Whooping cough outbreak – science and simple math

whooping cough outbreak

I have written extensively about several whooping cough (Bordetella pertussis) outbreaks which had reached epidemic levels in areas like the Washington state, which had been considered one of the worst outbreaks in the USA during the past several decades. This whooping cough outbreak has lead to several deaths here in the USA and in other countries such as the UK.

Of course, these outbreaks and epidemics have lead to the “blame game” from the antivaccination cult, because they have claimed that since A) most kids are vaccinated, and B) we’re having this outbreak, then C) either the vaccines are useless or are actually the cause of the outbreak. Seriously. They blame the vaccines.

There have been numerous reports about a whooping cough outbreak in the Reno County, KS area, with about 70 cases of the disease being reported. The report indicates that most of the kids who have the disease were vaccinated. It is unclear who said this, and what are the actual statistics. But for now, we’ll take this at face value.

Since this outbreak will undoubtedly lead to the typical antivaccine rhetoric about the whooping cough vaccines, DTaP or Tdap (which also protect against tetanus and diphtheria), I decided to search the internet to find the most popular vaccine denialist arguments regarding pertussis vaccinations–then debunk them. Hopefully, this will be useful for those who are observing what’s going on in Reno.

Continue reading “Whooping cough outbreak – science and simple math”

Adult vaccines – the CDC wants to save adult lives too

adult vaccines

Generally, when I write about vaccines, it’s about protecting children’s lives from vaccine preventable diseases. That itself is a noble goal for vaccines. But in case you didn’t know, there is also a CDC schedule for adult vaccines, which is as important to adults as they are to children.

Vaccines have one purpose – to protect us and those whom we love from potentially deadly and debilitating diseases. Many of us in the blogosphere have talked about the children’s schedule a lot, often to debunk claims of people who are ignorant of science, and think that the children’s vaccine schedule is causing undue harm. Yeah our intellectually deficient president, Donald Trump, thinks he knows more than the CDC, but that’s a problem shared by many vaccine deniers.

One adult vaccine I push regularly is the flu vaccine. It protects adults, pregnant women, the elderly, children, and healthy young adults from a severe infection that hospitalizes and kills more people every year than you’d think. Because flu is not really a serious disease, in some people’s minds, a lot of people decide that they don’t need the vaccine. They’d be wrong.

Just in case you were wondering, there is more to adult vaccines than just flu vaccines. There are several other vaccines indicated for adult use, including those adults with underlying health issues like diabetes, HIV and heart disease – unfortunately, the uptake for adult vaccines is depressingly low. Let’s take at the low uptake and the recommended adult vaccines schedule.

Continue reading “Adult vaccines – the CDC wants to save adult lives too”

Pertussis vaccine waning effectiveness – the facts

pertussis vaccine waning effectiveness

The issues with the pertussis vaccine waning effectiveness has been circulating for several years. There have been a number of well-designed studies that have provided evidence of the issues with the pertussis component of the DTaP or Tdap vaccine (which also provides immunization against tetanus and diphtheria, both dangerous diseases).

According to current research, individuals who have been vaccinated against whooping cough (Bordetella pertussis), with either the DTaP (version for usually for children) or Tdap vaccine, lose protection against whooping cough in some time period after being vaccinated.

A new article, published in Pediatrics, written by Nicola P Klein et al.,  examined children who received the Tdap vaccine in the Kaiser Permanente Northern California (KPNC) health care plan, a vertically integrated managed care system which closely tracks patients after vaccination. Their data provide important information about the strategies for the vaccine going forward.

Continue reading “Pertussis vaccine waning effectiveness – the facts”

Why we vaccinate – pertussis and epilepsy are linked

There is really only one reason to vaccinate – protecting everyone, especially children, from dangerous vaccine preventable diseases. We have eliminated smallpox. We have almost eliminated polio.

And we had almost made measles extinct, until the myth that the MMR vaccine (to prevent mumps, measles and rubella) caused autism, started by one of sciences greatest fraudsters, the defrocked MrAndy Wakefield. It’s a myth that’s been thoroughly and definitively debunked.

One vaccine preventable infectious disease that we’ve been unable to conquer is  whooping cough (caused by the bacteria, Bordetella pertussis), also known as pertussis. Pertussis is a relatively dangerous infection, the disease itself has serious consequences for children and adults:

  • 1 in 4 (23%) get pneumonia (lung infection)
  • 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
  • Two thirds (67%) will have apnea (slowed or stopped breathing)
  • 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
  • 1 or 2 in 100 (1.6%) will die

Whooping cough can be easily prevented by the DTaP or Tdap vaccines (which also protect against tetanus and diphtheria). The vaccines can be given to infants as early as 6 weeks to 2 months old.

As with all medical procedures, there are some adverse effects with the pertussis vaccines. Moderate adverse effects from the vaccine occur in about 1 in 10,000 (or even fewer) injections. The most severe effects, which may or may not be causally related to the vaccine since the rate is  so low, are in the range of 1 out of a million doses.

One out of one million doses of the vaccine cause a serious adverse event (maybe). Compare that to the 1-2 out of 100 will die of the disease. Unless you flunk math, there is no rational reason to avoid the vaccine. Continue reading “Why we vaccinate – pertussis and epilepsy are linked”

Why we vaccinate–to protect our children from pertussis

 

tdap-mother-pertussis

During this past week, a 25 day old baby in Santa Barbara, CA died from pertussis, commonly known as whooping cough (caused by the Bordetella pertussis bacteria). The disease can be easily prevented by the DTaP or Tdap vaccines (also protect against tetanus and diphtheria), which can be given to infants as early as 6 weeks to 2 months old.

According to the California Department of Public Health, infants who are too young to be fully immunized or those who are not vaccinated are most vulnerable to severe and fatal cases of pertussis. In 2014, 66 of the pertussis hospitalizations cases were children four months of age or younger. Two infants have died of pertussis in California during 2014. Continue reading “Why we vaccinate–to protect our children from pertussis”

Worldwide vaccine uptake-2014

vaccines-saves-live-cloud

I make it a point to update this blog with the most current CDC analysis of vaccine uptake in the USA for kindergarten children (usually around 5 years old). Generally, the numbers have stayed stable, at around 95% vaccinated, although there is high variance from state to state, and locality to locality. The weakness in the vaccination uptake in the USA is that some areas may approach 100% vaccinated, but then other areas may be 50%, which makes those areas with low vaccine uptake susceptible to a quick spread of diseases that are not endemic to the USA (such as measles, polio, and others) through that unvaccinated population.

Given the 95% vaccine uptake rate, it begs the questions of why I push so hard for vaccination–because I want to protect the lives of children, and those 5% who aren’t vaccinated are at risk of serious disease and even death. And vaccines are the safest way to protect a child–protect them from death.

Nearly 55% of the readers of this blog are not American (a couple of years ago,this blog got a regular reader from Iran, which meant that all countries were represented amongst this blog’s readers). I have been accused of being a bit American-centric, but at the same time, I was also curious about vaccine uptake worldwide.  Continue reading “Worldwide vaccine uptake-2014”

Why we vaccinate–so mom will protect her newborn baby

tdap-mother-pertussisOne of the important hypotheses of vaccination is to make sure that all family members or others who may encounter a newborn child be vaccinated, especially since many vaccinations are not indicated for infants for a couple of months after birth–those newborns are very susceptible to vaccine preventable diseases until they themselves are vaccinated with the DTaP vaccine (which also protects against tetanus and diphtheria).

This protective “cocoon,” especially important with whooping cough (Bordetella pertussis), theoretically blocks the transmission of the disease to a newborn by creating a protective circle of vaccinated individuals around the newborn. A teenage sibling could catch the disease and accidentally infect the infant. Pertussis is bad enough for a teenager, but it can be deadly to a baby.

Even though the evidence for cocooning is growing, there are some flaws to the idea that are still being investigated in various parts of the world. One of the concerns is that asymptomatic carriers of pertussis (who have been vaccinated) might transmit the disease through a cocoon. However, scientists have known that the current version of pertussis vaccine, called acellular pertussis, isn’t as effective as it should be, but it is still better than not vaccinating. Much better. But that is a potential hole in the protective cocoon that needs to be understood better through research. Continue reading “Why we vaccinate–so mom will protect her newborn baby”

Why we vaccinate–because pertussis kills babies

The California Department of Public Health (CDPH) recently announced that the number of whooping cough (Bordetella pertussis) cases through May 2014 has already exceeded the number in 2013. As of 27 May 2014, the CDPH reported 2,649 cases of pertussis since the beginning of the year. More concerning, there were 800 cases reported in April alone, the highest monthly number since California’s 2010 whooping cough epidemic.

whooping-cough-vaccinated

Whooping cough can be easily prevented by the DTaP or Tdap vaccines (which also protect against tetanus and diphtheria), which can be given to infants as early as 6 weeks to 2 months old.

According to the CDPH, infants who are too young to be fully immunized or those who are not vaccinated are most vulnerable to severe and fatal cases of pertussis. In 2014, 66 of the pertussis hospitalizations cases were children four months of age or younger. Two infants have died of pertussis in California this year.

Of the 2,649 cases so far this year, 83% have occurred in infants and children younger than 18 years of age. Of these children, 8% were younger than 6 months old, and 70% were 7 through 16 years of age. In other words, all children are susceptible to the disease.

The CDPH breakdown by county (pdf) shows a stark and troubling trend:

  • Sonoma County–83.28 (incidence rate per 100,000 residents)
  • Napa County–42.42
  • Marin County–38.30
  • Tehama County–37.83
  • Trinity County–22.32
  • Humboldt County–19.29
  • City of Berkeley–18.24

TDaP-vaccine-vialFor those of you who do not live in California, these are some of the wealthiest, most educated counties in the country, let alone California. Marin County is one of the whitest, wealthiest (a median income over US$113,000), best educated, and most liberal (nearly 75% of the county voted for Barack Obama). Sonoma, Napa, Trinity, Humboldt and Tehama counties, along with the City of Berkeley, are very similar in socioeconomic makeup.

These constitute probably the largest pockets of vaccine denialism, which is demonstrated by the unusually high incidence of pertussis versus the statewide incidence rate of the disease of 6.93. This provides me, at least, with additional evidence that liberals can be as anti-science as right wing fools. Vaccines are safe. Vaccines prevent diseases like pertussis which can kill children. I’m not sure why the parents in these areas miss these basic points, But these pockets of hostility towards vaccines will be ground zero for any future epidemic in other diseases like measles or chickenpox.

As a reminder, the CDPH makes these recommendations about vaccinating against pertussis:

  • Pregnant women receive a pertussis vaccine booster during the third trimester of each pregnancy, even if they’ve received it before.
  • Infants be vaccinated against pertussis as soon as possible. The first dose is recommended at two months of age but can be given as early as 6 weeks of age during pertussis outbreaks. Children need five doses of pertussis vaccine by kindergarten (ages 4-6).
  • California 7th grade students receive the pertussis vaccine booster as required by state law.
  • Adults receive a one-time pertussis vaccine booster, especially if they are in contact with infants or if they are health care workers who may have contact with infants or pregnant women.

These are very similar to CDC recommendations regarding the vaccine.

These two babies would not have died, if they had been vaccinated (along with anyone in close contact) against whooping cough. A simple, effective, extremely safe vaccine. Are parents’ ignorance of scientific facts an excuse for these dead babies? Not in my world, where protecting children from harm should be a primary goal of society.

 

Visit the Science-based Vaccine Search Engine.

Refuting another antivaccination lie about the pertussis vaccine

Here we go again. There have been some articles published in peer-reviewed journals which have caused the antivaccination cult to not only misinterpret the data (shocking), but then broadcasting another lie (more shocking) which could lead to lower vaccinations rates.

Smart baboons searching for the pertussis vaccine.
Smart baboons searching for the pertussis vaccine.

According to research, some individuals who have been vaccinated against whooping cough (Bordetella pertussis), with either the DTaP or Tdap vaccine (which also protect against tetanus and diphtheria), remain infected with the pertussis bacteria, although they are asymptomatic. This is been morphed into the internet meme that only those who have been vaccinated carry the disease. Or worse yet, that the vaccine causes the asymptomatic infection. Typical of pseudoscience, the vaccine deniers take a little bit of scientific fact, and mutate it into something that meets their own biases.

First, let me give you a bit of background about the disease and vaccine, so that you can have a bit more context on what we’re discussing. The original DTP vaccine, sometimes called DTwP, became available in the USA in 1948 and was critical to dropping the number of cases of whooping cough from 260,000  in 1934 to less than a few thousand per year in the 1990′s. The original vaccine contained what was called “whole-cell” pertussis (thus wP), which includes all of the antigens of the pertussis bacterium, partially because it wasn’t understood (and to some extent still not fully understood) which antigens on the bacteria actually induce the proper adaptive immune response to destroy a pertussis infection. Continue reading “Refuting another antivaccination lie about the pertussis vaccine”

Pertussis vaccine reduced length and severity of whooping cough

Except for the evidence that says it's not a failure.
Except for the evidence that says it’s not a failure.

I know, there are just so many tropes and outright lies pushed by the vaccine deniers, it’s really hard for this writer to keep up with it all. But there’s one that has always bothered me, but I didn’t have quite enough evidence to lustfully debunk in my usual manner.

As has been shown in few studies, the vaccine against whooping cough (Bordetella pertussis), either  DTaP or Tdap (which also protect against tetanus and diphtheria), isn’t as effective in providing long-term protection as our expectations, based on other vaccines. Although the antivaccination cult has misinterpreted and misstated the actual numbers, an analysis of the data from the Washington State pertussis epidemic in 2011-2012 provided us with the following information:

  • Ages 5-9 unvaccinated or under vaccinated children are 6 times more likely to become infected with pertussis than fully vaccinated. 
  • Ages 10-13 unvaccinated or under vaccinated are 25 times more likely to become infected with pertussis than fully vaccinated. 
  • Ages 14-18 unvaccinated or under vaccinated  are 6 times more likely to become infected with pertussis than fully vaccinated.

In other words, not getting the vaccine made it easier to get infected with whooping cough. Continue reading “Pertussis vaccine reduced length and severity of whooping cough”