Comparing effectiveness of two types of pertussis vaccines

whooping-cough-cocoonOver the past year or so, there have been several outbreaks of whooping cough (Bordetella pertussis), including one that reached epidemic levels in Washington state, which has been considered one of the worst pertussis outbreaks in the USA during the past several decades. The disease lead to 18 infant deaths from whooping cough during 2012.

The original DTP vaccine (diphtheria, tetanus and pertussis) 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, 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 immune response to have the body destroy a pertussis infection.  Continue reading “Comparing effectiveness of two types of pertussis vaccines”

Consequences of not vaccinating–Report 5

A baby died in Florida from whooping cough (Bordetella pertussis) last week. According to the report, “officials said the family chose not to vaccinate their child. Some parents are choosing not to fully vaccinate their children because they worry there is a link between the vaccinations and autism.” Of course, there is no evidence that vaccines cause autism.

Let’s place the blame for this death right where it belongs, right at the feet of  MrAndy Wakefield, the de-licensed physician, who caused the drop in MMR vaccine uptake through his fraudulent claim that MMR caused autism. Wakefield is a horrible excuse for a human being, and probably should take responsibility for this and many other deaths that resulted from his fraudulent and retracted study claiming that vaccines cause autism.

Parents have a moral obligation to vaccinate their children.

We have a moral responsibility for the health of our children and this has to dominate any other belief systems we hold. Even worse, by not vaccinating children, we are putting other people’s children at risk, as well as our own. If another child dies of measles, or whooping cough, or meningitis, and was infected by our own, non-vaccinated child, are we partly responsible?

And they should start by ignoring Wakefield’s lies. Because vaccines would have saved this baby’s life.

 

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How vaccines saved millions of lives

Infographic: How People Died In The 20th Century

 

Over 5.2 billion people died in the 20th Century. Although the 20th Century ended a mere 13 years ago, from a statistics standpoint, we know we will probably die of different diseases (and other less natural causes) than our forebears. The causes of death evolve over time as medicine improves, science ameliorates risk, lifestyles change, environments shift, and politics reshape our world. British data journalist David McCandless (of Information is Beautiful) created this fascinating infographic based on a project, commissioned by the Wellcome Trust, a U.K. charity devoted to human health, called Death in the 20th Century, which shows us, graphically, the leading causes of mortality from 1900 to 2000, worldwide. 

Some of the numbers are shocking. Humanity is the cause of nearly 1 billion (or just short of 20%) of the deaths in the 20th Century. These numbers include war, murders, religious intolerance, suicide, and other deadly crimes that humans perpetrate against one another. Maybe the 21st Century will knock that number down, though I doubt any of us are optimistic given the way this century has started.

But the most interest information is in the Infectious Disease section. Nearly 1.7 billion people have died from infectious diseases. Some of the more interesting numbers are:

In the 21st Century, the numbers of deaths from these diseases will probably be in the few thousand worldwide. Why? Because of vaccines. Not better sanitation. Not better health care facilities. But because of vaccines.

And in the 21st Century, as more vaccines are developed and brought to market, many of these infectious diseases will be less of a problem. 

Vaccines saves lives. Literally hundreds of millions of lives.

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Waning whooping cough immunity after DTaP–a new analysis

Protect Your Baby from Whooping Cough.

Despite the fact that over 95% of kindergarteners in the United States are properly vaccinated against whooping cough (Bordetella pertussis) with the DTaP vaccine, there are persistent reports that the rates of whooping cough have risen during the past few years. Several outbreaks, along with an outright epidemic in Washington state, seemed to indicate that the vaccine’s effectiveness is waning faster than expected.

A recently published study in Pediatrics evaluates reports of increased rates of pertussis in the six years after receipt of the fifth (of five) DTaP doses. These reports suggest that waning of immunity to pertussis from DTaP is occurring before the recommended booster age of 11 to 12 years. The researchers tracked more than 400,000 Minnesota and Oregon children using immunization records and state health department whooping cough data. All of those children were born between 1998 and 2003 and received the recommended series of five DTaP shots, the final one usually given at 4-6 years old. Continue reading “Waning whooping cough immunity after DTaP–a new analysis”

Whooping cough vaccine–facts about waning immunity

A new article published this week in the Journal of the American Medical Association (JAMA) by Misegades et al. analyzed a recent whooping cough (Bordetella pertussis) outbreak in California children. Misegades determined that those who had not been vaccinated against the disease were nine times more likely to get pertussis than those who had received the entire five-shot series. However, among children who were fully vaccinated, the longer it had been since their final dose of the DTaP vaccine (which protects against diphtheria, tetanus and pertussis), the higher the risk of contracting whooping cough. This is in line with the decrease in effectiveness of the vaccine that has been discussed here and elsewhere. Continue reading “Whooping cough vaccine–facts about waning immunity”

Whooping cough update: outbreak in Montana continues

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.”

Continue reading “Whooping cough update: outbreak in Montana continues”

CDC recommends pertussis vaccination for all pregnant women

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.

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Whooping cough update: Colorado outbreak hits 1000 cases

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.

Continue reading “Whooping cough update: Colorado outbreak hits 1000 cases”

State legislatures making vaccine exemptions more difficult to obtain

Outstanding news. Tara Haelle reported in Nature News & Comment that US state legislatures are beginning to pass laws that make it more difficult for parents to obtain so-called personal exemptions to vaccinations before children attend public schools.

According to Haelle, “Each US state sets its own vaccination policies, and most will not generally allow children to attend public school unless they have been vaccinated against diphtheria, tetanus and pertussis (whooping cough); hepatitis B; the Haemophilus influenzae bacterium; measles, mumps and rubella; polio; and varicella (chicken pox).” In general, most states require that students meet the Centers for Disease Control and Prevention schedule (pdf) for children between 0 and 6 years old, which is set by the Advisory Committee on Immunization Practices.

All states allow legitimate medical exemptions from the immunization schedule, because of certain medical conditions that might make vaccinations problematic for young children. Some of these medical issues are: allergies to some of the components in the vaccines, immunocompromised conditions, family history of seizures, and other issues outlined in the General Recommendations on Immunization of the Advisory Committee on Immunization Practices. Continue reading “State legislatures making vaccine exemptions more difficult to obtain”

Protecting infants from whooping cough by cocooning

Infant being treated for pertussis infection. ©CDC, 2012.

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: