Once upon a time I was a professional who went to work every day with a jacket and a little floppy tie. I did battle with second order differential equations, multiple computers with various quirks (like the VAX), varying data for parameter studies and working in a large bullpen room full of engineers like myself. That was back when I was intelligent, before I had kids. Little did I know what I was to expect.
I was and still am an avid newspaper reader, so I remember seeing news reports of a rise of pertussis. By using my library’s database I found some samples from what was then the afternoon newspaper (the online search at the newspaper’s website only goes back to 1990):
WHOOPING COUGH RISES THIS YEAR IN COUNTY
THE SEATTLE TIMES – Friday, May 23, 1986
Author: CHARLES E. BROWN
Pertussis, more commonly known as whooping cough, is on the rise in King County, with more cases reported so far this year than for all of 1985.
At least 20 cases of pertussis have been reported to the Seattle-King County Health Department since the start of 1986, compared with just two cases reported during the first five months of last year and only 19 cases for the entire year, said Dr. Jesse Tapp, the health department’s communicable disease control officer.
“It’s not what we call an epidemic at this point, but we’re edging up into the range where we could be on the threshold of an epidemic,” Tapp said.
… and …
OFFICIALS SEE MORE WHOOPING COUGH – MOST IN CHILDREN WITHOUT SHOTS
THE SEATTLE TIMES – Thursday, June 5, 1986
Author: WARREN KING
A whooping-cough outbreak in King County is continuing, and health officials are concerned because nearly three-fourths of the 22 cases have been in unimmunized children.
More than half of the whooping-cough, or pertussis, cases have occurred in the past two months, and two of the children were hospitalized. Only 19 cases were reported in 1985. Usually only 10 to 20 cases are reported here for the entire year, although there was a major epidemic two years ago.
Boase said most of the parents of the 16 unimmunized children who got the potentially deadly disease expressed fear of the vaccine, commonly called the DPT shot _ for diphtheria, pertussis and tetanus.
During the past three years, the risks of the pertussis vaccine have received wide publicity, including three nationally broadcast television shows devoted to the subject.
In the current King County outbreak, 12 of the children were under 6 months old, the most dangerous age for the disease because the respiratory systems are not fully developed. Nine of those children had not yet received any vaccine.
Seven older children _ up to 13 years old _ had not received any DPT shots. The others had at least part of the series. The vaccine is not effective 10 percent of the time.
Bolding and italics added by me, see more information on those media reports here.
There was even talk in the office about the issue with the DPT vaccine. One gentleman I worked with became convinced due to the news coverage that his adult daughter’s seizures were related to the vaccine.
I must confess I was beginning to believe it. I tried to consult my brand new copy of the American Medical Association Family Guide, and got very little help. They just said that there was an effective vaccine for pertussis.
Then there was more news, just about the time I got pregnant:
CHILDHOOD DISEASES ARE BACK ON THE RISE – CASES OF MEASLES AND MUMPS INCREASE AS VACCINATIONS DROP
THE SEATTLE TIMES – Sunday, January 3, 1988
Author: WASHINGTON POST
WASHINGTON _ Cases of measles, mumps and whooping cough have risen steadily over the last several years while the percentage of young children receiving vaccines has dropped.
Public health officials have become worried that if the trend continues, childhood diseases that are now considered minor problems in the United States could return in force.
Health experts say that diminished federal funds have been responsible for at least part of the problem. As funds have been cut during the past five years, it has become increasingly difficult for poorer children to gain access to vaccines.
The issue was not so much of the media attention to the vaccine injury issues, but to actually getting kids the vaccines.
In September of 1988 I had a long hard labor and gave birth to a healthy baby boy. That is until two days later when he started to have ongoing neonatal seizures and was taken to the children’s hospital NICU across town. Fortunately he responded to the Phenobarbital, and was transferred to the intermediate infant care unit.
But due to the issues brought up in the previous years about the pertussis part of the vaccine, his doctor recommended that he only receive the DT vaccine.
I do not remember how I managed to cobble together that he was in danger because of the lack of pertussis vaccine. I know I only worried because he had not received the vaccine, I know that I did not know even he had been vaccinated he would only be partially protected. My doctor may have mentioned it. It may have come up in the prenatal class at the hospital (where all sorts of issues were discussed). Or one of the more cognizant moms at the mom/baby group I went to might have mentioned it. Or even the trained facilitator of that group might have mentioned it (it was an organized program for new parents).
Whatever the reason, I knew he depended on herd immunity. So I did ask if any of the children he came into contact with were vaccinated. I only encountered one mother who snootily said she did not vaccinate at a new mom/baby group I was checking out. Her attitude really bugged me, and I never bothered to go back to that group.
Fortunately I did not encounter another mother like her for a long time. That was years later on an email listserv I participated on for my son’s disability. But that is another story.
I did have an interesting exchange when my son was a bit older. I was reading a parenting magazine at a kid play center when I saw something about the new DTaP vaccine that was safer, and mentioned it to another mother standing nearby. She responded with a glare saying that pertussis was dangerous for babies, and I should make sure my son was vaccinated. I looked up and said he had a seizure disorder, and I wanted him to get the new vaccine since he was denied the old vaccine. She relaxed and said “Oh, okay!”. So I was not the only one who was paranoid!
He did get finally get vaccinated for pertussis with the Tdap at age eighteen.
As I was looking for historical evidence to back up my fading memory, I decided to check the levels of pertussis in my county. Unfortunately their online data only goes back to 1996, not terribly useful. So I made a table from the CDC Pink Book Appendix G data on pertussis:
Did you notice something very scary? While I was reading news stories on the increase of pertussis in the 1980s, they were still at level much lower than in the last eight years!
Paranoia does not even begin to describe what is required now!
I will summarize here: Pertussis is a bacterial infection that even if you get it naturally will not confer total immunity. It is kind of like a strep infection, which can happen more than once. If the natural infection does not give immunity forever, why expect the vaccine to? So it is prudent to get boosters.
Make sure the kids get their boosters. Make sure you, as an adult, get your Tdap boosters.
The rest is just data kvetching, because my county has some really cool Epilog newsletters. Also, I used to do number crunching for a paycheck, so it is something I like to do. Todd W. has expanded on some of my number crunching here, check it out. Though please, bear with me.
I created a table using data extracted from these Epilog Newsletters, where the data only go back to 1996. I then put on the table the percentage of the county cases compared to the CDC numbers. With a population of almost two million in a country with 310 million, the county should have only about 0.6% of the cases. Now look at those percentages:
|Year||Cases||% of CDC|
Did I mention I live in the uber natural woo combined with uber science nerd bipolar county? Sigh.
To be fair, the numbers on both charts are estimates from those who actually reported the disease. These are actually underestimates. Perhaps I just live in a county with a very vigilant public health department, or where a bunch of folks don’t like vaccines (Hello Vashon Island and an enlightening powerpoint, it really needed some serious editing in the notes… yes, it is an island, but unfortunately there is really good ferry service).
Whatever the reason, only four years show alignment with the national figures (that is anything between 0.5% and 0.8%). The other years show a higher incidence than the national average. This is something a parent who has a child with immune issues should be aware of. It pays to be vigilant. Though it would be easier if there were fewer parents of perfectly healthy children who did not erode herd immunity by skipping vaccines.