Monday, August 2, 2010

California’s Whooping Cough Epidemic: An Opportunity to Reexamine Vaccination Decisions?

by Melissa Garvey, ACNM Writer and Editor

According to state public health officials, California residents are experiencing epidemic levels of whooping cough. With five infant deaths already and nearly 1500 reported cases so far in 2010, California is on track to experience the highest levels of whooping cough in 50 years.

The Fall and Rise of Whooping Cough in America

Whooping cough, also known as pertussis, is a highly contagious, life-threatening infection. In the early 1900s, it was a leading cause of childhood death in the United States. By the 1970s, following the introduction of a vaccine, infection levels waned.

Since the mid-1970s, cases of whooping cough have been increasing—especially in infants too young to have completed their vaccination schedule and in teens and adults whose immunity has expired.

Could Vaccines be Linked?

Some experts are wondering if California’s low rate of vaccination against whooping cough could be a factor in the state’s epidemic. While the state’s rate of adolescent vaccination is above the national average, it falls short of many states who require adolescents to receive the pertussis vaccine (commonly known as Tdap) by law. California legislation currently does not require Tdap.

Given this information, does this change your mind about vaccination decisions for you, your family, or your patients? Does it reinforce your beliefs or encourage you to reconsider your opinions?


Ethel said...

The issue in California, and Idaho (which is also experiencing pertussis outbreaks) reinforces my belief that children need to be vaccinated and adults need booster shots. Those who do not wish to get vaccinated are essentially opting out of being part of society and should keep to that option until they vaccinate.

pinky said...

I agree with Ethel, those who do not get vaccinated put others at risk.

Janey M. Roth MPH, CNM said...

We count on herd immunity - if most are vaccinated, the few who aren't (religious reasons, allergy to eggs, etc.) are unlikely to come in contact with the other "few" who are not vaccinated. Once the few becomes many, you get the perfect set up for epidemics to spread. And as midwives, we very much need to worry about pregnant women and new moms/their newborns. The severe coughing could caused pre-term rupture of membranes! "Pertussis can occur at any age. However, infants and young children, particularly those who are not immunized or who are not fully immunized, are at highest risk for getting severe whooping cough and suffering from serious, potentially life-threatening complications. It can also be particularly dangerous to older seniors, having devastatingly fatal effects."

Tiffany said...

I'm experiencing a dilemma now with a pregnant couple who have a lot of family in California, including a pregnant sister-in-law. The sister-in-law was vaccinated by her OB. This woman now wants to know if she should get vaccinated since they travel to CA frequently and family from there will be coming to visit also. I told her I would get back to her....we don't even have that vaccine in our office!