An Advisory Committee statement (ACS) : Statement on the booster for 4-6 year olds for protection against pertussis

METHODS NACI reviewed the key questions and literature review proposed by the Tetanus, Diphtheria, Pertussis and Polio Working Group including such considerations as the burden of illness of the disease to be prevented and the target population(s), safety, immunogenicity, efficacy, effectiveness of the vaccine(s), vaccine schedules, and other aspects of the overall immunization strategy. [...] As of 2011, all provinces and territories, with the exception of Québec, gave diphtheria, tetanus, acellular pertussis and polio containing vaccine to 4- to 6- year-olds which contained the same concentrations of these antigens as is included in the infant doses (DTaP-IPV). [...] Following the Quadracel® shortage, which began in the winter of 2012, all Canadian provinces and territories, except for Saskatchewan and the Northwest Territories, changed to Tdap-IPV for the 4- to 6-year-old tetanus, diphtheria, acellular pertussis and polio booster. [...] With the introduction of the whole-cell pertussis vaccine in 1943, the incidence of pertussis decreased significantly in Canada, from an average of 165 cases per 100,000 population from 1933 to 1943 to a low annual average of 6.7 cases per 100,000 from 2001 to 2011.(4) A resurgence of pertussis was observed beginning in 1990. [...] This was likely due to a combination of factors, including the low effectiveness of the combined adsorbed diphtheria-tetanus-pertussis whole-cell vaccine given to children in Canada between 1981 and 1998, waning immunity from the previous vaccine among adolescents and adults, as well as increased physician awareness and improved diagnosis and reporting of pertussis infection.(5) The whole cell vac