title: Epidemiological and Economic Effects of Priming With the Whole-Cell Bordetella pertussis Vaccine.
abstract: Current acellular pertussis vaccines may not protect against transmission of Bordetella pertussis.
  
  
  
  To assess whether a priming dose of whole-cell pertussis (wP) vaccine is cost-effective at reducing pertussis infection in infants.
  
  
  
  Mathematical model of pertussis transmission fit to US incidence data in a simulation of the US population. In this simulation study conducted from June 2014 to May 2015, the population was divided into 9 age groups corresponding to the current pertussis vaccination schedule and fit to 2012 pertussis incidence.
  
  
  
  Inclusion of a priming dose of wP vaccine into the current acellular pertussis vaccination schedule.
  
  
  
  Reductions in symptomatic pertussis incidence by age group, increases in wP vaccine-related adverse effects, and quality-adjusted life-years owing to changing vaccine schedule.
  
  
  
  Switching to a wP-priming vaccination strategy could reduce whooping cough incidence by up to 95% (95% CI, 91-98), including 96% (95% CI, 92-98) fewer infections in neonates. Although there may be an increase in the number of vaccine adverse effects, we nonetheless estimate a 95% reduction in quality-adjusted life-years lost with a switch to the combined strategy and a cost reduction of 94% (95% CI, 91-97), saving more than $142 million annually.
  
  
  
  Our results suggest that an alternative vaccination schedule including 1 dose of wP vaccine may be highly cost-effective and ethically preferred until next-generation pertussis vaccines become available.
authors.affiliation: New Mexico State University, Las Cruces.
authors.forename: Haedi
authors.initials: H
authors.lastname: DeAngelis
authors.affiliation: Santa Fe Institute, Santa Fe, New Mexico.
authors.forename: Samuel V
authors.initials: SV
authors.lastname: Scarpino
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut.
authors.forename: Meagan C
authors.initials: MC
authors.lastname: Fitzpatrick
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut4Yale Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut.
authors.forename: Alison P
authors.initials: AP
authors.lastname: Galvani
authors.affiliation: New Mexico State University, Las Cruces2Santa Fe Institute, Santa Fe, New Mexico.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Althouse
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001886:Bordetella pertussis; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008954:Models, Biological; D008962:Models, Theoretical; D010567:Pertussis Vaccine; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000379:methods; D014917:Whooping Cough / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D010567:Pertussis Vaccine