Association of Diphtheria-Tetanus–Acellular Pertussis Vaccine Timeliness and Number of Doses With Age-Specific Pertussis Risk in Infants and Young Children

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Abstract
Widespread rollout of the diphtheria-tetanus–whole-cell pertussis (DTwP) vaccines in the 1940s resulted in a dramatic decrease in pediatric pertussis incidence until the 1970s and 1980s in the US.1,2 Owing to concerns surrounding the safety and reactogenicity of DTwP vaccines, a less reactogenic diphtheria-tetanus–acellular pertussis (DTaP) vaccine was developed.1,3 The DTaP vaccines are safe and efficacious, and most developed countries recommend them for their infant primary series in national immunization programs.4 Preschool and adolescent booster doses are also included in immunization schedules, especially in high-income countries, owing to concerns about increases in age at infection and waning vaccine-induced immunity.5 Despite high vaccination coverage for both the primary series and boosters, the US has experienced a resurgence in pertussis since the 1990s.6

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