Table of Contents
Journal of Vaccines
Volume 2015, Article ID 593819, 4 pages
Research Article

Differences in Pertussis Incidence by Income among Oregon Teens during an Outbreak

Oregon Immunization Program, Oregon Health Authority, 800 NE Oregon Street, Portland, OR 97232, USA

Received 29 August 2015; Revised 13 November 2015; Accepted 16 November 2015

Academic Editor: Wagner Quintilio

Copyright © 2015 Steve G. Robison et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


That disease and poverty are connected is a cornerstone of public health thought. In the case of pertussis, however, it is possible that the expected relationship to poverty is reversed. Grounds exist for considering that increases in income are associated with increases in pertussis rates, both in terms of real risk through social and network features and through the possibility of greater likelihood of care seeking and detection based on income. Using reported adolescent pertussis cases from a 2012 outbreak in Oregon, pertussis incidence rates were determined for areas grouped by zip code into higher, middle, and lower median household income. Adolescents of ages 13–16 years in higher income areas were 2.6 times (95% CI 1.8–3.8) more likely as all others to have reported pertussis during the 2012 outbreak and 3.1 (95% CI 1.4–6.5) times as likely as those in lower income areas. The higher pertussis rates associated with higher income areas were observed regardless of Tdap rate differences. These results suggest that income may be associated with disease risk, likelihood of diagnosis and reporting, or both. Further evaluation of this finding is warranted.