Whooping cough on the rise

Maryn McKenna—science journalist and Scary Disease Girl extraordinaire—talks about vaccinations, the precarious dance of herd immunity, and the time she caught whooping cough.

Maggie Koerth-Baker is the science editor at BoingBoing.net. She writes a monthly column for The New York Times Magazine and is the author of Before the Lights Go Out, a book about electricity, infrastructure, and the future of energy. You can find Maggie on Twitter and Facebook.

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Anonymous

It doesn’t take a statistically significant number of people to stop vaccinating before the herd immunity is compromised and large numbers of people can start getting sick

Once again, the CDC numbers disagree with you. They have estimates of the coverage that you need for a herd immunity, and we’re still there and have been there for quite awhile.

So, back to my question: If vaccination rates are stable and high enough for herd immunity to kick in, then how much can they be hurting you?

On the flip side, I’ve seen dozens of news articles that all hyped the tiny number of people who choose not to vaccinate, and ignored all of the adults who vaccinate their children but ignore their own CDC-recommended boosters.

So, are you angry at the people who are too stupid to get vaccinated, the people who choose not to, the people who can’t, all of the above, or some other combo? :)
Evil Chicken

Not immunizing puts the whole of society at danger. Grab ‘em and stab ‘em.
djsparxx

i actually think i have whooping cough right now :-(
tacticus

Also the stupid is quite Clumpy so you get groups of people not vaccinating which destroys the herd immunity in that area
Spikeles

We had someone at our workplace get it. That was months ago, he still gets coughing fits now every so often.

At the start of the year there were reports in Australia of an increase of Whooping Cough(especially in South Australia). The Australian Medical Association said it was due to increased detection because of testing of Swine Flu.

So there are lots of people out there who may have it but don’t see a doctor? Scary.
bklynchris

vaccinations….again. I believe in being vaccine educated and adherent but not subservient. My son had a huge rxn (extreme swelling at sight, seizures, developmental delays, etc) to the old DTaP, which was the new DPT, and NONE of the doctors at pediatric practice or the ER wanted to be the one who submitted the adverse rxn report to the CDC. I now have his blood tested for active immunity (DTPMM&R) every year, and at the first sign of waning I will indeed vaccinate.

Anyway, I think pharma is more profit directed than public health directed (I’ve got 500 pens, pads, stress squeezies, and innumerable luncheons that suggest as much).

I would rather have my children have had chicken pox than the vaccine. I believe that some diseases that are less virulent might make us more immune to those that are more so. eg-cowpox infections that led to the discovery of the small pox vaccination.

I am also curious to see what the compliance will be for Gardisil will be between boys and girls now that many school boards are requiring it for boys as well. For those still requiring it for girls only, a pox on them (pun intended).

And anon? The Spanish flu was a direct result of war (WWI) and its spread facilitated by war and poverty, and I bet you would have any number of epidemiologists argue that to a great extent its virulence was as well.

Also, I don’t like the herd immunity argument against vaccinating. I would hope that herd immunity would really be for the protection of those who although vaccinated are not ultimately immune. Of course, in my book, this includes-do not go carting an unvaccinated infant around in public (ESPECIALLY on planes, and more importantly international flights), if the child happens to contract an infection it can just as easily spread them.

A commenter on McKenna’s sight finds these citations which are of some interest

You say “As far as anyone can tell, the rise in pertussis is not due to any change in the organism,” but is that true? There’s some evidence that Pertussis is adapting to the vaccine. Have we looked at the Pt isolated from patients in the US to check?

http://www.cdc.gov/ncidod/eid/vol7no3_supp/mooi.htm
“Adaptation may have allowed B. pertussis to remain endemic despite widespread vaccination and may have contributed to the reemergence of pertussis in The Netherlands.”

http://jmm.sgmjournals.org/cgi/content/full/56/4/533
“In Taiwan, as in other countries, an epidemic trend in pertussis has in part been attributed to the antigenic divergence in B. pertussis strains due to vaccine-driven selection as a result of using whole-cell pertussis vaccines for long periods”

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0000904
“B. pertussis is dynamic and is continuously evolving, suggesting that the bacterium may use gene loss as one strategy to adapt to highly immunized populations.
Robbo

Being an old geezer I recall the days before there even was a whooping cough vaccine.

In my family we ALL caught whooping cough. I was maybe 4 years old but I remember our Dr. Wheeler – back when they made house calls – lining all us kids up on the staircase, like some kind of Von Trapp Leave It To Beaver Typhoid Mary exhibit, and checking our throats with the same wooden tongue depressor. We were all coughing our asses off and I was quite proud that I coughed right in his face. Being only 4 I had no idea what was going on except we were all sick, all coughing and (being a competitive monkey) I was determined to be the best of the lot.

We all survived – even Dr. Wheeler – and the world carried on as before. I’m not a proponent for dismissing the well established value of inoculation programs but I do keep an open mind for the equally well established shenanigans of pharmaceutical companies who value profits above human health. I’ve never been inoculated against small pox – not bearing the tell-tale scar upon the upper arm – and do not live in fear of that. I’ve survived measles and a host of other contagions and am still relatively intact.

I suspect as we continue our battle against the various viral and bacteriological foes which threaten to wipe us off the Earth before we ourselves have a chance to succeed in that quest (always competitive monkeys) we will always find ourselves rising and falling in the scorecards kept of these things. It’s always worth noting that the consistent and most major cause of the spread of infectious disease can be narrowed to 2 distinct factors:

Poverty and War.

Solve those and any remaining fight against disease becomes an easy walk in the park.

Cheers.
Anonymous

Robbo, I enjoyed reading your post but know that some viruses (like the Spanish Flu) cause the human body’s own immune system to attack itself, therefore the healthier your immune system is the greater chance you have of dying from it. Getting infected by the Spanish Flu was just a matter of time unless you isolated yourself but the young and old were mostly spared while fit young adults died by the millions. “Poverty and War” had little to do with survival rates.
spcfgt

Denialism — A great idea until your kid dies from something you didn’t vaccinate him for.

The sad part is, there are few enough of these people that it’s entirely possible none of their kids will die from things they weren’t immunized against for a few years yet.

Some yahoo will compare the numbers without looking at proportional representation and deem that it’s suddenly OK to stop immunizing.

And then 10, 20, 30 years from now we’ll be facing all of this crap we’ve already beaten all over again.
- Anonymous
  
  Yeah, like the chicken pox. Damn that chicken pox! It killed my child!
  
  Oh, wait, you mean like polio. Oh, okay. I see.
  
  What I’m saying is that, although I see where you’re coming from and mostly agree with you, you can’t lump vaccinations together. It’s just a category that we put alot of different medications in, for different things. The risks of each medication and illness are different.
  
  So someone who get their pertussis, measles, and polio, but skips the chicken pox and Gardisil vaccine is okay in my book.
  
  Also, people in their 20s who haven’t followed the CDC schedule for vaccination aren’t any less culpable than parents who choose not to follow the CDC schedule for their children.
  
  (So how old are you, and are you revaccinated?)
  
  :P
Lynne

Too much of modern science – including medical science – is based in gaining compliance with bogus “gold standard” studies and number crunching, just because it rewards the grant process, fluffs the bureaucratic budget, and pads the ego — and using fear to do it.

Soon enough, modern science will be right up there with religious fundamentalism: “Do what we say, or you’ll burn in hell/whooping cough!”

Whatever.

Diseases come and go, and always will. That’s part of the natural cycle. Junk science, pumped out by corporate interest and disguised as “GOOD FOR YOU!” is not part of any natural cycle that makes the human body work.

Sorry investors and True Believers.
Anonymous

I had whooping cough in middle school (1993). Apparently when my sister and I were of an age to get vaccinated, the HMO that covered us decided we didn’t need pertussis immunity.

I cracked a rib from coughing so hard.

Whooping cough is one of the worst things I’ve ever experienced. Immunity wanes after ten years, so if you haven’t had your Tetanus-Diptheria-Pertussis booster lately, go get it!
Anonymous

The CDC has repeatedly issued press releases stating that vaccination rates have remained stable, and at a high level. The last press release was in 2009, which may be because the 2010 data isn’t in yet. :)

The ‘plummet’ (as the NY Times put it) in vaccination rates seems to be a creation of the media, as opposed to, you know, fact.

I tried to look it up myself, and couldn’t find rates any closer to now than 2006, so the CDC press release is the best source I have for this.

So I guess what I’m saying is that I’d like to see proof that vaccination rates are declining before I blame an increase in illness on it.
- Anonymous
  
  So can the argument for compulsory vaccination be made? Individual liberty ends when it infringes on another persons freedom, and comprising herd immunity definitely seems to fall into that category.
- knappa
  
  Ok, so I looked at what the CDC’ stats for 13 to 17 year olds are and their 2008 report (at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a2.htm ) says:
  
  Nationally, vaccination coverage for the three most recently recommended adolescent vaccinations and one childhood vaccination increased from 2007 to 2008: MCV4 (from 32.4% to 41.8%), Tdap (from 30.4% to 40.8%), â‰¥1 dose of HPV4 (from 25.1% to 37.2%), and â‰¥2 doses of VAR among those without disease history (from 18.8% to 34.1%). However, substantial variability in vaccination coverage was observed in 2008 among state and local areas and by race/ethnicity and poverty status.
  
  I’m not quite sure at what percentage the phase change to herd immunity occurs, but these numbers seem quite low to me. The relevant vaccine, Tdap, has increasing rates but still less than 50% coverage!
  
  To Robbo: To some extent, you are displaying selection bias in that you are alive to post here while those who died are not. However, since you were old enough to remember having it, you had a 99.8% chance of surviving anyway — whooping cough mostly kills infants. Also, vaccines aren’t profit centers for industrial pharm — unlike things like lipitor and other drugs you have to take every day for the rest of your life. The rewards for cutting corners for a big payoff just aren’t there.
  - IronEdithKidd
    
    Knappa, if you have kids, I doubt they’re freshly minted. My son’s first year (he’s 15 months now) of immunizations cost approximately $1600. That was just for the drugs. There were additional charges of $15/shot for “labor”. Forgive me if I find your claim that immunization drugs don’t equate to big pharma profit incredulous. $250-$300 a pop is pretty steep for drugs with R&D costs recovered 30-40 years ago.
- sloverlord
  
  But that’s exactly the problem. It doesn’t take a statistically significant number of people to stop vaccinating before the herd immunity is compromised and large numbers of people can start getting sick (read the article, it talks about how none of us are actually immune to things like whooping cough anymore: we only were as children and it’s herd immunity keeping us safe now).
  
  That’s what makes me so angry at the vaccination conspiracy theorists. It’d be one thing if their stupidity only harmed themselves, but it’s a serious threat to everyone.