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Acellular pertussis vaccine efficacy: An updated systematic review and meta -analysis.

Med J Islam Repub Iran · 2016 · PMC5419227 · PMID 28491826

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an increasing trendno p-value reported
In Iran, in spite of vaccination program covering more than 90% of the population, reports show an increasing trend of incidence rate in some years which may be due to lack of control in adults ( 6 ).

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.