted that the combined [vaccine] strategy would reduce [quality-adjusted-life-years] loss by 95% and reduce costs by 94%,” wrote Haedi DeAngelis, of New Mexico State University in Las Cruces, and colleagues. “These results suggest that the combined strategy is both an epidemiologically favorable and an economically viable alternative to [DTaP].”

The findings from Skoff and Martin “provide more evidence that we have not figured out how to prevent Bordetella pertussis infections very well. Although it has been clear for several years that immunity following acellular pertussis vaccines wanes … this study documents the epidemiologic effect of this waning of immunity at a population level,” noted Mark H. Sawyer, MD, of Rady-Children’s Hospital San Diego, in an accompanying editorial.

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