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I have a question about Pertussis


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Our state is at an epidemic level apparently for pertussis (whooping cough). The news says that this is because the vaccine only lasts 10 years and people need booster shots. So my question is - before vaccination did people get a longer immunity from actually getting the disease? And if the vaccine only lasts 10 years, why would they be saying that this is the highest since the 70's? Wouldn't we have seen problems a lot sooner than now? Do you understand what I'm asking?

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Well, the new acellular vaccine was introduced in 1997, so that's why we're only now beginning to see the effects of changing the composition of the vaccine. Children who were receiving this vaccine are having waning immunity at this point.

 

Adults generally have very little immunity to pertussis, but they haven't been contracting it in the numbers we have seen in the past five years. It's mild in many adults, and they don't realize they are spreading it. What's been devastating is parents or grandparents who have contracted it and then spread it to an infant. It's really sad, because at least nine infants have died in this manner.

 

If you haven't had a DTP booster and you're an adult...go get one.

 

Link to CDC article: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm

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Search for "baby whooping cough" on YouTube before deciding whether or not to get your family a booster. It's heartrending. (Directed generally, not at the OP.)

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Our state is at an epidemic level apparently for pertussis (whooping cough). The news says that this is because the vaccine only lasts 10 years and people need booster shots. So my question is - before vaccination did people get a longer immunity from actually getting the disease? And if the vaccine only lasts 10 years, why would they be saying that this is the highest since the 70's? Wouldn't we have seen problems a lot sooner than now? Do you understand what I'm asking?

 

I was also reading about it. the vaccine was reformulated in the 90's to "make it safer". of those who have been vaccinated and still have gotten sick, preliminary indicators are they received the reformulated vaccine. there is also the problem that we have one of the highest rates of non-vaccination in the country. the cdcp is still trying to figure out exactly what is going on.

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My biological children have a medical exemption to vaccines signed by 3 doctors - neurologist, geneticist and pediatrician. My adopted son is fully vaccinated. A huge percentage of our church is unvaccinated due to "fear" of autism and other natural health concerns.

 

I am talking with our pediatrician about getting my children caught up on vaccines bc of the risk, even though it could be dangerous for them. We had a pertussis outbreak at our church a couple years ago. I don't want to risk them getting exposed to pertussis again...

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I had it (the disease, not the vaccination) when my big kids were preschoolers. Absolutely awful. I have wondered if my immunity because of that is stronger. I hope so as I get sick on a dime. UGH.

 

The only vaccination related thing I'm not immune to, as far as I know, is Rubella. I was vaccinated a couple times as an adult because I didn't show immunity and still am not showing immunity. My body just won't do right for that one.

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I was also reading about it. the vaccine was reformulated in the 90's to "make it safer". of those who have been vaccinated and still have gotten sick, preliminary indicators are they received the reformulated vaccine. there is also the problem that we have one of the highest rates of non-vaccination in the country. the cdcp is still trying to figure out exactly what is going on.

 

The article I saw brought up the non-vaccination rate here but then admitted that the people getting sick have actually been vaccinated. At least the children - I don't know about adults who might have lighter cases and might give it to the children.

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Medpage today has an article up about it being a combo of factors. Some studies are showing immunity may wane in as little as 3 years (see fairly recent Forbes piece on this online), which is even shorter than previously thought. THe acellular version is less reactive and therefore deemed "safer" by many, but it also hasn't provided the same level of immunity. This particular medpage piece up today says despite many people thinking it is due to nonvaxers, it appears to be tied to other factors more than that. A local school had a few cases several months ago and all cases involved were in fully vaccinated individuals.

 

The pertussis vaccination is a vax against the toxin produced by pertussis. It isn't against the actual bacteria itself. For that reason asymptomatic people can possibly spread it as well (this is documented). There are asymptomatic carriers as well out in the community. If you are coughing a lot, then you certainly are probably coughing up more particles. BUt people with subclinical infection who seem asymptomatic can also spread pertussis. If you culture fully vaxed people, you'll still find people with pertussis in their passages, because again, the vax doesn't work against the actual bacteria, but instead against the toxin produced by that bacteria.

 

There was a paper I looked at recently that mentioned we have made a tradeoff in that pertussis has always circulated in communities. The thought is that there was a natural boost that way, and that many people were exposed but many didn't necessarily contract the full illness. So that general circulation was bad in that some people did get really sick (particularly the most vulnerable, like infants), but the population as a whole was regularly boosted via circulation of subclinical disease in the community. With the vaccination, you may do a better job of protecting the most vulnerable, but you also lose some of that subclinical circulation that provided a natural booster to the community in the past.

 

http://www.ncbi.nlm.nih.gov/pubmed/22111856

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A couple of questions: if DH and I had the vaccine as children, it sounds like our immunity could be wearing off. So maybe boosters would be in order for us, even if I don't plan to get it for the children. But since I'm nursing our littlest, could that put him at risk for it if I got the booster, even though he's at very low-risk for getting it otherwise? (DH works in a very, very small office, and we are not around very many people; if there was a significant outbreak around here, we absolutely could keep the children home and out of the general public for an extended period of time.)

 

Another slightly silly question: if we (DH and I) don't currently have health insurance, would we have to pay for the vaccine?

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My friend and her daughter, both vaccinated have now had it twice. They have had it mildly but have still been quite ill. I had a booster as did DH before Possum came home from NICU. We were told to ensure Grandparents also had boosters as they are the common carriers. In my state there has been serious outbreaks for the past 18m. Our health department says its because of people failing to vaccinate their children and the numbers support it. I know several large families who don't vaccinate who had it last year and were wiped out for 6m.

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Fewer people are being vaccinated these days, which allows the disease to get a foothold in a community.

This is being refuted in many of the most current pieces, and the CDC is refuting that as well.

 

That also means people who refuse to have their children vaccinated probably aren't driving the epidemic, Selecky added.

 

"That's a bad thing, but we can't blame this whole wave on that phenomenon," Schuchat said.

 

(Selecky is from the Washington State health dept and Schuchat is from the CDC)

 

 

Quote from medpage today but you probably need a login. This was literally just put up today, so probably reflective of the most up to date information. Medpage Today is an online news update/newsletter for healthcare providers that summarizes the most recent medical news.

 

http://www.medpagetoday.com/InfectiousDisease/Vaccines/33829?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g352182d0r&userid=352182&email=e-beasley@comcast.net&mu_id=5345887

 

 

In recent years they have been blaming the non vaxers, but they seem to be realizing that is not the primary cause of the epidemic now.

Edited by Momof3littles
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The little boy I take care of still has his lingering cough from a few months ago when he had pertusis. He was fully vaccinated. The doctors here explained that it is a different strain than what he is vaccinated for. Fortunately for us, despite daily intense exposure to it before diagnosis, no one in my family came down with it. My youngest has not been fully vaccinated against it, and according to the above information the vaccinations my oldest had would be wearing / worn off. Not to mention I've never had a booster. All that to say, it's not necessarily people not getting vaccinated causing the outbreaks.

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Whopping cough is a bacteria. They can not vaccinate for a bacteria. The only thing the vaccine does is lessen the symptoms, so a vaccinated person can spread it and not even no it. That is one reason my children do not get the vaccine.

 

 

In early 2010, a spike in cases appeared at Kaiser Permanente in San Rafael, and it was soon determined to be an outbreak of whooping cough -- the largest seen in California in more than 50 years.

Witt had expected to see the illnesses center around unvaccinated kids, knowing they are more vulnerable to the disease.

"We started dissecting the data. What was very surprising was the majority of cases were in fully vaccinated children. That's what started catching our attention," said Witt.

http://www.reuters.com/article/2012/04/03/us-whoopingcough-idUSBRE8320TM20120403

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Whopping cough is a bacteria. They can not vaccinate for a bacteria. The only thing the vaccine does is lessen the symptoms, so a vaccinated person can spread it and not even no it. That is one reason my children do not get the vaccine.

 

 

In early 2010, a spike in cases appeared at Kaiser Permanente in San Rafael, and it was soon determined to be an outbreak of whooping cough -- the largest seen in California in more than 50 years.

Witt had expected to see the illnesses center around unvaccinated kids, knowing they are more vulnerable to the disease.

"We started dissecting the data. What was very surprising was the majority of cases were in fully vaccinated children. That's what started catching our attention," said Witt.

http://www.reuters.com/article/2012/04/03/us-whoopingcough-idUSBRE8320TM20120403

 

:iagree:In my years of investigating outbreaks of pertussis in the community, it was not a problem being "caused" by the unvaccinated. In fact, in 99.9% of cases, the children were fully and correctly (meaning on time and correct spacing) vaccinated. Pertussis isn't going anywhere - vaccination or no vaccination. The vaccine can lessen severity and duration of the illness for the person who contracts pertussis (which is still possible even if one is vaccinated). That subclinical case of pertussis can still be spread around - and often, no one thinks it's pertussis because a) vaccination occurred and b) the classic symptoms aren't present. therefore, we possibly end up with close contacts being exposed and not prophylactically treated...thus mommy has a not-so-bad case of undiagnosed pertussis and infant who is un- or undervaccinated gets a full-blown case a few weeks later.

i'm not saying don't get vaccinated. i am saying it's not as cut and dry as "get vaccinated and all is well"

 

for the pp who asked about tdap while nursing (taken from sanofi pasteur's site...)

8.3 Nursing Mothers

It is not known whether Adacel vaccine is excreted in human milk. Because many drugs are

excreted in human milk, caution should be exercised when Adacel vaccine is given to a nursing

woman.

Edited by jackson'smama
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for the pp who asked about tdap while nursing (taken from sanofi pasteur's site...)

8.3 Nursing Mothers

It is not known whether Adacel vaccine is excreted in human milk. Because many drugs are

excreted in human milk' date=' caution should be exercised when Adacel vaccine is given to a nursing[/font']

woman.

 

Thanks for sharing that. Still not sure. I'll have to look into the likelihood of it around here.

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