A Change in Vaccine Efficacy and Duration of Protection Explains Recent Rises in Pertussis Incidence in the United States

摘要: Over the past ten years incidence of pertussis in United States (U.S.) has risen steadily, with 2012 seeing highest case number since 1955. There also been a shift over same time period age group reporting largest cases (aside from infants), adolescents to 7–11 year olds. We use epidemiological modelling and large dataset explain upsurge. investigate several hypotheses for upsurge by fitting suite dynamic models data National Notifiable Disease Surveillance System (NNDSS) between 1990–2009, as well variety sources 1950–1989. find that: best-fitting model is one which vaccine efficacy duration protection acellular (aP) lower than that whole-cell (wP) vaccine, (efficacy first three doses 80% [95% CI: 78%, 82%] versus 90% 87%, 94%]), increasing rate at disease reported NNDSS not sufficient 3) 2010–2012 predicted well. In this study, we all available U.S. surveillance to: 1) fit set mathematical determine best explains these 2) vaccine-related parameter values model. evidence difference two types, wP aP (aP wP). Future refinement presented here will allow an exploration alternative vaccination strategies such different age-spacings, further booster doses, cocooning.