Pertussis-the case for universal vaccination.

PURPOSE Does the literature support universal vaccination of adolescents and adults, reducing disease incidence in infants and young children? DESIGN & METHODS An extensive literature review and a meta-analysis of four case-control studies, evaluating effects of missed or late vaccine doses, was conducted. RESULTS The literature confirms (a) increasing pertussis rates; (b) adults and adolescents are the primary carriers; (c) vaccine effectiveness wanes over time; and (d) pertussis persists despite disease control efforts. PRACTICE IMPLICATIONS Missed or late doses mean an increase in likelihood of contracting pertussis, supporting full vaccination for children and boosters for adolescents/adults.