It’s vaccine awareness month and I am very aware this is a sensitive subject! I have no delusions of convincing anti-vaxxers to start vaccinating. That would be like me asking a vegan to go game hunting. My goal with my vaccine posts this month is to discuss this medically and explain why physicians still recommend vaccination. Somewhere in history, anti-vaccinators started acting as if doctors were the enemy, as if drug companies are buying us. This couldn’t be further from the truth, in fact, I am a minimalist when it comes to using medication. We recommend vaccines based on medical history of these diseases and the facts about vaccine safety. Take this information for what it is, information. It is not my opinion, it is medical information.
When people think of vaccines, they think of the childhood series. But adults have vaccines as well. In 2014, California saw the worst outbreak of whooping-cough since 1950, with 10 babies less than 2 months old that lost their lives. While many people wanted to blame it all on anti-vaxxers, it isn’t just their fault. Anti-vaxxers certainly played a part, leaving their children and themselves susceptible to the disease, but the vaccine isn’t perfect either.
The vaccine changed from whole-cell to acellular. The whole-cell vaccine is an inactivated form of the whole pertussis organism. It was very effective, but had some minor reactions at the time of administration. This led to the development of the acellular vaccine, composed of the inactivated toxin and parts of the inactivated pertussis organism. The acellular form does not have the side effects the whole-cell version did, but it is not as effective as it’s parent compound and requires a booster from time-to-time, although this is not widely known and often forgotten. It is this booster that I want to discuss.
What is Whooping Cough
The bacteria Bordetella pertussis causes whooping-cough and acts by latching to the cilia (microscopic hairs that line your airways) where it releases toxins. These toxins cause cough, swelling of airways, and damage to the surrounding tissues. It is called whooping-cough because the coughing fits are so violent that the victims expel all the air out of their lungs and then make a loud whooping noise in-between coughs. Pertussis is a much milder disease in adults so most are unaware they have contracted it.
For the young, this is a dangerous disease usually requiring hospitalization. For those less than 6 months, this can actually be deadly as we saw in California. Part of the childhood vaccination schedule is to get 5 DTaP vaccines which protects against tetanus, diphtheria, and pertussis. This vaccine series starts at 2 months of age, leaving those under 2 months susceptible to contracting these three bacteria. The only way to protect those who are under 2 months or who cannot get the vaccine is to vaccinate the adults surrounding the child. In adolescence we receive the Td booster every 10 years. This booster does not protect against pertussis and adults can easily contract it, but usually with little cause for concern. We now have a Tdap booster for adults in place of one of the Td boosters.
Who Should Get the Booster
- Any adult that will be around a child less than 12 months of age or a young child that can’t be vaccinated. This includes parents, grandparents, and caregivers.
- All pregnant women should receive a Tdap booster with EACH pregnancy. When given during the third trimester, the mother passes immunity to her child to provide protection during those first months of life when the infant cannot get the vaccine.
- Healthcare providers.