OBJECTIVES: Epidemiology of pertussis shows that despite effective vaccination in childhood, naturally acquired and vaccine induced immunity is waning over time leading to higher incidence in adolescents and adults. Literature estimates the annual incidence of pertussis in the UK reaches 330/100,000 compared with an incidence of 4/100,000 based on statutory notifications, highlighting the degree of under-reporting. This analysis examines the cost-effectiveness of the addition of an adolescent routine booster vaccination against pertussis to the schedule in England and Wales from a payer perspective. METHODS: An age stratified, compartmental dynamic model was developed and calibrated on HPA  data corrected for symptomatic and asymptomatic cases and empirical contact rates. Two scenarios were compared: current pertussis vaccination schedule (2, 3, and 4 months of age) and a similar schedule with additional booster vaccination at 15 years with coverage of 59%. Total costs and quality adjusted life years (QALYs) were estimated. RESULTS: At equilibrium pertussis booster vaccination at 15 years is projected to reduce the combined reported and unreported incidence of pertussis in the following age categories: 10-19 years (55.0%), 20-59 years (31.3%) and 60-75 years (27.9%). There are 7155 QALYs gained annually in the UK population. Unreported symptomatic cases were assumed to incur no cost and 50% of the QALY benefit of reported cases but provided 98% of the total quality of life gained through total symptomatic cases. Annual implementation costs (£9.4M) would be partially offset by savings associated with reported cases (£1.5M). The incremental cost per QALY would be £1,103 from a payer perspective. CONCLUSIONS: Model projection indicates that adolescent routine booster vaccination against pertussis would reduce pertussis burden, and is likely to be cost-effective from a payer perspective.