A whopping amount of whooping cough in California

Friday the 13th is rarely a good day. Friday, June 13, 2014, did not disappoint. On that day, California public health officials declared the state is now in the midst of a pertussis epidemic. Over 3,400 cases have been reported state-wide and the year is not even half over. The three counties with the highest rates of whooping cough are Marin, Napa, and Sonoma counties, all in the PHC network. Hmmm.

One factor in the epidemic is the reality that the current vaccine is not as effective as the older version. The pertussis vaccine was reformulated two decades ago to lessen the risk of side effects. Formerly, the pertussis vaccine was a “whole cell” vaccine containing intact dead pertussis bacteria. Since 1997, the vaccine has been an acellular preparation. While the acellular vaccine is better tolerated, it is less immunogenic. (This brief post will not attempt to present the current recommendations for vaccinations, but one can find this information on-line at http://www.cdph.ca.gov/programs/immunize/Pages/SchedulesandRecommendations.aspx.)

But a second factor in the epidemic is parents’ increasing refusal to let their children be vaccinated. Due to misinformation, misunderstanding, and mistrust, a growing number of parents feel their children’s health is jeopardized by vaccines.

Shortly after the Friday the 13th announcement, I saw a local news broadcast discussing the state’s pertussis epidemic. The reporter even-handedly gave equal time and play to a physician saying why it is important to vaccinate your children and to a parent who was describing why her children were not going to be vaccinated. The parent sounded very reasonable and rational, saying she had never seen any children get these infections and that “no one, not even doctors, really know what is in these shots” which are “introducing toxins into children’s bodies.” I suppose the reporter was trying to be objective, but by presenting the physician and the parent as equally legitimate voices, the reporter did a disservice to medicine, to science, and to the health of children in California. It is fine for the TV-viewing public to hear anti-vaccine viewpoints. But when all is said and done, and there are facts which disprove opinions, public media has a responsibility to present the facts. Especially when we are talking about life and death issues. And even more so when we are talking about life and death issues involving children.

OK, I’ll climb down off my high horse now. At least for a while. I don’t mean to bash any heads, not those of the public media, not those of parents who are ill-informed about the realities and dangers of infectious disease. Education is key. Physicians and other clinicians can and should work to educate our patients and families about how to best to protect their health.

For a recent excellent post by Dr. Marshall Kubota on delayed-vaccination schedules, click here: http://phcprimarycare.org/?p=960.

Richard Fleming, MD

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