Published online October 31, 2008
PEDIATRICS Vol. 122 No. 5 November 2008, pp. 1021-1026 (doi:10.1542/peds.2007-3025)
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ARTICLE

Potential Impact of Acceleration of the Pertussis Vaccine Primary Series for Infants

Myrick C. Shinall, Jr, BAa,b, Timothy R. Peters, MDc, Yuwei Zhu, MD, MSd, Qingxia Chen, PhDd and Katherine A. Poehling, MD, MPHc,e

a School of Medicine
b Divinity School, Vanderbilt University, Nashville, Tennessee
c Departments of Pediatrics
e Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
d Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee

OBJECTIVE. This study estimates the potential impact, on rates of pertussis infections, hospitalizations, and deaths among infants in the United States, of administering the first dose of diphtheria and tetanus toxoids and acellular pertussis vaccine at 6 weeks rather than 2 months of age.

METHODS. We used existing data to estimate current US rates of pertussis infections, hospitalizations, and deaths according to age and infant population in 2004. We then estimated the potential impact of accelerating the administration of the first dose of diphtheria and tetanus toxoids and acellular pertussis vaccine from 2 months to 6 weeks of age, an alternative schedule consistent with current vaccination guidelines. We used Poisson distribution analysis to determine 95% confidence intervals for projected rates of pertussis disease.

RESULTS. Acceleration of administration of the first dose of diphtheria and tetanus toxoids and acellular pertussis vaccine from 2 months to 6 weeks of age is expected to prevent 1236 cases of pertussis, 898 hospitalizations, and 7 deaths attributable to pertussis per year in the United States. These decreases represent 9% reduction in cases, 9% reduction in hospitalizations, and 6% reduction in deaths attributable to pertussis among infants <3 months of age. Acceleration of the second and third doses by 2 weeks is expected to prevent an additional 923 cases, 520 hospitalizations, and 2 deaths attributable to pertussis each year.

CONCLUSION. Acceleration of administration of diphtheria and tetanus toxoids and acellular pertussis vaccine from 2 months to 6 weeks should reduce the burden of pertussis among young infants.

Key Words: pertussis • infants • vaccine • epidemiology • preventive health care visits

Abbreviations: DTaP—diphtheria and tetanus toxoids and acellular pertussis vaccine • DTP—diphtheria and tetanus toxoids and pertussis vaccine • Tdap—tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine • CI—confidence interval

Accepted Mar 20, 2008.


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