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ACIP reviewed published and unpublished data from VAERS, Sanofi Pasteur (Adacel) and GlaxoSmithKline (Boostrix) pregnancy registries, and two small studies here and here.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.
It’s getting close to flu season, and it’s time to get your flu shot. Of course, there are myths for why people won’t get their flu shots. All of them are amusingly bad.
Last fall, Dr. Mark Crislip published A Budget of Dumb Asses (requires a Medscape account) that takes on anti-science with a whole new level of snark. I have part of it here for you, thanks to Biodork’s (great name) Time for your flu shot! It’s all about getting (or not getting) the flu vaccination, but you can replace flu with any other vaccination. Apparently, he wrote it for health care workers, but hey, I think it works for patients too!
Mark Crislip starts out his snark with a quick statement about not getting a flu shot. You might be a dumb ass, if you’re unwilling to get the vaccine:
I wonder if you are one of those Dumb Asses who do not get the flu shot each year? Yes. Dumb Ass. Big D, big A. You may be allergic to the vaccine (most are not when tested), you may have had Guillain-Barre, in which case I will cut you some slack. But if you don’t have those conditions and you work in healthcare and you don’t get a vaccine for one of the following reasons, you are a Dumb Ass.
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”
Chickenpox, or Varicella zoster, is a common childhood disease that can result in fairly serious complications such as encephalitis, pneumonia, sepsis, hemorrhagic varicella, and death. Individuals at especially high risk from complications from varicella are immunocompromised, usually from some sort of immunodeficiency or immunosuppression (usually pharmaceutical treatments for cancers or autoimmune diseases). For immunocompromised individuals, it is important that any individuals around them should be vaccinated against common childhood diseases, whether chickenpox or other diseases (mumps, rubella, etc.), because the chances of transmitting these diseases is extremely high and the risk of complications are serious.
The Washington State Department of Health has reported (pdf) that the current whooping cough (Bordetella pertussis) epidemic has hit 2883 cases, over 10X more than the 210 cases reported at the same time last year. The epidemic seems to have peaked a few weeks ago, although concerns will remain as children return to school in the autumn.
The Washington State Department of Health is reporting that there are 2647 confirmed cases of whooping cough (Bordetella pertussis) as of June 23, 2012. This number compares to only 187 cases during the same period in 2011. The epidemic has stricken 31 out of 39 counties (pdf) in the state with Skagit County having the highest number at 508 confirmed cases.
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.
Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud “whooping” sound. This extreme coughing can cause you to throw up and be very tired. The “whoop” is often not there and the infection is generally milder (less severe) in teens and adults, especially those who have been vaccinated.
Whooping cough can be easily prevented with the Tdap or DTaP vaccine. The problem is that infants are not initially vaccinated until they are 2 months old, and are not fully immunized until they’re 6 months old, so they are susceptible to adults who may be infected. Adults may have lapsed immunity or may have not been vaccinated.
It’s unknown why the epidemic in Washington state has grown so fast and so large, but it may be that there is a pool of anti-vaccine sentiment in the area.