• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Bacterial Infections  • Pediatrics  • Adolescent Medicine  • Public Health  • Immunization  • Pulmonary Diseases  • Pulmonary Diseases, Other  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Tami H. Skoff, MS; Amanda C. Cohn, MD; Thomas A. Clark, MD, MPH; Nancy E. Messonnier, MD; Stacey W. Martin, MS

Arch Pediatr Adolesc Med. Published online January 2, 2012. doi:10.1001/archpediatrics.2011.1093

Objective  To evaluate the impact of the adolescent Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine) vaccination program on pertussis trends in the United States.

Design  Retrospective analysis of nationally reported pertussis cases, January 1, 1990, through December 31, 2009.

Setting  United States.

Participants  Confirmed and probable pertussis cases.

Intervention  The US Tdap vaccination program.

Main Outcome Measure  Rate ratios of reported pertussis incidence (defined as incidence among 11- to 18-year-olds divided by the combined incidence in all other age groups) modeled through segmented regression analysis and age-specific trends in reported pertussis incidence over time.

Results  A total of 200 401 pertussis cases were reported in the United States from 1990 to 2009. Overall incidence ranged from 1.0 to 8.8 per 100 000 persons (1991 and 2004, respectively). Slope coefficients (estimated annual rate of change in rate ratios) from segmented regression showed a steady increase in pertussis incidence among adolescents 11 to 18 years old compared with all other age groups before Tdap introduction (slope = 0.22; P < .001), and a steep decreasing trend post introduction (slope = –0.48; P < .001), suggesting a direct impact of vaccination among adolescents. Indirect effects of adolescent vaccination were not observed among infants younger than 1 year.

Conclusions  Changes in pertussis incidence in the United States from 2005 to 2009 revealed a divergence between 11- to 18-year-olds and other age groups, suggesting that targeted use of Tdap among adolescents reduced disease preferentially in this age group. Increased Tdap coverage in adolescents and adults is needed to realize the full direct and indirect benefits of vaccination.

Author Affiliations: Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

How to Fight Whooping Cough?
Florens G. A. Versteegh and Kathryn M. Edwards
Arch Pediatr Adolesc Med. 2012;0(2012):201112431-3.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

How to Fight Whooping Cough?
Versteegh and Edwards
Arch Pediatr Adolesc Med 2012;0:archpediatrics.2011.1243v-3.
FULL TEXT