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Seven months ago my small home daycare had a whooping cough (pertussis) outbreak. I have an “open door” policy regarding vaccination and the children in my care range from fully vaccinated to having no vaccines at all. I considered this fact very carefully when we were one of 10,000 cases that appeared throughout California in 2014 – the largest outbreak to date. Out of the six children in my care, three came down with the cough. The first to show symptoms was a fully and recently vaccinated 18-month-old. The second was my own son who was on a delayed vaccination schedule. Lastly my daughter was confirmed though her only symptoms at the time were a runny nose. I write extensively about it all here, my most popular post to date.

I worked closely with a public health nurse and scoured the CDC database for answers. Was this because I had children in my care who were not up to date on their vaccines? This turned out to be an easy question to answer. I simply asked the public health nurse about the vaccination status of the cases in our area. Here is her reply:

“Dear Ms. Trotter,
 
Your e-mail asking for further information about pertussis cases in San Diego was forwarded to me by my staff member, ——. 
As of 8/8/2014, the total number of pertussis cases in 2014 in San Diego County is 1,183.  Of those cases, 84% were up-to-date on pertussis vaccinations, with 11% not up-to-date, 1% too young for immunization, and 4% immunization status unknown.”

I was shocked. How can 84% of confirmed (via a swab test) cases be fully up-to-date on their pertussis vaccinations? It was maddening. Mostly because I found nothing that clearly stated we were dealing with a vaccine failure. I looked and looked and found nothing. No CDC studies. No articles in scholarly journals. We were just one of the “unlucky” 1,183 people who had to go through this. It didn’t matter that we were the 11% that were not up-to-date. Over a thousand people who were fully vaccinated still got sick.

A few months later the “Measles Outbreak” was a steady headline in the six-o-clock news. Initially a wave of sheer panic came over me, but it was quickly dismissed when I saw the numbers. To date only 116 people linked to that outbreak came down with measles. In my state of California alone there were over 10,000 cases of pertussis last year. As unlucky as we were to have come down with that cough, I knew I could trust those odds against measles. This realization started me back on my quest to find out why so many cases of pertussis in the fully vaccinated?? The measles outbreak lit up the vaccine debate like never before and was quick to blame the un-vaccinated for the cases that started at Disney. Here is what the CDC says about that, “The outbreak likely started from a traveler who became infected overseas with measles, then visited the amusement park while infectious. However, no source has been identified.”

Measles is an interesting side-project, but my real purpose of late has been to get to the bottom of the pertussis outbreaks. After digging, and digging and digging it turns out that the answers were there all along. I just had to piece them all together. Is wasn’t easy. Many of the online medical journals require a subscription and even charge a fee to download and read about recent studies. I was determined. Here is what I found after searching extensively through credible sources of information. All of the scientists agree on one thing. The problem with pertussis is not a simple one. There are actually six or seven things wrong with the vaccine. Here are some of them.

The current pertussis vaccine DTaP is not as effective as it’s predecessor DTP. In the 1980’s a group of parents noticed that the DTP vaccine was causing bad reactions including high fevers, seizures and inconsolable crying after their infants received the shot. Many refused a second dose and a small group successfully sued manufacturers for vaccine injuries including devastating neurological damage. These parents successfully drove the old DTP vaccine out of the market and forced vaccine makers to create the current DTaP shot which is a more diluted version but much less reactive. It is also much less effective and recently has been discovered to only last 3 to 5 years before wearing off. The New England Journal of Medicine stated that “the major epidemics in 2005, in 2010, and now in 2012 suggest that failure of the DTaP vaccine is a matter of serious concern.”

There is a new strain of B. Pertussis that the current vaccine does not cover. One study showed that up to 85% of recent cultures were actually a new strain of pertussis. Scientists were able to conclude that this new strain is capable of invading vaccine-induced immunity, causing the rapidly increasing number of cases. What is most alarming is that those who were fully vaccinated with the DTaP were 2 to 4 times more likely to become sick with this new strain (called pertactin-negative bordetella) compared to the un-vaccinated. Even those who were partially vaccinated had an increased risk in getting this genetically mutated form of pertussis. “In the United States, pertussis is currently the least well controlled vaccine-preventable disease despite excellent vaccination coverage and 6 vaccine doses recommended between 2 months of age and adolescence.” -The Oxford Journal of Clinical Infectious Diseases.

The recently vaccinated are actually spreading the disease. Whooping cough can be spread by the recently vaccinated who show no symptoms but still can transmit the disease to those who have no immunity to it. This finding was released by a prominent medical journal who studied baboons after they were vaccinated with B. Pertussis. While they showed no symptoms of the disease after being vaccinated, they would still spread it to those they came in contact with. We now know that the current DTaP vaccine is not as effective and begins to wane after 3 years. Therefore, the majority of the vaccinated children over age three are susceptible to acquiring the disease when having come into contact with a recently vaccinated person. Infants and children who have been recently vaccinated are actually silent carriers of pertussis into the community. The purpose of this study explains it best, “we hypothesize that current acellular pertussis (aP) vaccines fail to prevent colonization and transmission.” Here is an article the New York times wrote about it. “When you’re newly vaccinated you are an asymptomatic carrier, which is good for you, but not for the population,” the article explains.

What does the CDC have to say about the pertussis vaccine? “In 2012, the CDC acknowledged that pertussis vaccine immunity has waned in older children, that DTaP/Tdap immunity begins to wane within five years of vaccination and that unvaccinated individuals and children with vaccine exemptions are not to blame for current whooping cough outbreaks.” -From the National Vaccine Information Center. However, the CDC still stands by their premise that the current pertussis vaccine does shorten the severity and duration of the illness even if it does not prevent infection. In 2012 they launched a huge campaign to have all pregnant women vaccinated in hopes that they will not become sick while their baby is a newborn. Infants less than two months old are the most at risk of death from this disease.

The top three reasons the DTaP vaccine is a failed vaccine:
1. The infants and children who receive the vaccine are silent asymptomatic carries of the disease which can “shed” or infect those who have no immunity to it for up to six weeks.
2. The vaccine only protects against one strain of pertussis called pertactin-positive when studies show this may cover as little as only 15% of cases while the other 85% are a pertactin-negative strain.
3. The current DTaP vaccine is much less reactive but a lot less effective than it’s predecessor because it is a more diluted version.

Seven months ago when my daycare and then my family came down with a “vaccine-preventable disease” I never stopped wondering if this was because we were not up-to-date on our vaccines. Now I know we are not to blame. I even looked back at the shot records of each of the children in my care to see if any of them had been recently vaccinated with the DTaP shot during that time. It turns out that a six month old baby in my care had just had his second dose of DTaP five weeks prior to the the first sign of coughing in my house. Sadly though, this story will go mostly unheard. I will most likely be labeled as just another typical educated, upper-class, anti-vaccine heretic whose voice will be quieted and disproved with factoids. Maybe the 40 friends and family who are fans of my blog will click this link and maybe they will even get to the end of this post. But even if just one person who reads this has a five-day-old baby, my hope it that they will be better able to protect her.

“All of this implies an enormous effort, but I believe that we cannot allow a vaccine-preventable disease to be incompletely controlled, and that a new pertussis vaccine is needed.” –Clin Infect Dis. (2014) 58 (6): 830-833. doi: 10.1093/cid/cit934 First published online: December 20, 2013                 

 

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