White Coat Underground

I shouldn’t see any cases of pertussis (“whooping cough”), but I do. We have a safe, effective and affordable vaccine. But still, people are getting this disease. In the age group I see (adults), immunity has often waned, and if they haven’t been revaccinated, they can get the disease and pass it on. In adults it often looks like a cold, but not in kids. Most properly vaccinated children are immune and remain so until there little airways are large enough to cope with the illness. But a certain percentage of kids either don’t get vaccinated or aren’t successfully vaccinated, leaving them vulnerable to a disease that shouldn’t even exist at a measurable rate.

In small children, with their little airways, pertussis often leads to hospitalization, and not infrequently kills. It kills children who should never have been put at risk, either because their parents refused to vaccinate them, or people around them did and gave them the disease.

Children and adults who should be vaccinated but are not represent a public health failure, and in the case of parents who deny their kids the vaccine, an ethical failure as well.

As a reminder, this is what pertussis looks like in little kids.

Comments

  1. #1 G
    July 16, 2010

    Or the kids are too young to have been vaccinated yet. I know a kid who was hospitalized with whooping cough when he was just two weeks old. It was pretty rough, poor li’l tyke. He’s fine now, fortunately.

  2. #2 MosesZD
    July 16, 2010

    Well, even if the child was vaccinated it’s not foolproof. I know people don’t want to hear it, but that’s just the way medicines work. Even the DTaP, the most common vaccine given to fight pertussis, is 95% in effectiveness.

    Or, take me for example, I’ve been vaccinated for small pox many, many times. But despite the best efforts of the US Air Force, I’ve never got the blister or the scar from the blister and I’ve never gotten any actual assurance that the alternative vaccine the military gave me actually worked…

    So, as far as I know, despite the best efforts of my pediatrician, the CA schools, and the USAF, I’m not vaccinated… Becaues it just won’t work on me.

  3. #3 PalMD
    July 16, 2010

    Which, as stated above, is one of the most important reasons to have high vaccination rates.

  4. #4 Elf Eye
    July 16, 2010

    Moses ZD, the fact that the vaccine won’t work for a small number of people is a great reason to push for universal or near universal vaccination. If there is someone for whom the vaccine just won’t work, that person can still be protected if the people surrounding him or her have been successfully vaccinated. Even though a vaccine for pertussis might not provoke immunity in a particular case, the individual would still benefit from a vaccination campaign if the vaccine works for most people. The individual would be unlikely to fall ill because he or she will have little chance of coming into contact with a person who is contagious. So the fact that any vaccine is not ‘foolproof’ is no reason to shrug off the need for vaccinations. On the contrary, it is a good argument to vigorously campaign FOR vaccinations! After watching those children coughing, I certainly will ask my doctor whether I need any booster shots. Those children must have felt as if they were suffocating, and I don’t ever want to be the one who is responsible for exposing a child to such a terrifying illness.

  5. #5 skeptifem
    July 16, 2010

    Is there a time frame where it becomes reasonable to re-vaccinate adults? I am around sick people all the time because of working in a hospital, and I don’t mind getting shots.

  6. #6 Lorax
    July 16, 2010

    Actually I believe there is some evidence that vaccinated adults do get infected with Bordetella with incidence rates peaking every 5-7 years. These individuals have cold-like symptoms not whooping cough by any stretch. However, they could serve as excellent reservoirs for unvaccinated adults, children, and infants.

  7. #7 PalMD
    July 16, 2010

    @skeptifem

    the Tdap vaccine, which contains tetanus, diphtheria, and pertussis, is now recommended for adults from 19-64 years of age. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5517a1.htm

  8. #8 gnuma
    July 16, 2010

    thx for the kick in the pants — have been meaning to get vaccinated but haven’t made it a priority. you reminded me to look into it!

  9. #9 Peter
    July 17, 2010

    Here, Here!
    I’m one of those cases of pertussis you should never have had to see– vaccinated as a child but hit very hard as an adult. It took me over six months to throw the thing. The illness was severe enough that I passed out from the coughing a couple of times and even had students ask if I was dying. The medicine I took to help control the symptoms made it hard for me to think and my graduate work suffered. I’ve had malaria too, and on the whole I’d say this was worse. I take the anti-vaccination movement personally because… well… it’s their misguided refusal to honestly consider consequences(not to mention scientific evidence) that was at fault. I was only inconvenienced for half a year– I didn’t die but I feel horrible for the poor children who weren’t as lucky as myself.

  10. #10 Beauzeaux
    July 17, 2010

    I am 68 years old and spent my first seven years on a farm in the mid-West. I was never vaccinated as a child. I had whooping cough as a baby and nearly died. I was very fortunate never to have contracted tetanus since I ran around barefoot all summer.
    I don’t remember when I finally got a DTP shot but I was first immunized against smallpox in 1970.
    My family wasn’t opposed to vaccination — they just didn’t know any better.

  11. #11 Lyle
    July 17, 2010

    Re #10
    Actually you just squeaked in to smallpox the stopped in 1973 so that no one younger has had the vaccination. It would be interesting to know when the state you lived in put inoculations in as a requirement to attend school. Generally people got their injections at that time if not earlier. On entering and at the various grade points when physicals were required.

  12. #12 The Gregarioius Misanthrope
    July 17, 2010

    I just checked my shot record and my last DTap/Tdap was 2001, I’m due next year. Uncle Sam is quite assiduous about such things.

    Anyone considering NOT vaccinating his/her child should sit a few hours with a child suffering whooping cough. Kind of a scared straight program for anti-vaxxers.

  13. #13 MosesZD
    July 17, 2010

    I’m one of those cases of pertussis you should never have had to see– vaccinated as a child but hit very hard as an adult.

    The vaccine for pertussis doesn’t last. You have to get a booster in your teen years. You have to get boosters through-out your adult life.

    I have a 45-year-old friend with pertussis right now. And his idiot doctor can’t “see it” despite the fact it’s a classic case of adult pertussis: cough, cough, vomit… cough, cough, vomit…

    The doctor, a complete idiot, says it can’t be whooping cough because there is no “whoop” at the end. Which is crap, because adults frequently don’t get the whoop. I told him to get a new doctor and demand a pertussis test.

    But… With the economy being bad, he’s had to lapse his health-insurance in order to keep his business afloat… So he takes OTC medicines and hopes for the best…

  14. #14 MosesZD
    July 17, 2010

    Moses ZED, the fact that the vaccine won’t work for a small number of people is a great reason to push for universal or near universal vaccination.

    lol. I know. It’s just I’m commenting on the whooping cough baby and how one cannot, with certainty, extend “whooping cough” to “unvaccinated.” The child, frankly, may have been immunized. Looks old enough to have even gotten her second shot, possibly third shot seeing the head control…

    With pertussis, we have vaccination that does not reach its 95% efficacy in protection until the fourth shot, given at 18 months here in the US. A booster is given at five to keep reasonable immunity through K-5th grade. At that point, it starts falling off and need to boost your kid again. Otherwise he/she will be a walking time-bomb.

    Then you have to keep getting boosters every ten years on the the Tdap schedule as an adult. Which most people do not.

    So, while I wish things were different, I don’t see eradication as a possibility with this disease or significant herd-immunity in the general population seeing as adults just don’t get vaccinated like they should. Much of it having to do with our lousy medical-industrial complex that has no reason to serve everyone, only those who can afford it’s ridiculous over-charging.

    Best we can get, at this point in time I think, is a reasonable herd immunity amongst our children. Which is why I vaccinated them. To protect them, and their friends from my children being disease vectors.

  15. #15 Edsepdx
    July 17, 2010

    Re: #11: I got a smallpox vax in 1975 in the US, so am likely one of the youngest non-military, non- research people with the vaccine. We were going to India at the time, and the vaccine was still recommended for travel there. I’ve heard it isn’t a lifetime vaccine though.

    The anti-vaxers need to understand that their choices affect many people and not just their families. Maybe we need a better word than “herd immunity”. However, I suspect that the major problem is good old fashioned American self-centeredness and “me first” attitudes.

  16. #16 deadendrite
    July 17, 2010

    Thanks for this post. I think a lot of people don’t realize that immunity can wane in adulthood (I found out the hard way as I am certain I had pertussis a few years back–my kids were vaccinated but we attended playgroups and so it is feasible I picked it up there.) It was a very unpleasant experience and seems to have left me with some residual issues.

    I presume there is no harm in receiving the vaccine if one does have immunity? In other words, if in doubt take the vaccine?

  17. #17 Chris
    July 17, 2010

    I just checked my shot record, I got the smallpox vax in 1974 when I was sixteen and living in the Panama Canal Zone. I actually took the bus to the Ft. Clayton medical dispensary from Ft. Amador to renew my vaccinations (even interrupting an Army training film in production to get into the door before it closed, saw one of my high school friends in the “wounded” crowd).

    Unfortunately, my last DT vaccine was less than ten years ago, and it was just before the Tdap was being recommended to adults. I made sure all of my teenage children got it as soon as possible.

  18. #18 History Punk
    July 17, 2010

    For the anti-vaccine crowd, it’s important to note that treating Whooping cough makes “Big Pharma” a lot more money than simply getting a vaccine.

  19. #19 Shay
    July 17, 2010

    For the un/under-insured, check with your county health department. Most offer TDap vaccine to adults for a nominal fee.

  20. #20 Alexis
    July 17, 2010

    MosesZD, my understanding is also that the pertussis vaccine does a poor job of preventing transmission, and that it may also mean that you simply contract a milder form of the disease–so, room for transmission even amongst vaccinated individuals. Don’t get me wrong, I still think it’s a very worthwhile vaccine–but it doesn’t create herd immunity nearly as effectively as, say, the MMR.

  21. #21 Maryn McKenna
    July 17, 2010

    In my last newspaper job, I wrote a story about an 18-day-old infant who died of pertussis. His mother was infected sometime in her last trimester, but neither she not her OB suspected pertussis; she and all her family were fully vaccinated and had no idea the protection wasn’t life-long. (The story is behind a paywall, unfortunately; I can get a copy to anyone who feels the need.) It was an especially resonant story for me because I had pertussis myself about 5 years earlier — caught it in India, thought it was bad bronchitis exacerbated by terrible air quality. Then I mentioned the symptoms to a friend (lie down, cough nonstop, vomit, fracture rib) and his eyes got big and he went and got a textbook. Bingo.

  22. #22 Caro
    July 17, 2010

    I’m with Peter at #9, except that I was coughing for “only” five months. I got pertussis at age 18. (That’s only four years ago. Recent case, this.) It was absolutely awful, and I would never wish it upon anyone. Also, I’m not surprised little babies die of this thing, given the violence of the coughing fits – I remember coughing so hard I bent double. I was a classic case, all coughing and whooping, though my classmates didn’t appreciate the fact :P Some even thought I was faking it (I guess that’s what you get when these diseases become less common), though teachers having to pause class every day for months on end because the fits were so loud eventually brought the point home. I know I tried not making so much noise, but when you’re gasping for air, that suddenly isn’t so important any more. Let’s just say I was pretty damn loud :P

    I survived just fine, but I’ll be asthmatic for the rest of my life. In fairness, I had a genetic predisposition to it, and had escaped it until then, but the five months of coughing did their job marvellously. Whoop-de-doo!

    I can’t believe anti-vaccinationists even exist. Who would want to expose their children and society to these diseases?

  23. #23 Vaxxed
    July 17, 2010

    “For the anti-vaccine crowd, it’s important to note that treating Whooping cough makes “Big Pharma” a lot more money than simply getting a vaccine. ”

    How do you figure? Vaccinating every man, woman and child for pertussis is far more profitable than treating a few thousand cases with antibiotics. If not caught early, I don’t think there is anything “Big Pharma” has to offer in terms of profitable treatment.

    What I don’t understand is if we have been inoculating nearly everyone with the pertussis vaccine since the 1940s, why do we still need to vaccintate for it? Has it not been effective? Who are the few unvaccinated people getting the disease from?

  24. #24 Chris
    July 18, 2010

    It is obvious you have never spent a night in a hospital with a child struggling to breathe even though he was hooked up to several ventilation devices. Trust me, they cost many bucks. Plus spending time in a hospital with an infant, and later with a toddler is not “super duper fun time.”

    Anyone who thinks treating a disease in a hospital instead of preventing it with a vaccine is cheaper or preferable is a complete idiot.

    The few thousand cases require more treatment than a million vaccines cost. And, yes, the protection does wear off. Because the vaccine and natural protection wears off, and the fact the vaccine is only about 80% effective, almost everyone needs to be vaccinated to ensure little transmission.

    Sorry, the complaint that it wears off (which it even does for getting it naturally!) and the vaccine is not 100% effective is an argument for better herd immunity. When it is time for your next ten year tetanus booster, make sure you get the Tdap instead of the TD vaccine.

    The reason there has been an increase pertussis cases is because there is a segment who will not vaccinate, so it circulates through the population. It has been shown that in areas with high refusal of vaccine acceptance, the disease increase: Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis.:

    There is substantial evidence for an increased risk of vaccine-preventable diseases among vaccine refusers (7, 19–21). Our study demonstrates that in addition to the risk to individuals, the community-level risk of outbreaks is also increased in the presence of geographic clusters of exemptors.

    Basically, even though there may be a total of high vaccination rates, if there is a population of those who refuse to be vaccinated… there will be an increase of the disease there. Even among those who are nearby and vaccinated. Yeah, those who do not vaccinate hoping to ride free on the area’s herd immunity effect the entire community.

  25. #25 dr. luba
    July 18, 2010

    When I was a young teen, I used to read (often assigned for school) books which included fairly graphic descriptions of illness, including pertussis. One that I still remember vividly is “Mrs. Mike,” about the wife of a Canadian Mountie living in the Northwest Territories. Both of her young children died from whooping cough during an epidemic.

    I’ve always been a strong advocate of immunization.

    Perhaps out children are reading the wrong books in school?

  26. #26 Vaxxed
    July 18, 2010

    “It is obvious you have never spent a night in a hospital with a child struggling to breathe even though he was hooked up to several ventilation devices. Trust me, they cost many bucks.”

    “Big Pharma” doesn’t make money from hospitalizations or ventilation machines so I’m not sure how that is relevant to my comment above if that is what you are responding to.

    “Anyone who thinks treating a disease in a hospital instead of preventing it with a vaccine is cheaper or preferable is a complete idiot.”

    That would depend on the severity of the illness and the safety and efficacy of the vaccine which can only be determined using scientific evidence. Blanket generalizations aren’t scientific by definition.

    “there will be an increase of the disease there. Even among those who are nearby and vaccinated.”

    Perhaps I misunderstand, but I thought the point of vaccines was to prevent the illness spreading from the unvaccinated to the vaccinated. You seem to be implying they don’t.

  27. #27 Chris
    July 18, 2010

    Vaxxed:

    “Big Pharma” doesn’t make money from hospitalizations or ventilation machines so I’m not sure how that is relevant to my comment above if that is what you are responding to.

    Are you out of your mind? Who do you think makes the IV solutions? Who do you think sells the monitor adhesives? Who do you think sells the antibiotics? Who do you think makes the pain killers?

    There are medical companies who make ventilators, blow-by tubes (which can be turned into a toy after use, just found the last one in the garage) and monitoring equipment. Is “Big Hospital Suppler” better than “Big Pharma”? Are you advocating reducing the use of vaccines so you can invest in those companies?

    You have obviously never spent anytime in a hospital. Especially if you want to play the balance of an infant with pertussis with a child suffering with measles encephalitis (1 out of 1000).

    The point of the vaccine is to prevent transmission of the disease. Unfortunately they are not 100% effective, so herd immunity is required. The pertussis vaccine is only about 80%, and wears off (so does protection from getting the actual disease). The object is to have enough immune in a community to prevent the spread.

    That would depend on the severity of the illness and the safety and efficacy of the vaccine which can only be determined using scientific evidence. Blanket generalizations aren’t scientific by definition.

    Do tell us which vaccine is so dangerous that it is financially prudent to stop using? How would you prevent pertussis? What evidence would you have. Here are examples:

    Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001
    Zhou F, Santoli J, Messonnier ML, Yusuf HR, Shefer A, Chu SY, Rodewald L, Harpaz R.
    Arch Pediatr Adolesc Med. 2005;159:1136-1144.

    An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.
    Zhou F, Reef S, Massoudi M, Papania MJ, Yusuf HR, Bardenheier B, Zimmerman L, McCauley MM.
    J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.

    Impact of universal Haemophilus influenzae type b vaccination starting at 2 months of age in the United States: an economic analysis.
    Zhou F, Bisgard KM, Yusuf HR, Deuson RR, Bath SK, Murphy TV.
    Pediatrics. 2002 Oct;110(4):653-61.

    Pediatric hospital admissions for measles. Lessons from the 1990 epidemic.
    Chavez GF, Ellis AA.
    West J Med. 1996 Jul-Aug;165(1-2):20-5.

    Measles epidemic from failure to immunize.
    Dales LG, Kizer KW, Rutherford GW, Pertowski CA, Waterman SH, Woodford G.
    West J Med. 1993 Oct;159(4):455-64.

  28. #28 augustine
    July 18, 2010

    chris: “The point of the vaccine is to prevent transmission of the disease. Unfortunately they are not 100% effective, so herd immunity is required. The pertussis vaccine is only about 80%, and wears off (so does protection from getting the actual disease). The object is to have enough immune in a community to prevent the spread.”

    The vaccines aren’t 100% rhetoric. would you say the exact same statement if the vaccine was 50% effective? 30% effective? Think about it.

  29. #29 PalMD
    July 18, 2010

    That’s a rather misguided question, augustine. If a vaccine were only 30percent effective, there are few if any situations where it would be useful.

  30. #30 Caro
    July 18, 2010

    Vaxxed: Don’t get me started on how much my lifelong treatment for asthma will cost me. Right now, if it wasn’t for living in Norway, I’d be spending 15% of my student loans on meds. I’m permanently disabled by this disease, and therefore a good source of income for “big pharma”. I am lucky to live in a country that pushes prices down, as a response to that, and to live in an age where these meds are available in the first place.

    That’s also not counting in five months’ worth of ethylmorphine cough syrup and the antibiotics. Not very expensive, but I think they do total more than the vaccine.

  31. #31 augustine
    July 18, 2010

    Pal: “If a vaccine were only 30percent effective, there are few if any situations where it would be useful.”

    OT: The flu vaccine is 30-40% effective in the target populations. That doesn’t stop the CDC.

    The question is Guided not misGuided. Some people would not take a vaccine at certain risk percentages depending on their individual value choices. I’d like to know at what percentage cut off would this person keep using the rhetoric of “not 100% effective”. The wording skews the assumption that vaccines are somewhere near 100% effective. None are 100% effective unless you want to change the definition of effective.

    And if your goal is to protect someone else or persuade someone to take a risk to protect someone else you might want to know the evidence of that ACTUALLY happening.

    http://www.adacel-locator.com/support/brochure/adacelpatientbrochure.pdf

    If there were ironclad literature on the questions then you’d think a patient information brochure would clear that up.

    The sales pitch:

    “Even more frightening is the fact
    that 80% of pertussis deaths occur in infants
    under 6 months of age” (actually most are under 3 mos.)

    The fine print:

    “It is unknown whether immunizing adolescents and
    adults against pertussis will reduce the risk of transmission
    to infants”

    Don’t you think they should KNOW the answer to that question? They do know the answer to that question.

  32. #32 Chris
    July 18, 2010

    PalMD, Little Augie is a troll who has migrated from Respectful Insolence. He cannot be reasoned with, and it is best to ignore him.

  33. #33 augustine
    July 18, 2010

    Chris, Why can’t you deal with the content instead of answer back with ad hominems? I know why you can’t deal with the content. Better to stick with the ad hominems.

  34. #34 augustine
    July 19, 2010

    Since the CDC says that 90-95% of pertussis cases are never reported, meaning they are mild, I think it’s reasonable to take my chances of not getting a vaccine for it.

    So tell me again, Chris, why should I take Adacel? For the infants who are too young to take the vaccine you say?

    “It is unknown whether immunizing adolescents and
    adults against pertussis will reduce the risk of transmission
    to infants”

    If you take the vaccine based on evidence, then where’s the evidence? It’s a pretty important piece. Why don’t you send it to Sanofi so they can update their marketing?

  35. #35 Vaxxed
    July 19, 2010

    “I’m permanently disabled by this disease, and therefore a good source of income for “big pharma”.”

    You have my empathy regarding asthma. I had it as a teenager but then fortunately grew out of it. If getting the pertussis infection as a youngster caused your lifelong asthma affliction, I don’t know how comfortable I would feel getting it injected into my body though. Is it a chronic pertussis infection that is causing your symptoms or is it more a chronic autoimmune disorder triggered by the bacteria that is now gone?

  36. #36 Caro
    July 19, 2010

    You seem rather dim, “Vaxxed”, but I’ll try to spell it out for you: I didn’t get a booster in time, contracted pertussis, coughed for five months and triggered lung disease. I should’ve been better protected in the first place, and this is why I’m all for pertussis boosters. “Chronic pertussis infection”, what nonsense. It lasted for five months and then it was over. (What next, “full-body cancer”? “Systemic candida”?) In the real world, pertussis is an awful disease that can have serious long-term consequences, in addition to killing the very young, which is the whole point: It’s a very good reason to vaccinate against pertussis.

    You’re not comfortable with “getting it injected” – you say it as it is a bad thing – because you don’t understand what vaccination is. And you don’t seem to want to understand.

    I am not only comfortable to get vaccinated against pertussis, but also seasonal influenza – which has become a necessity now that I’m asthmatic. Again, this probably makes “big pharma” more money than if I had been properly vaccinated in the first place. That argument holds no water.

  37. #37 augustine
    July 19, 2010

    but also seasonal influenza – which has become a necessity now that I’m asthmatic.

    A necessity? good luck with proving the effectiveness of that strategy. Evidence? You want find any that doesn’t look like swiss cheese. What you’ve done is put your faith in authority. Nothing wrong with that. Just don’t be a hypocrite about it. Mixing science with opinion and theory can be very misleading.

  38. #38 Vaxxed
    July 19, 2010

    “You seem rather dim, “Vaxxed”, but I’ll try to spell it out for you”

    Why the rudeness?

    “I didn’t get a booster in time, contracted pertussis, coughed for five months and triggered lung disease. I should’ve been better protected in the first place, and this is why I’m all for pertussis boosters.”

    So what is causing your symptoms? If it isn’t chronic pertussis, then is it an over active auto-immune system, allergy, or some other mechanism?

    “Chronic pertussis infection”, what nonsense.

    A simple “no” would have sufficed.

    “It lasted for five months and then it was over.”

    I assume your immune system eventually cleared it after five months, so why do you have chronic symptoms? Does a childhood pertussis infection trigger asthma?

    “(What next, “full-body cancer”? “Systemic candida”?)”

    Full-body cancer? I don’t think that is even a legitimate disease. I am not a doctor, but I am pretty sure pertussis doesn’t cause “full-body cancer” or “systemic candida”. Perhaps you know differently?

    “In the real world, pertussis is an awful disease that can have serious long-term consequences, in addition to killing the very young, which is the whole point: It’s a very good reason to vaccinate against pertussis.”

    How do you know that your asthma was caused by pertussis infection? I had asthma as a teenager and never had pertussis so perhaps you would have got it anyway, its pretty common from what I understand.

    “You’re not comfortable with “getting it injected” – you say it as it is a bad thing – because you don’t understand what vaccination is. And you don’t seem to want to understand.”

    You are telling me that a pertussis infection caused you to have disabling life long asthma. What is to stop the same thing happening from getting the same organism injected into the body? Sorry for the questions, but I am trying to make sense of it. Seems counter-intuitive.

  39. #39 gaiainc
    July 19, 2010

    Because the pertussis vaccine is not the WHOLE organism, Vaxxed and you can’t get pertussis from the vaccine. It’s a part of the organism, so that vaccine in and of itself does not cause and cannot cause pertussis. Your body doesn’t not need to see the whole organism in order to become immune to it. For instance, the Hepatitis B vaccine does not have the whole virus in it. It just has those proteins that have been shown to be the keys to providing immunity in humans. The pertussis vaccine is similar.

    As for pertussis triggering asthma, who knows? Asthma shows up when asthma shows up and can go away when it decides to for reasons that are not well-elucidated. There are people who have had known exposures to something and have since developed asthma. It is possible Caro had asthma that was sufficiently mild as not to be noted as asthma, then the pertussis infection set off a series of events inside the lungs that now the lungs are asthmatic and react as being asthmatic.

    BTW–there is no treatment for pertussis. The antibiotics we give are to try and decrease transmission, but in all honestly, the best we can do is supportive care. Which can include a lot of cough syrup and more if needed.

    Augustine, what is your source that the flu vaccine is only 30-40% effective in the target populations? Given that flu can kill me or at least make my life misery for 1-3 weeks, I’ll take the vaccine, even if it was only 30% effective. Heck I’d even take a vaccine against Hep C or HIV that was only 30% effective. Then again, I also know that my risk of significant morbidity and mortality when I drive my car is huge compared to the risk I take when I vaccinate myself or my child.

    Oh and Augustine, to assume that 90-95% of pertussis are not reported because they are mild is not logical. Cases are not reported for a lot of reasons, not the least of which patients do not come in to see the clinician, even when they are really sick. Yes, some cases of pertussis are mild, some are not. Some people have a greater tolerance for persistent coughing than others.

  40. #40 augustine
    July 19, 2010

    “Augustine, what is your source that the flu vaccine is only 30-40% effective in the target populations?”

    http://www.influenzareport.com/influenzareport.pdf

    Did you not believe me?

    “I’ll take the vaccine, even if it was only 30% effective”

    That’s fine but millions of people will not and would not. Manufacturers would have to do something to increase demand and volume or you would risk not getting your product or pay a very high price for it. There’s a financial incentive for the consumer to increase demand.

    Pal says it would not be very useful if it were only 30% effective yet you would still BELIEVE in it’s powers.

    “Some people have a greater tolerance for persistent coughing than others.”

    Some? obviously a lot or…it’s misdiagnosed or…CDC estimates are wrong or… yes, lot’s of reasons why 90-95% cases aren’t reported.

  41. #41 PalMD
    July 19, 2010

    You’re cherry picking your stats, bro. Read the whole thing you linked to, because I just did and it made you look like an idiot.

  42. #42 augustine
    July 19, 2010

    Pal: “You’re cherry picking your stats, bro. Read the whole thing you linked to, because I just did and it made you look like an idiot.”

    What part of 30-40% effectiveness do you not understand, doctor?

    The “cherries” I picked stand alone and do not need the whole bush to justify their existence

    Nice fallacy attempt with a personal attack thrown in.

  43. #43 Chris
    July 19, 2010

    PalMD:

    Read the whole thing you linked to, because I just did and it made you look like an idiot.

    Not a surprise.

    To add what gaiainc said, the reason antibiotics are not terribly effective for pertussis (and tetanus) is that the bacteria produce toxins. The antibiotics will do very little for those toxins.

  44. #44 augustine
    July 19, 2010

    Chris: “Not a surprise.”

    What? That Pal has an opinion.

  45. #45 Chris
    July 20, 2010

    Cherry picking and deliberate obtuseness are signiture little augie.

  46. #46 sdamot
    July 20, 2010

    Would you believe I have a friend whose ~10 y/o child got whooping cough last year and she considers this a good thing because he is now “naturally” immune to it for life. This has made her no less suspicious of vaccines (she reluctantly agrees to get her child some but not if they come in any combo-shot) and does not care that her unvaccinated child may put other children who cannot be vaccinated at risk, as she feels she is making the best possible medical choices for her son.

    I’m not sure how anyone can watch her son cough to the point of vomiting, for weeks on end and not wish she could have spared him that ordeal but there you go.

  47. #47 augustine
    July 20, 2010

    Not able to honestly deal with facts and decisions that contradict her values, a signature of Chris.

    sdamot: “and does not care that her unvaccinated child may put other children who cannot be vaccinated at risk, as she feels she is making the best possible medical choices for her son.”

    Do you not understand how the vaccine works, sweety? The vaccinated can still get the disease and still spread the bacteria. You’re barking up the wrong tree on this vaccine.

  48. #48 sdamot
    July 20, 2010

    @Augustine, I’m not sure what makes you think it’s appropriate to refer to me as “sweety.” Is it because I am in all likelihood a woman? I’ll ignore your patronizing tone though and answer you honestly.

    Yes, I do understand how vaccines work. Given the choice between a vaccine which gives me symptom free or nearly symptom free immunity (for any period of time) instead of having to risk a full outbreak of a disease like, say, polio, pertussis, measles or flu, I will gladly choose the vaccine. Yes, vaccines aren’t 100% effective. Yes, you may still carry a disease that does not cause an outbreak, though clearly, if you are not spewing bodily fluids about, your risk of contaminating those unable to be vaccinated are greatly diminished. The reason polio is not the scourge it once was is because so many people are vaccinated. The evidence suggests strongly that vaccines are a more humanitarian and healthy route to immunity than waiting to get infected and hoping one’s body will manage to fight the disease and you will walk away unscathed.

    The risk of illnesses like whooping cough are far far greater than any risk from the vaccine and most of us are exceedingly lucky that we haven’t experienced the fear, death and suffering that people used to see when these illnesses were more prevalent. Whatever your arguments are, you have not made any compelling case against vaccines you’ve only supported the argument that we need herd immunity.

  49. #49 augustine
    July 20, 2010

    “Yes, I do understand how vaccines work.”

    I was speaking specifically about pertussis vaccine. It is common for SBMers to speak of vaccineS instead of address the specifics of a particular vaccine and disease. This subconscious tactic speaks of their IDEA of vaccination instead of actually having to deal with objections.

    The relative risk vs. benefit argument as you’ve given is a common straw man argument that is made by bloggers.

    The “you haven’t seen what I’ve seen or therefore you’d..” argument is based in propaganda not facts.

    Whatever your arguments are, you have not made any compelling case against vaccines you’ve only supported the argument that we need herd immunity.

    The term herd immunity is much older than the term vaccines. I have no problem with herd immunity. But you better know the differences in vaccine before you start preaching about forced herd immunity.

  50. #50 sdamot
    July 20, 2010

    @Augustine

    IDEA of vaccination instead of actually having to deal with objections.

    Please do explain your objection.

    The relative risk vs. benefit argument as you’ve given is a common straw man

    Then you don’t know what a strawman argument is because comparing the risks and benefits of any medical procedure is not a strawman. A lower risk of contracting an illness that can kill you, by way of a vaccine that is very safe is a legitimate reason to consider a vaccine. A strawman is arguing that because a vaccine isn’t 100% effective, there is no merit to being vaccinated.

    The “you haven’t seen what I’ve seen or therefore you’d..” argument is based in propaganda not facts.

    I haven’t made this argument. You and I have same access to footage of people suffering from polio and I’m incredibly glad I haven’t experienced it. Are you suggesting that a vaccine is worse than polio (or whooping cough or measles)? I’m trying to understand which part is the propaganda.

    The term herd immunity is much older than the term vaccines. I have no problem with herd immunity.

    How are you proposing that herd immunity happens without vaccines?

    But you better know the differences in vaccine before you start preaching about forced herd immunity.

    I’m sorry, where did I say “forced herd immunity”? Do I feel that people who do not vaccinate are denying their child and their community a healthier better and safer life? Yes. Have I stated anywhere that vaccines should be mandated? No. What I’ve said is that your arguments so far, simple bolsters the claim that herd immunity would benefit society. If you know of another safe and effective way to build herd immunity, get to writing it up. There may be a nobel prize in it for you.

  51. #51 augustine
    July 20, 2010

    “If you know of another safe and effective way to build herd immunity, get to writing it up.”

    I’m not interested in building herd immunity. I’m interested in raising a healthy family and that doesn’t involve 60 vaccines. There are plenty of parents who raise their children healthy and drug free. My kids have NEVER had a drug in their lives. It’s not luck.

    I’ll wait for your “free riding” objection and then we can discuss the unscientific portion of your beliefs.

  52. #52 augustine
    July 20, 2010

    “You and I have same access to footage of people suffering from polio and I’m incredibly glad I haven’t experienced it.”

    Speaking of propaganda. I watched the PBS special on the polio vaccine and it had a random black and white film of chilren running out of a school building similiar to the last day of school excitement. But the narrator told a different story. As this portion of the film was showing, he was speaking on the fear of polio. The deceiving implication was that the fear of polio had school children running out of school houses en mass in 1955. THAT is PROPAGANDA.

  53. #53 sdamot
    July 20, 2010

    @augustine

    My kids have NEVER had a drug in their lives. It’s not luck.

    I’ve never been in a deadly car accident but I still wear my seatbelt. I have never had my house burn down but I still buy insurance. You have chosen the risks you wish to take. You have not explained your reasons for distrusting vaccines. As far as I can tell you are unwilling to explain what your problem is and you simply wish to throw out random irrelevant arguments such as:

    I watched the PBS special on the polio vaccine…[edited for brevity]…The deceiving implication was that the fear of polio had school children running out of school houses en mass in 1955. THAT is PROPAGANDA.

    So you saw a documentary and you felt that a single line of it was dishonest. And I’m absolutely positive that I can find you ooodles of intellectually dishonest anti-vax propaganda. Neither would change what is true and what isn’t

    I’ll wait for your “free riding” objection and then we can discuss the unscientific portion of your beliefs.

    So basically you are unwilling to present an argument and are hoping I’ll make some comment you can refute.

    It’s been nice talking to you. If you have something interesting to add let me know.

  54. #54 augustine
    July 20, 2010

    “So basically you are unwilling to present an argument and are hoping I’ll make some comment you can refute.”

    You see, I already know ALL of your arguments. If you’re good then you already know mine and then round we go. Ne’er the ‘tween shall meet.

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