To evaluate reporting sensitivities for vaccine adverse events, reporting rates were estimated by dividing the number of events reported to the Monitoring System for Adverse Events Following Immunization and the Vaccine Adverse Event Reporting System in a given period by the number of doses administered or distributed during the same period. Reporting sensitivity was calculated as the ratio of the rates at which events were reported to each passive surveillance system (numerator) and occurred in controlled studies (denominator). Reporting sensitivities were generally better in the public sector than in the private sector. The significant underreporting of known outcomes, together with the nonspecific nature of most adverse event reports, highlights the limitations of passive surveillance systems in assessing the incidence of vaccine adverse events.
To evaluate the role of adults in the transmission of pertussis during an epidemic, persons presenting with unexplained cough to ambulatory care clinics were evaluated for evidence of pertussis infection. Nasopharyngeal specimens for culture and serum samples for IgG and IgA antibodies to filamentous hemagglutinin and pertussis toxin antigens of Bordetella pertussis were obtained. Thirty-eight adults were enrolled in the study; 10 (26%) had serologic evidence of B. pertussis infection. Clinical findings were not significantly different among persons with and without evidence of pertussis infection. Pertussis should be considered in the differential diagnosis of persistent cough in all age groups. Future use of new acellular pertussis vaccines in adults may substantially impact the control of the infection.
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