Whooping Cough Vaccine Stirs Debate

New research has shown that protection from whooping cough (pertussis) weakens a few years after preschool children get their final diptheria, tetanus and pertussis (DTaP) shot. The current recommendation from the Centers for Disease Control and Prevention (CDC) is that children receive a booster between ages 11 and 12.

It’s likely that the trend is linked to a change in the vaccine in the 1990s. An acellular pertussis vaccine with fewer side effects was introduced and replaced the original whole-cell vaccine. The new research notes that children may be at risk of developing whooping cough before age 11 because their immunity is declining from a weaker vaccine.

Dr. H. Cody Meissner is a pediatrician at Tufts University School of Medicine in Boston and notes, “There’s a fairly dramatic and startling increase in pertussis [whooping cough] in children in the seven to ten-year old age group.”

Sara Tartof from the Southern California Permanente Medical Group in Pasadena led the group of researchers on the new study. Immunization records of 400,000 Minnesota and Oregon children who received the recommended series of five DTaP shots were analyzed.

“An important thing to remember is the kids who do receive all five doses on time generally have milder [whooping cough] than those who are under-vaccinated or unvaccinated,” Tartof said. “Even though there is waning immunity…getting the five doses on time is still the best protection you can give your kid.” Parents should continue to follow the CDC’s vaccine schedule.

The CDC Advisory Committee on Immunization Practices has decided not to recommend an alternative revaccination schedule despite the waning pertussis protection. The group cited that the risks of pertussis decrease with age.

“It is so important that people do not interpret this as the vaccine doesn’t work, and then not get vaccinated at all,” Meissner concludes. “Because then we would really have a problem.”

In New York, this is already becoming a problem as the rise in religious exemptions for children is paralleling a rise in whooping cough cases. “It’s troubling from an ethical standpoint,” Dr. Jana Shaw, a professor of pediatrics at SUNY Upstate Medical University states. “If you have gotten an exemption for your child, not only are they at high risk of [whooping cough], but you’re putting other children at risk – even those who have been vaccinated.”

Clay County in Missouri is having a vaccination campaign for childcare workers, parents and grandparents in July. The Public Health Center believes that vaccinating those who come into contact with infants will decrease the cases of whooping cough in the county. Whooping cough is often unknowingly spread from unvaccinated adults to children who don’t have full immunity until they are 12-15 months of age.

‘Buffy the Vampire Slayer’ actress Sarah Michelle Gellar is also supporting the pertussis vaccine. Gellar, who has two small children, has partnered with March of Dimes to increase awareness about the importance of childhood vaccines. She also recommends adults be vaccinated for whooping cough.

Vaccines are one of the best forms of protection for children. Parents should consult their child’s pediatrician if they have questions or concerns about the vaccine schedule or a particular vaccine.

Australia's Anti-Vaccine Approach

Australia conducted a national survey on the attitudes of vaccination and found that 50% of parents are worried about the safety of childhood vaccines. This statistic has heightened concerns of childhood outbreaks of disease.

Parents who were opposed to vaccination stated that the Internet was their main source of information. Those in favor of vaccination obtained their information from their family doctor. Over 92 percent of 2-year olds in Australia are fully immunized, but officials note some areas have lower coverage. No Jab No Play law changes have been proposed to allow preschools and childcare centers to ban unvaccinated children.

“If the attitude of complacency becomes too widespread, we risk falling back into an epidemic situation again,” says Immunologist Sir Gustav Nossal. “Diseases will re-emerge if immunization rates drop too low.” The recent measles outbreak in Wales highlights this point.

Australian Health Minister Tanya Pilbersek condemned the amount of misinformation around vaccination while encouraging parents to immunize their children. All three of Pilbersek’s children are fully immunized.

“Vaccination has been repeatedly demonstrated to be one of the most effective public health measures at our disposal and saves an estimated three million lives around the world each year,” Pilbersek states.

“Dr. Google has been a negative influence in this debate,” she continues. “Instead of giving credence to thoroughly disproved theories, parents should read about the myths and realities of vaccination and talk to their general practitioner.”

Pilbersek’s statements coincide with Australia’s release of the updated booklet, Immunisation Myths and Realities. The booklet addresses many common myths and safety concerns and stresses that the benefits of vaccine in terms of reducing illness and death far outweighs the small risks.

Dr. Seth Berkley, the CEO of the GAVI Alliance, which provides children in developing countries with access to vaccines, says that most parents who opt-out of vaccinations are being guided by irrational fears that are a luxury of living in the developed world.

“There is a real danger that such fears will trickle down into the developing world where lives are even more vulnerable. In wealthy countries most of us have either forgotten or never knew the horror of these diseases,” Dr. Berkley notes.

“This issue of mistrust is not about whether vaccines work,” he continues. “On the contrary, parents who opt out are very much counting on it, relying on everyone else to provide the herd immunity they have so willingly rejected. If everyone does this, then the fear of a remote possibility of your child having an adverse reaction to the vaccine is replaced by the far more immediate risk that they could become seriously ill.”

The situation Dr. Berkley refers to was magnified by the measles outbreak in Wales, when long lines began forming, as parents caught their children up on the MMR vaccine. Vaccine Watch encourages all parents to address their vaccine fears by talking with their family doctor.

HPV Virus Fears

The Journal of Pediatrics published a study in March that shows the number of teenagers being vaccinated for the human papillomavirus (HPV) is declining.  The Centers for Disease Control and Prevention (CDC) recommends that both boys and girls receive three HPV shots as pre-teens to prevent cervical cancer.

Actor Michael Douglas recently brought HPV back to the forefront of media attention when he stated that his neck and throat cancer in 2010 was caused by HPV he contracted through oral sex. HPV is incredibly common and statistics show that 85% of the population will be infected by it at some point, with 20 million people being actively infected at any given time.

2010 statistics show that three quarters of girls age 13 to 17 were not up to date on their HPV series and 44 percent of parents didn’t plan to get their daughters the rest, or any of their HPV shots.

Multiple studies have shown that the HPV vaccine isn’t linked to any serious side effects and offers protection against the virus that causes cervical cancer. However, many sensationalized articles report girls having bad reactions to the vaccine. Natural News published a suggestive article earlier this year, linking HPV and tetanus vaccines to the autoimmune disease antiphospholipid syndrome (APS).

Dr. Amanda Dempsey is a pediatrician and vaccine researcher with the University of Colorado in Denver. “Safety concerns have always risen to the top of the pile, in terms of being one of the main reasons people don’t get vaccinated, which is unfortunate because HPV is one of the most well-studied vaccines and is extremely safe.”

Dempsey urges parents not to rely on the media or the Internet to learn about vaccines, since it’s hard to tell what information is legitimate. “If they have questions or concerns, they should trust their provider to give them information about the vaccine.”

Heather Millar is a cancer survivor and blogs for WebMD. She recently posted about Michael Douglas and HPV and notes, “Yet here’s one thing we can absolutely do to prevent cancer: The CDC recommends the HPV vaccines.”

The CDC does state that in rare cases, vaccines cause side effects, but 90% of the time the side effects are mild like a fever or soreness. Serious side effects are only shown in less than 1% of those vaccinated.  Millar comments on the harrowing experiences of cancer treatment and notes that she can’t imagine skipping a vaccine that might prevent cancer.

In a write-up about the Hepatitis A vaccine, CDC states, “…the vaccine is much safer than getting the disease.” This statement is true of all the vaccines recommended by CDC.

“The most serious popular notions about vaccines, such as the idea that some of them can cause autism, have been disproved again and again,” Millar states. “Remember: vaccines are given to prevent diseases that used to kill people in the tens of millions.”

Vaccine Watch encourages all parents to speak with their pediatrician about the risks and benefits of the HPV vaccine. This series of shots is a simple preventative measure that protects boys and girls from the dangers of cervical, throat and neck cancer.

Get Vaccinated: It's the Law

A growing number of parents in Oregon aren’t vaccinating their children against deadly diseases because they believe vaccines can have irreversible adverse health effects. Oregon leads the national exemption list, with 5.8 percent of kindergartners (or more than 2,600 children) being exempt from vaccines last year, according to the Centers for Disease Control and Prevention (CDC).

However, the Oregon Court of Appeals ruled in April that eight young children who were taken into state custody last year could be vaccinated. Their parents have claimed that religious beliefs exempt the children from vaccination. The Oregon Department of Human Services (DHS) has argued and carried the point that because the state has custody of the children, the state can also make medical decisions for the children.

DHS had checked with a doctor to make sure the children didn’t have allergies or other medical conditions. The doctor recommended immunizations, and DHS turned to a judge for permission when the parents refused. The Oregon appeals court noted that North Carolina and Georgia courts have also denied parents without custody of their kids a say in immunizations. Conversely, Arizona ruled in favor of a mother who didn’t want her child vaccinated.

Oregon continues to represent ground zero in the childhood vaccine debate with the state Senate voting in May on a bill that would require parents to be educated about vaccines before they can exempt their children from them. The number of unvaccinated kindergarteners increased to 6.4% this year and officials fear a public safety disaster similar to the recent measles outbreak in Wales.

The bill stipulates that parents enrolling unvaccinated children in school would have to prove they consulted a physician for information, or show a certificate verifying they watched an online educational video about the risks and benefits of immunization. In 2011, Washington passed similar legislation. Although Oregon has debated both sides of this bill, it was passed by the Oregon Senate on Thursday, June 6th and is now in the Oregon House.

“The more people you have that are unvaccinated, the more likely you are to have those diseases spread,” Dr. Jay Rosenbloom, a spokesman for Oregonians for Healthy Children stated. “The percentage of Oregon parents signing personal-beliefs vaccine exemptions has been rising steadily since 2001, but declining a vaccination doesn’t just affect the individual.”

The vaccine debate will continue, both with parents of young children and in other areas. Vaccine Watch urges those concerned about vaccines to speak with a doctor about the risks and benefits before making a decision.

Vaccine Confidence Project

Dr. Heidi Larson

The internet and its rapid spread of information can magnify and expand a vaccine scare in a short amount of time. Now, the internet can also combat misinformation. Dr. Heidi Larson of the London School of Hygiene and Tropical Medicine and a team of colleagues adapted the HealthMap automated data collection system to track rumors and online sentiments about vaccines on the internet. HealthMap was originally developed to track disease outbreaks.

“The internet has sped up the global spread of unchecked rumors and misinformation about vaccines and can seriously undermine public confidence, leading to low rates of vaccine uptake and even disease outbreaks,” Dr. Larson said.

The surveillance system covers 144 countries and looks at online articles, blogs and reports about vaccines and vaccine-preventable diseases. By identifying the first signs of the negative reports, Dr. Larson and her colleagues hope to take preventative action on anti-vaccine sentiment before it becomes a larger problem like the recent measles outbreak in Wales or the polio outbreak in Nigeria that re-introduced polio to 20 countries that had been free of the disease.

The original data collection for the Vaccine Confidence Project took place from May 1, 2011 to April 30, 2012 and identified 10,380 online mentions of human vaccines. 3,209 of these reports, or 31%, were negative and included fears about adverse events and vaccine distrust. The negative reports focused on vaccination programs, disease outbreaks, attitudes about vaccine believes, awareness and perception and vaccine safety.

“Bad news stories damage vaccination programs as much as biological hazards, and these stories evolve over minutes or hours, needing immediate action,” said University of Toronto public health specialists Natasha Crowcroft and Kwame McKenzie. “By the time a detailed specific analysis of vaccine safety issue is completed, the story is no longer newsworthy.”

Ideally, the Vaccine Confidence Project will identify early signs of vaccine misinformation in real time and enable public health officials to act immediately to dispel unfounded fears. “Public health systems need to move beyond passive responses to vaccine safety events towards active preparedness,” Crowcroft and McKenzie continue. “It is important for researchers to discover how to make communities resilient to bad science and interest-driven scare stories.”

By continuing to build public belief and trust in vaccines, health officials can avoid unfortunate situations like the recent measles outbreak and Nigeria’s polio epidemic. HealthMap and other tools available will be beneficial in containing vaccine fear tactics and enhancing education systems.

Vaccines and The Media

Childhood vaccines have been strongly debated in the media recently, both positively and negatively.

Billboards

The National Vaccination Information Center (NVIC) has posted billboards in Tucson, Arizona; Chicago, Illinois; and Austin, Texas urging parents to check the risk of vaccinations. The non-profit organization believes there are gaps in science and that vaccines can be risky. The billboards were placed in states currently discussing vaccine exemptions.

Arizona is one of twenty states that allow vaccination exemption for personal beliefs. A bill recently failed in the legislature that would have required parents to get a doctor’s signature before exempting children from vaccination. Kathy Malking of the Pima County Health Department believes parents should be informed, but finds fault with the billboards and NVIC website. “It [the website] focuses on all the negatives of vaccines and doesn’t talk about any of the positive aspects and how vaccines have saved many lives,” she states.

Internet

Many websites and blogs spread misinformation, encouraging parents not to vaccinate their children. From Natural News to VacTruth, just running a google search on childhood vaccines brings up many anti-vaccination websites.

VacTruth published a blog post in April that stated the media uses propaganda to condition people to accept vaccines. VacTruth claims that pharmaceutical companies use propaganda and pay doctors to sell drugs, including vaccines. VacTruth goes on to state that the polio vaccine had little to do with the decline of polio. Unfortunately, VacTruth did not use any scientific research or studies as references for their blog post, the entire post was fueled by propaganda and anti-vaccine sources.

Greeting Cards

For the past eighteen years, Hallmark has run the “For America’s Babies” program, printing personalized greeting cards for new parents that include a detachable growth chart and immunization schedule. In a new addition to the program, Hallmark teamed up with twenty-seven state governors, and the cards now come from the governor, urging parents to vaccinate their children. 

The immunization schedule in the cards reflects the Centers for Disease Control and Prevention (CDC) current recommendations. Hallmark pays for printing the cards in English and Spanish, and taxpayer dollars fund the small cost of distributing the cards to hospitals. Hospitals can choose whether or not to participate in the program.

The Florida greeting card is sent by Governor Scott and his wife Ann, and reads:

“Congratulations on the birth of your new baby! As you grow together in family and community, we encourage you to build your baby’s healthy imagination through reading and your baby’s healthy life through immunizations.”

In 2010, Florida ranked second for the percentage of children up to date on immunizations at 80%.

Vaccine Watch encourage parents to carefully consider all media they see and read about vaccines. Consult your pediatrician with questions about vaccines, as media like billboards and websites often only present one side of the argument.

Measles Outbreak in Wales

In November, cases of measles in Wales began increasing. Throughout April, the number of measles cases continued to rise and one man died. Last week the number of cases rose again, reaching 1,243 total across Wales.

Fifteen years ago, many parents chose not to vaccinate their children because Andrew Wakefield linked vaccines to autism in a 1998 report in the Lancet. His work has since been discredited and he was stripped of his medical license, however many children in this era were never vaccinated. Young people aged 10 to 18 have been the hardest hit by the measles outbreak in Wales because they missed this key vaccine as infants.

Health officials are now concerned about the area of Gwent in Wales, where 84 measles cases have been reported since November. There are about 10,000 people aged 10 to 18 in Gwent that aren’t vaccinated for measles, mumps and rubella (MMR).

“It should be remembered that in 2011, we only saw 19 measles cases in the whole of Wales for the whole year,” Dr. Marion Lyons, the director of health protection for Public Health Wales states. “The 84 cases in Gwent are a huge concern to us and with 10,000 children still in need of vaccination, we are warning young people and parents not to be complacent just because they don’t live in the outbreak area.”

Since the outbreak began, more than 43,000 non-routine MMR vaccines have been given, reducing the number of unvaccinated children by 46%. However, 38,000 children in Wales remain unvaccinated, prompting concern among health officials about future outbreaks. Health officials have also estimated there are two million school children total in Britain who didn’t receive the vaccine when they were infants. A campaign was conducted earlier in the year to vaccinate one million of these children.

“It’s encouraging to see so many parents bringing their children for vaccination now who refused the vaccine in the past, and we must keep this up if we are going to see an end to the current outbreak and have the best chance of preventing more outbreaks in the future,” Dr. Lyons continues.

MMR is administered in two doses, the first dose provides 90% protection and with both doses, there is 99% protection. Measles is highly contagious with a rash and fever, as well as feeling poorly. Complications can include blindness, severe diarrhea, ear infections, pneumonia, or in extreme cases, death.

Dr. Sarah Wollaston is a former general practitioner and is a member of parliament representing Totnes, near Devon, where 30% of 5 year olds haven’t received both doses. With herd immunity, if 95% of children in a community are vaccinated the community is protected from outbreak. “The real ‘herd’ effect may be an unwarranted fear that vaccination is harmful or the belief that ‘natural’ methods like homeopathy can boost a child’s immunity and thereby offer a safe alternative to protect against that virus,” she explains.

“The MMR is a well-tested vaccine and offers protection against three of the most infectious childhood diseases,” Dr. Sam Barrell, a Brixham general practitioner states. “Measles is highly infectious and while most get over it quickly, for some it can have life-changing consequences.”

The tragic harm caused by Andrew Wakefield's fraudulent research continues to fuel vaccination fears and misinformation. It may take decades of education to undo this damage.