When I take Willow to the Pediatrician and she gets any kind of shots, the doctor gives us a pamphlet with information on the shots (Likely from the CDC). So, since everyone is all up in arms about the links between vaccinations and things like autism, I thought I'd take an in-depth look at the vaccinations. Next in line is the Pertussis (also known as "Whooping Cough") vaccination, which is a combination vaccination along with Diphtheria, and Tetanus. However, I am only going to talk about Pertussis here today.
The United States' Centers for Disease Control and Prevention (CDC) Vaccinations and Immunizations section has a recommended immunization schedule that you can download. They also have a lot of great information for each and every vaccination so this is where I will start in my search for information. Here is their pamphlet on the DTaP Vaccination.
The Pertussis vaccination is given as a combination vaccination along with Diphtheria and Tetanus (DTaP) in five doses. The first is at 2 months of age, the second at 4 months of age, the third at 6 months of age, the fourth at 15-18 months of age, and the final vaccination is given between 4-6 years of age. This vaccination is may be given at the same time as other vaccinations.
First, what exactly is Pertussis? Pertussis, also known as whooping cough, is a highly contagious disease caused by the bacterium Bordetella pertussis; it derived its name from the characteristic severe hacking cough followed by intake of breath that sounds like "whoop"; a similar, milder disease is caused by B. parapertussis. Although many medical sources describe the whoop as "high-pitched", this is generally the case with infected babies and children only, not adults.
Worldwide, there are 30–50 million pertussis cases and about 300,000 deaths per year. Despite generally high coverage with the DTP and DTaP vaccines, pertussis is one of the leading causes of vaccine-preventable deaths world-wide. Most deaths occur in young infants who are either unvaccinated or incompletely vaccinated; three doses of the vaccine are necessary for complete protection against pertussis. Ninety percent of all cases occur in the developing world. Children tend to catch it more than adults.
Pertussis History/Background: Infection with pertussis induces immunity, but not lasting protective immunity, and a second attack is possible. Efforts to develop an inactivated whole-cell pertussis vaccine began soon after B. pertussis was grown in pure culture in 1906. In the 1920s Dr. Louis Sauer developed a vaccine for whooping cough at Evanston Hospital (Chicago, IL). In 1925, the Danish physician Thorvald Madsen was the first to test a whole-cell pertussis vaccine on a wide scale. He used the vaccine to control outbreaks in the Faroe Islands in the North Sea. In 1942, the American scientist Pearl Kendrick combined the whole-cell pertussis vaccine with diphtheria and tetanus toxoids to generate the first DTP combination vaccine. To minimize the frequent side effects caused by the pertussis component of the vaccine, the Japanese scientist Yuji Sato developed an acellular pertussis vaccine consisting of purified haemagglutinins (Has: filamentous HA and leucocytosis-promoting-factor HA), which are secreted by B. pertussis into the culture medium. Sato's acellular pertussis vaccine was used in Japan since the autumn of 1981. Later versions of the acellular pertussis vaccine used in other countries consisted of additional defined components of B. pertussis and were often part of the DTaP combination vaccine.
In the pre-vaccine era, pertussis was a common childhood disease and a major cause of child and infant mortality in the United States. Routine childhood vaccination led to a reduction in disease incidence from an average of 150 reported cases per 100,000 persons between 1922 and 1940 to 0.5 per 100,000 in 1976. The incidence of reported pertussis began increasing in the 1980s, and in 2005, the incidence of reported pertussis was 8.6 per 100,000 persons. Reasons for this increase are not fully understood, but likely contributing factors include increased awareness of the disease and the increased use of diagnostic tests for adolescents and adults.
From 2001 through 2003, persons older than 10 years of age accounted for 56% of reported cases, 3 more than double the 24% they accounted for from 1990 to 1993.
Despite this increase in reported pertussis among adolescents and adults, incidence remained highest among young infants. In 2005, most (38 of 39) pertussis-related deaths reported to CDC were among infants aged younger than 6 months, who were too young to have received three doses of DTaP vaccine.
Pertussis is a very contagious disease, and one that is fairly common in the United States, even today.
Signs of Whooping Cough (Pertussis): After a two day incubation period, pertussis in infants and young children is characterized initially by mild respiratory infection symptoms such as coughing, sneezing, and runny nose (catarrhal stage).
After one to two weeks, the cough changes character, with an increase of coughing followed by an inspiratory "barking" sound (paroxysmal stage). Coughing fits may be followed by vomiting due to the sheer violence of the fit.
In severe cases, the vomiting induced by coughing fits can lead to malnutrition and dehydration. The fits that do occur on their own can also be triggered by yawning, stretching, laughing or yelling. Triggering fits gradually diminish over one to two months during the convalescent stage. Other complications of the disease include pneumonia, encephalitis, pulmonary hypertension, and secondary bacterial superinfection.
How is Pertussis (Whooping Cough) Spread?
How is Pertussis Prevented?
Now, a little about the DTaP vaccination (since we are talking about childhood vaccination). DTaP combines vaccines against three diseases, Diphtheria, Tetanus and Pertussis into one shot. (The small “a” in the name stands for “acellular,” which means that the pertussis component of the vaccine contains only parts of the pertussis bacterium rather than the whole cell.) The diphtheria and tetanus components of the vaccine are not technically vaccines, but “toxoids.” In other words, they help the immune system develop protection against the toxins produced by the diseases rather than against the disease bacteria themselves. All three components of DTaP are “inactivated” (killed). Tetanus, diphtheria and pertussis (DTP) vaccines have been in common use since the 1940s. DTaP vaccine (with the acellular pertussis component) was first licensed in 1991.
Risks of DTaP vaccination - Getting diphtheria, tetanus, or pertussis disease is much riskier than getting DTaP vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small.
Mild Problems (Common)
These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, lasting 1-7 days (up to about 1 child in 30).
Other mild problems include:
These problems generally occur 1-3 days after the shot.
Moderate Problems (Uncommon)
Severe Problems (Very Rare)
Several other severe problems have been reported after DTaP vaccine. These include:
These are so rare it is hard to tell if they are caused by the vaccine.
Some children should not get the vaccine or should wait to get it. They include:
Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.
Talk with your doctor if your child:
I found an awesome website that lists the package inserts and ingredients for all available vaccinations (e.g. provided by MERK or GlaxoSmithKline). It's called the World Association for Vaccine Education. You can find their page on DTaP here.
Since we always hear about the link between getting vaccinated and some other disease or condition, I did a search to see if there were links between the DTaP vaccination and any kind of disease or neurological disorder and I couldn't find anything that wasn't mentioned in the vaccination information pamphlet.
More Information:
And since there are those people that are concerned about links of vaccinations to neurological disorders and the like I thought I'd include some of their links as well:
Generation Rescue is an international movement of scientists, physicians and parent-volunteers researching the causes and treatments for autism and mentoring thousands of families in recovering their children from autism.
The Thinktwice Global Vaccine Institute was established in 1996 to provide parents and other concerned people with educational resources enabling them to make more informed vaccine decisions. Thinktwice encourages an uncensored exchange of vaccine information, and supports every family's right to accept or reject vaccines. Thinktwice's DTaP page.
I asked my pediatrician if she had a lot of parents who were choosing to NOT vaccinate their children. She said she could count on one hand the total number and that she, of course, recommends AGAINST not vaccinating your children.
Previously:
Hepatitis B Vaccination Information
Rotavirus Vaccination Information
Diphtheria Vaccination Information
Tetanus Vaccination Information
Next Week: Haemophilius influenzae type b Vaccination
October 29, 2008
About Vaccination: Pertussis (Whooping Cough)
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