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Despite widespread vaccination, pertussis remains endemic in the United States. Unimmunized infants, typically those under 2 months of age, are at greatest risk for severe disease and death. Previous studies have shown that household contacts, usually mothers, are the most common source of infant infection. In 2005, the CDC recommended a Tdap (tetanus, diphtheria, and acellular pertussis) vaccine booster for children entering middle school, and in 2013, recommended Tdap vaccination during every pregnancy to protect mothers and to provide infants with passive immunity before their first pertussis immunization. Yet pertussis continues to circulate.
To examine sources of infection, researchers reviewed surveillance records for 1306 infants <1 y…