Unfortunately, I could not stay both days, because I had to get back to teach on Thursday. But that one day was instructive. Like last time, this meeting was data-heavy and intensive, and the process was thorough.
While a number of anti-vaccine activists attended, there was no real indication that they followed the committee’s deliberations, tried to understand what was discussed, or learned from the information presented.
Their comments during and after the meeting did not contribute substantively to the discussion or offered anything that could lead to meaningful policy changes.
Because of the length of this review, it will be divided into two parts:
On June 5, 2018, the US Third Circuit Court of Appeals overturned a District Court’s decision to dismiss a case filed by a nurse who alleged she was terminated for refusing a Tdap vaccine for medical reasons. The focus of the decision was not the vaccine refusal per se; the focus was what are the pleading standards in a claim alleging a failure to provide a reasonable accommodation of a disability. While the specific claim of the nurse’s vaccine refusal is unconvincing in many ways, I think the Third Circuit (“the court”) was right to allow her case to proceed at least a bit further.
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.
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.
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.
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.
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.
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.
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”
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”
One 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.
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.
Sonoma County–83.28 (incidence rate per 100,000 residents)
City of Berkeley–18.24
For 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 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.