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There was no evidence of genetic drift, although the role of waning immunity is unclear.
These three vaccine-preventable disease resurges illustrate that low immunization coverage, waning immunity, and accumulation of susceptibles can each provide challenges to disease control.
In response to the problem of waning immunity, a second pertussis booster immunization at 11-13 years of age was introduced in 1998 (6).
Absence of an anamnestic response might indicate waning immunity, Dr.
Postmarketing studies should look for waning immunity and evaluate the need for a booster and the effect of a booster over time, panelists recommended.
However, we can address the issue of waning immunity by assigning a higher cost per vaccination series (as in the sensitivity analyses) to reflect the cost of a booster.
Preliminary data don't suggest that waning immunity plays a major role.