For the first time in many years, being a pediatrician in Dallas means that I am seeing children with pertussis (whooping cough). That is due to the fact that Dallas-Ft. Worth is in the midst of a whooping cough epidemic, the worst in over 20 years. But pertussis is not just a problem in the DFW area, the entire country continues to see rising pertussis cases.
The CDC reported that in 2012 the U.S. had more whooping cough cases reported( >41,000) than since 1955. There are currently 16 states, including Texas reporting higher pertussis rates than last year. In 2012 there were 18 reported deaths in the U.S. due to whooping cough. Sadly, there have already been more than 2,000 cases of whooping cough reported in Texas this year, and there have been 6 deaths in infants and children.
Unfortunately, one reason for increasing pertussis cases seems to be that some parents are choosing to either not vaccinate their children, or to vaccinate them on an “alternative” vaccine schedule. A study just published shows that unvaccinated or under-vaccinated children between the ages of 3 months and 36 months of age are at greatest risk for getting whooping cough. The study from The Institute for Health Research at Kaiser Permanente Colorado stated that “children who had not received the recommended 3 or 4 doses of DTaP (diptheria, tetanus, pertussis vaccine) were about 18-28 times more likely to have had pertussis than children who were fully vaccinated”.
These children are not only at risk for getting ill from pertussis themselves, they also pose a public health risk for others as they spread the bacteria (bordetella pertussis) with their coughs. This is especially true for innocent infants under the age of 2 months who have not even started their DTaP vaccines. The recommended schedule for DTaP is 2,4,and 6 months of age with a 4th dose between 15-18 months of age.
What we doctors do know is that vaccines are safe, effective and save lives. They are given on a schedule for a reason. We also know that when too many children “opt out”, or rather their parents choose not to vaccinate them, we see increase in disease numbers. This is not only true in this country with pertussis, but with measles as well. Measles cases in the United States are also at their highest in years.
The other group of people who need to be immunized are teens and adults. Many adults incorrectly think that they “don’t get more shots”. But, adults need “booster” shots as well as children. This is especially true with the TdaP (adult version of the pertussis vaccine). While this vaccine is safer than the older whooping cough vaccines, it doesn’t seem be as effective at providing long term immunity. This too may account for increased whooping cough rates in teens and adults. Research is looking at giving the TdaP more often as well as the possibility of a more effective vaccine.
The bottom line? Everyone needs to be up to date with their vaccines. Don’t depend on others to get vaccinated to protect you either, not everyone “plays by the rules”. Help protect those innocent babies under 2 months of age. In the meantime, try to limit your baby’s exposure to crowds until they have started their vaccines.