Mike the Mad Biologist

Maryn McKenna makes a critical, yet neglected point about the recent whooping cough (pertussis) outbreaks that have been hitting California–one that emphasizes that vaccination not only protects the vaccinated, but everyone else:

Between a day job as Scary Disease Girl and a childhood spent moving between continents, I am pretty much the most vaccinated person on the planet. I’d had my full series of pertussis vaccinations as a child. Surely I was protected?

Actually, no — and unless you’ve had a booster, neither are you. The immunity created by the 5-dose childhood series wanes over time; by the age of 12, even fully vaccinated people are vulnerable to pertussis again. Since 2006, the Advisory Committee on Immunization Practices has been recommending a single additional pertussis (Tdap) booster for anyone between the ages of 11 and 64. That may seem like overkill — adult cases of pertussis in previously vaccinated people are often milder than the child version; after all, I survived my bout. But as with so many vaccines, the beneficiary here isn’t just the adult taking the booster. Even more, it’s the more vulnerable person to whom that adult might pass the disease: an elderly person with age-related immune decay; someone with a chronic disease; an infant too young to be vaccinated. In those people, the disease can and does kill — as it did an 18-day-old infant, Nelyn Baker, whom I wrote about in 2004.

Let’s not forget the Mad Biologist’s Pentultimate Postulate of Vaccination: Effective vaccination is not about protecting you, it’s about protecting other people from you.

As I noted about the Streptococcus pneumoniae vaccine (‘PCV7′):

The PCV7 vaccine confers immunity to the seven most common types of Streptococcus pneumoniae, a bacterium that causes pneumonia (worldwide, S. pneumoniae is the leading killer of children under five, not the Big Three that the Gates Foundation focuses on. Just sayin’). In the U.S., starting in 2000, children under five were vaccinated against S. pneumoniae, which led to a 94% drop in cases of invasive pneumonia in young children three years after the introduction of the vaccination (my thanks to the Notorious K.A.T. for pointing me towards the reference).

But there was an unanticipated side effect of the PCV7 vaccine–and it was a good thing (sometimes the ‘law’ of unanticipated consequences works out well): invasive pneumonia dropped by two-thirds among the elderly during that same time.

Elderly people didn’t receive the vaccine. Only the young kids were vaccinated. And the pattern in the elderly was exactly as one would expect: the amount of invasive pneumonia caused by the S. pneumoniae that the vaccine protects against, dropped, while infections due to S. pneumoniae not found in the vaccine remained essentially constant.

This is why I’ve written before on this blog that the grandchildren are killing their grandparents (because they are). It’s also why I have, tongue-in-cheek, formulated the Mad Biologist’s Pentultimate Postulate of Vaccination.

I’ll just end by noting a gruesome irony. Many anti-vaxxers are worried about ‘toxins.’ Well, pertussis produces several dangerous, if not deadly, toxins–no scare quotes there–and they aren’t imaginary.

Comments

  1. #1 Chance Gearheart, NREMT-P/EMD
    July 31, 2010

    I’m getting a kick out of this since we’re treating atleast three pertussus patients at our hospital right now under the age of one.

    Vaccinations are good. Get them.

  2. #2 Julie Stahlhut
    August 1, 2010

    Not to mention that adult pertussis is not necessarily mild. A thirtyish friend of mine (vaccinated as a child) contracted pertussis, was miserably ill for weeks, and took nearly a year to regain her health.

    Incidentally, the relative of mine who was permanently disabled by pertussis caught it at the age of 15 days — too young to be vaccinated even if vaccines had been available in 1921. If vaccines HAD been available and had been given to slightly older children (as is the standard now,) he might never have been exposed to the pertussis, wouldn’t have spent his life in a wheelchair because of paroxysmal coughing that caused anoxia and brain damage, and might well have realized his potential become the first college-educated scientist in the family in those days before the ADA.

  3. #3 Sharon Astyk
    August 2, 2010

    During the years we cared for my husband’s grandparents, this was my great concern – the possibility of transmitting preventable diseases (the non-preventable ones were bad enough) to them through my children – and through other children that came to our house. The same is true at present – my father and I don’t always get along perfectly, but I have no desire to cause his demise ;-), and his permanent lung damage means that’s a real possibility if my children make him sick. During all the debate about flu vaccines, I was surprised how few people seemed to grasp that their parents and grandparents were put at risk by the failure to vaccinate their kids.

    Sharon

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