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Updated: Aug 15, 2026

Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
[Time for booster doses against whooping cough for 10-year-old children]
Rose-Marie Carlsson1, Leif Ekholm, Leif Gothefors
1Smittskyddsinstitutet, Stockholm. rose-marie.carlsson@smi.ki.se
Insights
Sweden reintroduced acellular pertussis vaccination in 1996, significantly reducing cases. An interim recommendation now includes pertussis boosters for 10-year-olds to maintain immunity.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Context:
- Sweden's 17-year hiatus from pertussis vaccination ended in 1996 with acellular vaccine introduction.
- The incidence of notified pertussis has declined tenfold over the past decade.
- Despite reductions, pertussis remains a concern, particularly for infants, with most cases in older individuals.
Purpose:
- To evaluate the impact of the 1996 acellular pertussis vaccine introduction in Sweden.
- To address the ongoing circulation of pertussis and protect vulnerable populations.
- To inform national vaccination program revisions and interim booster recommendations.
Summary:
- Acellular pertussis vaccination, reintroduced in Sweden in 1996, has led to a substantial decrease in reported cases.
- Pertussis is not eliminated, with continued infections in older children and adults, while infants remain at high risk for severe disease.
- An interim recommendation advises including pertussis in the 10-year school booster to enhance immunity.
Impact:
- Significant reduction in pertussis incidence following vaccine reintroduction.
- Ongoing need for pertussis control strategies, including booster doses.
- Interim recommendation to boost immunity in school-aged children pending a revised national program.
Abstract:
Acellular pertussis vaccine was introduced in Sweden in 1996 at the age of 3, 5 and 12 months, after a 17 year period without general vaccination against pertussis. At present, the incidence of notified pertussis has decreased to 1/10 of what was seen 10 years ago. In spite of the dramatic decrease, the disease is not eliminated. In accordance with the experience of other countries, most cases in Sweden are reported among older children and adults, while the highest risk of severe disease is still seen in infants. Many industrialized countries have introduced booster dose(s) in order to control the spread of pertussis. The Swedish National Board of Health and Welfare has recently initiated a major revision of the vaccines used and the schedule of the national vaccination program. Until the final proposal and in order not to miss the opportunity to boost pertussis immunity in children who were vaccinated as infants at the reintroduction of pertussis vaccination, the Board now recommends the Swedish municipalities as an interim measure to include pertussis in the current school booster against diphtheria and tetanus at 10 years of age with a full dose vaccine.
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