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Modelling pertussis transmission to evaluate the effectiveness of an adolescent booster in Argentina

  • G. FABRICIUS (a1), P. E. BERGERO (a1), M. E. ORMAZABAL (a2), A. L. MALTZ (a3) and D. F. HOZBOR (a2)...

Due to the current epidemiological situation of pertussis, several countries have implemented vaccination strategies that include a booster dose for adolescents. Since there is still no evidence showing that the adolescent booster has a positive effect on the most vulnerable group represented by infants, it is difficult to universalize the recommendation to include such reinforcement. In this work we present an age-structured compartmental deterministic model that considers the outstanding epidemiological features of the disease in order to assess the impact of the booster dose at age 11 years (Tdap booster) to infants. To this end, we performed different parameterizations of the model that represent distinct possible epidemiological scenarios. The results obtained show that the inclusion of a single Tdap dose at age 11 years significantly reduces the incidence of the disease within this age group, but has a very low impact on the risk group (0–1 year). An effort to improve the coverage of the first dose would have a much greater impact on infants. These results hold in the 18 scenarios considered, which demonstrates the robustness of these conclusions.

Corresponding author
*Author for correspondence: Dr G. Fabricius, Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas, Diagonal 113 y 64, Cc. 16, Suc. 4, 1900 La Plata, Argentina. (Email:
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1.Anon.Pertussis – United States, 1997–2000. Morbidity and Mortality Weekly Report 2002; 51: 7376.
2.WHO.Pertussis vaccines: WHO position paper. Weekly Epidemiological Record 2010; 85: 385400.
3.Baron S, et al. Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine use of vaccination. Pediatric Infectious Disease Journal 1998; 17: 412418. Melker HE, et al. Pertussis in The Netherlands: an outbreak despite high levels of immunization with whole-cell vaccine. Emerging Infectious Diseases 1997; 3: 175178.
5.Hozbor D, et al. Pertussis epidemiology in Argentina: trends over 2004–2007. Journal of Infection 2009; 59: 225231. Melker HE, et al. The incidence of Bordetella pertussis infections estimated in the population from a combination of serological surveys. Journal of Infection 2006; 53: 106113.
7.Mooi FR. Bordetella pertussis and vaccination: the persistence of a genetically monomorphic pathogen. Infection, Genetics and Evolution 2010; 10: 3649.
8.Kallonen T, He Q. Bordetella pertussis strain variation and evolution postvaccination. Expert Review of Vaccines 2009; 8: 863875.
9.Wendelboe AM, et al. Duration of immunity against pertussis after natural infection or vaccination. Pediatric Infectious Disease Journal 2005; 24: S5861.
10.Yih WK, et al. The increasing incidence of pertussis in Massachusetts adolescents and adults, 1989–1998. Journal of Infectious Disease 2000; 182: 14091416.
11.Forsyth KD, et al. Prevention of pertussis: recommendations derived from the second Global Pertussis Initiative roundtable meeting. Vaccine 2007; 25: 26342642.
12.CDC.Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months – Advisory Committee on Immunization Practices (ACIP), 2011. Morbidity and Mortality Weekly Reports 2011; 60: 14241426.
13.Anderson RM, May RM. Age-related changes in the rate of disease transmission: implications for the design of vaccination programmes. Journal of Hygiene 1985; 94: 365436.
14.Grenfell BT, Anderson RM. Pertussis in England and Wales: an investigation of transmission dynamics and control by mass vaccination. Proceedings of the Royal Society of London, Series B 1989; 236: 213252.
15.Hethcote HW. An age-structured model for pertussis transmission. Mathematical Biosciences 1997; 145: 89136.
16.van Boven M, et al. Waning immunity and sub-clinical infection in an epidemic model: implications for pertussis in The Netherlands. Mathematical Biosciences 2000; 164: 161182.
17.Luz PM, et al. A modelling analysis of pertussis transmission and vaccination in Rio de Janeiro, Brazil. Epidemiology and Infection 2006; 134: 850862.
18.Wearing HJ, Rohani P. Estimating the duration of pertussis immunity using epidemiological signatures. PLoS Pathogens 2009; 5: e1000647.
19.Lavine JS, King AA, Bjornstad ON. Natural immune boosting in pertussis dynamics and the potential for long-term vaccine failure. Proceedings of the National Academy of Sciences USA 2011; 108: 72597264.
20.Rohani P, Zhong X, King AA. Contact network structure explains the changing epidemiology of pertussis. Science 2010; 330: 982985.
21.Forsyth KD, et al. Pertussis immunization in the Global Pertussis Initiative International Region Recommended Strategies and Implementation Considerations. Pediatric Infectious Disease Journal 2005; 24: S93S97.
23.Argentinean Health Ministry database. ( Accessed 10 May 2012.
24.Riva Posse CA, Miceli IN. Pertussis: its evolution in Argentina at the end of the twentieth century. Medicina (Buenos Aires) 2005; 65: 716.
25.Anderson R, May R. Infectious Diseases of Humans: Dynamics and Control. Oxford: Oxford University Press, 1991.
26.Broutin H, et al. Large-scale comparative analysis of pertussis population dynamics: periodicity, synchrony, and impact of vaccination. American Journal of Epidemiology 2005; 161: 11591167.
27.Broutin H, et al. Impact of vaccination and birth rate on the epidemiology of pertussis: a comparative study in 64 countries. Proceedings of the Royal Society of London, Series B, 2010; 277: 32393245.
28.Van Rie A, Hethcote HW. Adolescent and adult pertussis vaccination: computer simulations of five new strategies. Vaccine 2004; 22: 31543165.
29.Rozenbaum MH, et al. Modelling the impact of extended vaccination strategies on the epidemiology of pertussis. Epidemiology and Infection. Published online: 24 November 2011. doi:10.1017/S0950268811002354.
30.Kretzschmar M, Teunis PF, Pebody RG. Incidence and reproduction numbers of pertussis: estimates from serological and social contact data in five European countries. PLoS Medicine 2010; 7: e1000291.
31.Mossong J, et al. Social contacts and mixing patterns relevant to the spread of infectious diseases. PLoS Medicine 2008; 5: e74.
32.Hethcote HW. Simulations of pertussis epidemiology in the United States: effects of adult booster vaccinations. Mathematical Biosciences 1999; 158: 4773.
33.Rohani P, Earn D, Grenfell BT. Opposite patterns of synchrony in sympatric disease metapopulations. Science 1999; 286: 968.
34.Simoes M, Telo da Gama MM, Nunes A. Stochastic fluctuations in epidemics on networks. Journal of the Royal Society Interface 2008; 5: 555566.
35.Gonçalves S, Abramson G, Gomes MFC. Oscillations in SIRS model with distributed delays. European Physical Journal B 2011; 81: 363371.
36.Brooks DA, Clover R. Pertussis infection in the United States: role for vaccination of adolescents and adults. Journal of the American Board of Family Medicine 2006; 19: 603611.
37.Quinn HE, McIntyre PB. The impact of adolescent pertussis immunization, 2004–2009: lessons from Australia. Bulletin of the World Health Organization 2011; 89: 666674.
38.Skoff TH, et al. Early Impact of the US Tdap vaccination program on pertussis trends. Archives of Pediatrics and Adolescent Medicine 2012; 166: 344349.
39.Jardine A, et al. Who gives pertussis to infants? Source of infection for laboratory confirmed cases less than 12 months of age during an epidemic, Sydney, 2009. Communicable Diseases Intelligence 2010; 34: 116121.
40.Bisgard KM, et al. Infant pertussis: who was the source? Pediatric Infectious Disease Journal 2004; 23: 985989.
41.Wendelboe AM, et al. Transmission of Bordetella pertussis to young infants. Pediatric Infectious Disease Journal 2007; 26: 293299.
42.Lavine JS, et al. Short-lived immunity against pertussis, age-specific routes of transmission, and the utility of a teenage booster vaccine. Vaccine 2012; 30: 544551.
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