Estimating the number of pertussis-susceptible children aged 0-23months in the United States. Using the National Immunization Survey(NIS) 2013 Open Access

Abstract

Despite high coverage with pertussis-containing vaccines in the United States (US), children who are unvaccinated or not fully vaccinated remain susceptible to pertussis. Over multiple birth cohorts, the number of children who are not immune to pertussis will accumulate due to factors such as the child's age and age-specific vaccination status and vaccine dose-specific vaccine effectiveness. The total number of pertussis-susceptible children aged 0-23 months in the US is unknown. By using age-specific data on receipt of pertussis-containing vaccine by children evaluated in the 2013 National Immunization Survey, and accounting for vaccine effectiveness, maternal transfer of anti-pertussis antibodies, and vaccination disparities by poverty status, we estimated the number of pertussis-susceptible children aged 0-23 months. Of 7,905,672 children aged 0-23 months in the US, we estimate that approximately 22% (1,726,113) are susceptible to pertussis. Children aged 0-23 months living below poverty are more susceptible to pertussis than children living at or above poverty (below 23% susceptible compared to 20% for at or above). In sensitivity analysis, a sustained decrease to 95% of current vaccination levels would increase the proportion of children susceptible to pertussis to 26%. Age was a large factor in susceptibility with 76% of children aged 0-2 months not immune to pertussis compared to 7% of children aged 21-23 months. These estimates underscore the need to monitor age-specific pertussis vaccine coverage and to increase childhood pertussis vaccine coverage, to maintain population level immunity and to prevent the spread of pertussis among young children.

Table of Contents

Introduction 1-3

Methods 3-8

Results 8-10

Discussion 10-15

Conclusion 15

Disclaimer 16

References 17-22

Tables 23-25

Figures 26-30

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	pertussis immunization DTaP vaccine disease susceptibility
Committee Chair / Thesis Advisor	Bednarczyk, Robert A, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs CDC

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