question and answer
September 2002
BARRY SLAPCOFF, MD, of Westmount, QC, notes, "Pertussis seems to be more common in the adolescent and young adult populations." He asks, "Is there a place for a booster of acellular pertussis vaccine to be added to the routine vaccination schedule?"
In Canada, the incidence of reported pertussis has gone up dramatically over the last two decades, and is currently at about 35 cases per 100,000 population. Most infections occur in infants, but the fastest rising rates are turning up in adolescents and adults. Studies of people over 15 years of age have demonstrated that pertussis may account for 20-30% of illnesses characterized by persistent cough of more than a week's duration. Pertussis is more often atypical in this population. A number of recent studies have proven the immunogenicity and safety of acellular pertussis vaccines in adolescents and adults. Given the apparent incidence of disease in this population, and their potential role in spreading infection to infants, there's a rationale for "boosting" people who've previously received the old whole-cell vaccine. Studies are currently underway in Canada and elsewhere to determine the clinical efficacy and cost effectiveness of revaccination (with acellular products) in adolescence. DM
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