Vaccines are one of the most important and crucial aspects for the long-term health of babies and young children. Except for a tiny, and irresponsible, minority of individuals who are opposed to vaccinations, greater than 95% of children are fully vaccinated for most vaccine preventable diseases by kindergarten. Unfortunately, a recently published article in Pediatrics provided evidence that teens are not keeping up with vaccinations that are critical to avoid infections from serious, and deadly, diseases. The study examines how vaccination rates have changed over the three year study period, and some of the reasons why they are not getting vaccinated. Continue reading “Survey identifies reasons for not vaccinating teens”
The Montana Department of Health has reported (pdf) that as of November 15, 2012, a whooping cough (Bordetella pertussis) outbreak has reached over 500 cases since the beginning of the year, compared to only 129 cases during the same time period in 2011. As of November 15, 33 cases of pertussis were found in infants of less than one year of age. Of these, four have been hospitalized. Because Montana is has a small population (about 1 million people), the overall incidence rate year to date is 50.5 pertussis cases per 100,000 Montana residents.
This past spring, there was a pertussis outbreak in several Montana counties, but it seemed to abate during the summer. The Department of Health is reporting that Flathead county, a northern county that borders Canada, is currently struggling to contain an outbreak in five school districts. “Since the beginning of October, we have 35 cases,” said Community Health Services Director for Flathead County Jody White. “Usually we won’t even see 35 in a year, so it is definitely unusual to have this many.”
On October 24, 2012, the Centers for Disease Control and Prevention recommended that “providers of prenatal care implement a Tdap immunization (Tdap or DTaP vaccine) program for all pregnant women. Health-care personnel should administer a dose of Tdap during each pregnancy irrespective of the patient’s prior history of receiving Tdap. If not administered during pregnancy, Tdap should be administered immediately postpartum.” This recommendation is based upon the Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States, guidelines, published Fall 2011, for whooping cough(Bordetella pertussis).
ACIP reviewed published and unpublished data from VAERS, Sanofi Pasteur (Adacel) and GlaxoSmithKline (Boostrix) pregnancy registries, and two small studies here and here. ACIP concluded “that available data from these studies did not suggest any elevated frequency or unusual patterns of adverse events in pregnant women who received Tdap and that the few serious adverse events reported were unlikely to have been caused by the vaccine.” In addition, both tetanus and diphtheria toxoids (together) and tetanus toxoid (alone) vaccines have been used worldwide in pregnant women to prevent neonatal tetanus without negative effects. The ACIP concluded that administration of the pertussis vaccine after 20 weeks of pregnancy was preferred to minimize any risk of a low percentage adverse event.
According to the CDC, only about 3% of pregnant women receive the vaccination. However, the CDC believes if the new recommendations are implemented, there would be a 33 percent reduction in cases, a 38 percent reduction in hospitalizations and a 49 percent reduction in deaths from whooping cough.
Vaccines Saves Lives.
- Centers for Disease Control and Prevention. CDC Advisory Committee for Immunization Practices Recommends Tdap Immunization for Pregnant Women. October 24, 2012.
- Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months — Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011 Oct 21;60(41):1424-6. PubMed PMID: 22012116.
- Czeizel AE, Rockenbauer M. Tetanus toxoid and congenital abnormalities. Int J Gynaecol Obstet. 1999 Mar;64(3):253-8. PubMed PMID: 10366047.
- Gall SA, Myers J, Pichichero M. Maternal immunization with tetanus-diphtheria-pertussis vaccine: effect on maternal and neonatal serum antibody levels. Am J Obstet Gynecol. 2011 Apr;204(4):334.e1-5. Epub 2011 Jan 26. PubMed PMID: 21272845.
- Talbot EA, Brown KH, Kirkland KB, Baughman AL, Halperin SA, Broder KR. The safety of immunizing with tetanus-diphtheria-acellular pertussis vaccine (Tdap) less than 2 years following previous tetanus vaccination: Experience during a mass vaccination campaign of healthcare personnel during a respiratory illness outbreak. Vaccine. 2010 Nov 23;28(50):8001-7. Epub 2010 Sep 25. PubMed PMID: 20875487.
The Colorado Department of Public Health and Environment has reported that as of October 6, 2012, a whooping cough (Bordetella pertussis) outbreak has hit over 1000 cases since the beginning of the year, far exceeding the 5 year average of 2007-2011. The chart below shows the dramatic weekly increases in cases in Colorado since beginning of the year.
This year, 2012, was one of the worst whooping cough (Bordetella pertussis) outbreaks in the USA for the past 70 years, which included an outright epidemic in Washington state. Some of the reasons for the spread of the disease were a reduced whooping cough (Dtap) vaccination rate and reduced effectiveness of the Dtap (or TDaP) vaccine. Whooping cough is a serious disease, especially to children under the age of one year old, who have not been fully vaccinated. According to the Centers for Disease Control and Prevention, of those infants who are hospitalized with pertussis about:
- 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 Continue reading “Protecting infants from whooping cough by cocooning”
Note: an updated version of this article can be found here.
Over the past few months I have written extensively about the the current whooping cough (Bordetella pertussis) outbreak which has reached epidemic levels in areas like the Washington state, and has been considered one of the worst outbreaks in the USA during the past several decades. The outbreak has lead to several deaths here in the USA and in other countries such as the UK. Of course, this outbreak has lead to the blame game from the antivaccination crowd, because they claim 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.
So I decided to search the internet (or just read the comments section of my blog) to find the most popular vaccine denialist arguments regarding pertussis vaccinations, and deconstruct and debunk them. Hopefully, it will be a useful tool for you when you’re engaging a ridiculous argument with one of those antivaccinationists. Of course, I could use the information too. Continue reading “Effectiveness of pertussis vaccines–myth vs. reality”
The North Carolina Department of Health and Human Services has reported North Carolina’s first infant death from whooping cough on August 20, 2012. The child was only 2 months old. “Babies and young children are not fully immunized until they have finished a series of vaccinations, so their only protection against whooping cough is the people around them,” said State Health Director Dr. Laura Gerald. “Anyone who lives with or will be around a baby should be vaccinated.” In other words, someone who was not vaccinated or not fully vaccinated passed the infection to this child. Continue reading “Whooping cough: North Carolina reports first infant death in 2012”
Steven Salzberg, at Forbes Magazine, has reported that the USA is experiencing the worst whooping cough epidemic in 70 years. In addition, the CDC has stated that as of August 4 2012 (pdf), there are 21,000 cases and 10 deaths in the United States from whooping cough(Bordetella pertussis) year-to-date. Wisconsin has the highest rate of infection, while Washington, as I have discussed on a number of occasions, has one of the highest total number of pertussis infections.
The Washington State Department of Health is reporting that as of August 4, 2012, the current whooping cough (Bordetella pertussis) epidemic has hit 3400 cases, over 15X more than the 214 cases reported at the same time last year. The epidemic has finally shown a big drop off in new reports this past week (pdf), although there are concerns that the numbers will increase against this fall as children return to school in the autumn.
According to the Centers for Disease Control and Prevention, pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized. Approximately 1-2% of infants who are hospitalized from pertussis will die. Continue reading “Whooping cough update: Washington state epidemic hits 3400 cases”
According to the Guardian, a total of 2,466 cases of whooping cough (Bordetella pertussis) have been confirmed in the United Kingdom between January and June of 2012, causing the deaths of 5 infants. The UK’s Health Protection Agency (HPA) said that the number of cases is six times larger than the last comparable outbreak in 2008. The government’s vaccination committee is “now considering recommending booster vaccinations for teenagers and pregnant women and has already recommended immunising healthcare workers who treat young children because infants are most at risk.”
Also according to the article, Mary Ramsay, the HPA’s head of immunization, said: “We are working closely with the Department of Health’s Joint Committee of Vaccination and Immunization to consider the most effective ways to tackle the ongoing outbreak. The committee is reviewing a number of options, including the introduction of a booster dose in teenagers and offering whooping cough vaccination to pregnant women. In the meantime we are actively reviewing our cases to see what interventions could have the quickest impact on the spread.” Continue reading “Whooping cough–UK epidemic leads to 5 infant deaths”