California Whooping Cough Cases "an Epidemic"

As reported by the San Jose Mercury News, the state of California is "in the throes of a whooping cough epidemic, state health department officials announced Friday. Dr. Ron Chapman, director of the California Department of Public Health, said 3,458 cases of whooping cough have been reported since Jan. 1 -- including 800 in the past two weeks. That total is more than all the cases reported in 2013." Public broadcaster KPBS notes that of the 621 people known to have come down with whooping cough in San Diego county, the vast majority (85 percent) were up to date on their immunizations.

Comments

Re:So there's 100 or so unimmunized?

[mysidia]

im one of those 15%, I'm allergic to the pertussis shot

Then the other 95% of that 15% are putting you in danger for no great reason, because they have no medical reason to not have the proper vaccinations.

Mexico Vaccinates Better Than The US

[CritterNYC]

Mexico's vaccination rates are higher than the US.

Re:Mexico Vaccinates Better Than The US

[AthanasiusKircher]

To truly see how well the whooping cough vaccination is working, you need to compare it to the percentage of total vaccinations.

THIS. The reporting in TFA is potentially making a false inference.

If this is unclear, think about it this way: If 85% of the 621 infected have been vaccinated, that means that 528 were vaccinated, and 93 were not.

Now, consider a hypothetical population of 10,000 people. And suppose (for the sake of argument) 99% of them are vaccinated. That means that 9900 people are vaccinated, and only 100 people are not.

Look at those statistics again for infections. If 93 of unvaccinated people were infected, that would constitute 93% of the entire unvaccinated population. In comparison, 528 out of the other 9900 would only be 5.33%.

In this hypothetical 99% vaccinated scenario, going without vaccinations means you are over 17 TIMES more likely to get infected if you are unvaccinated.

I doubt we can assume a 99% fully vaccinated rate, but as long as that rate is greater than 85%, the vaccine has some apparent effect. To wit:

Percentage of population vaccinated - relative risk
99% - 17.4 times higher risk for unvaccinated
97% - 5.7
95% - 3.3
90% - 1.6
85% - equal risk
less than 85% - vaccine is apparently not effective

You can't compare the incidence of things happening in two different subgroups without knowing the overall proportion of the subgroups within the population in general. Basic stats error.

Re:Mexico Vaccinates Better Than The US

[Miamicanes]

For what it's worth, "anchor babies" is another misleading term.

A baby born on US soil to a Mexican citizen in the US illegally enjoys automatic US citizenship, but it was established by the Supreme Court a few decades ago that being a child with US citizenship does NOT automatically convey a right to GROW UP on US soil unless at least one parent or legal guardian has US citizenship or residency. (I believe the Supreme Court's rationale was that a child needs a legal guardian, and since the constitution doesn't grant automatic citizenship to the PARENTS of US citizens, the child can't independently exercise his rights as a US citizen until he or she is legally an adult).

Under the best circumstances for the mother, her baby will be born in the US, get an official US birth certificate, then both will be deported to Mexico. 18 years later, the child can move to the US at will, but bringing his mother (or any other extended family member) will require demonstration of financial ability to support and sponsor the immigrant parent. In the end, all having an "anchor baby" really gives the mother is the ability to cut in front of other Mexican citizens and move to the front of the immigration line ahead of them.
immigration status.

Re:I don't think we need to immunize child so earl

[magamiako1]

There is no credible evidence that early vaccinations cause issues with children. That's a bunch of horse shit.

Re:So there's 100 or so unimmunized?

[Trepidity]

When one is immunized, one can handle the real thing quickly. That means the sickness cannot take hold, or not for long.

Unfortunately that appears to be no longer be as true for whooping cough as it used to be: the currently circulating strains have diverged from the strains that were used to develop the vaccine, so protection is worse than it used to be.

Real information on the pertussis vaccine.

[Vellmont]

The article is terrible. The CDC has a very good FAQ on the pertussis vaccine.

http://www.cdc.gov/pertussis/a...

Q: Can pertussis be prevented with vaccines?

A: Yes. Pertussis, or whooping cough, can be prevented with vaccines. Before pertussis vaccines became widely available in the 1940s, about 200,000 children got sick with it each year in the US and about 9,000 died as a result of the infection. Now we see about 10,000–40,000 cases reported each year and unfortunately about 10–20 deaths.

Pertussis vaccines are recommended for people of all ages. Infants and children should get 5 doses of DTaP for maximum protection. A dose is given at 2, 4 and 6 months, at 15 through 18 months, and again at 4 through 6 years. A booster dose of Tdap is given to preteens at 11 or 12 years of age.

Any adolescents or adults who didn't get Tdap as a preteen should get one dose. Getting Tdap is especially important for pregnant women. It’s also important that those who care for infants are up-to-date with pertussis vaccination. You can get the Tdap booster dose no matter when you got your last regular tetanus booster shot (Td). Also, you need to get Tdap even if you were vaccinated as a child or have been sick with pertussis in the past.

Learn more about preventing pertussis.

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Whooping cough can be deadly for babies. Learn how to protect them through vaccination. See this infographic.

Q: Why is the focus on protecting infants from pertussis?

A: Infants are at greatest risk for getting pertussis and then having severe complications from it, including death. About half of infants younger than 1 year old who get pertussis are hospitalized, and 1 or 2 in 100 hospitalized infants die.

There are two strategies to protect infants until they're old enough to receive vaccines and build their immunity against this disease.

First, vaccinate pregnant women with Tdap during each pregnancy, preferably at 27 through 36 weeks. By getting Tdap during pregnancy, mothers build antibodies that are transferred to the newborn, likely providing protection against pertussis in early life, before the baby can start getting DTaP vaccines at 2 months old. Tdap also helps protect mothers during delivery, making them less likely to transmit pertussis to their infants.

Second, make sure everyone around the infant is immunized. This includes parents, siblings, grandparents (including those 65 years and older), other family members, babysitters, etc. They should be up-to-date with the age-appropriate vaccine (DTaP or Tdap) at least two weeks before coming into close contact with the infant. Unless pregnant, only one dose of Tdap is recommended in a lifetime.

These two strategies should reduce infection in infants, since health data have shown that, when the source of pertussis could be identified, mothers were responsible for 30-40% of infant infections and all household members were responsible for about 80% of infections.

It's also critical that healthcare professionals are up-to-date with a one-time Tdap booster dose, especially those who care for infants.

Learn more about infant complications.

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Q: Do pertussis vaccines protect for a lifetime? If I've had whooping cough, do I still need a pertussis booster?

A: Getting sick with pertussis or getting pertussis vaccines doesn't provide lifelong protection, which means you can still get pertussis and pass it onto infants.

Pertussis vaccines are effective, but not perfect. They typically offer high levels of protection within the first 2 years of getting vaccinated, but then protection decreases over time. This is known as waning immunity. Similarly, natural infection may also only protect you for a few years.

In general, DTaP vaccines are 80-90% effective. Among kids who get all 5 doses of DTaP on schedule, effectiveness is very high within the year following the 5th dose

Re:Stay in the basement!

[sconeu]

I actually *had* pertussis back in 2001 (my '60s vintage vaccine wore off). It is horrible, I was coughing to the point of vomiting.

I hope the anti-vaxxers all get it and drop dead from it.

Re:So there's 100 or so unimmunized?

[mysidia]

Perhaps they can't afford it? Immunizations used to be dirt cheap but these days, not so much.

The DTaP vaccine is available free of charge through state health departments particularly to low-income families and to those without without health insurance; in addition, many private doctors participate in the Vaccines for children program.

Even if it's not free the price is not particularly high; basically $50/dose for immunization against Diptheria, Tetanus, Pertussis, and Polio; add another $60/dose for MMR.

Re:So there's 100 or so unimmunized?

[pla]

Anaphylaxis is not the only allergic reaction.

Absolutely true! But, uh... "tummy ache" ain't one of them. Not even with really bad puking and diarrhea. Sorry.

Re:So there's 100 or so unimmunized?

[dmr001]

Mexican kids tend to have at least as high vaccination uptake as US kids. (I say this based on personal experience as a primary care physician taking care of a population with lots of Mexican immigrants who keep their vaccination cards, and based on data you can Google easily: http://www.vaccinationnews.org..., and http://www.unicef.org/infobyco... which shows Mexican DTP rates around 99%, compared to the United States, which is 93% by the third dose.)

So, I wouldn't look so strongly at Mexico, as I would at San Diego, which is the backyard of Dr Bob Sears and his Vaccine Book. He promulgates a non-evidence-based Alternative Schedule that more or less gives privileged white parents permission to be suspicious of the pro-science crowd. (See http://pediatrics.aappublicati... for cogent commentary on the same.)

With a panel of about 2000 patients, I've got more or less 0 vaccine refusers among my Mexican and Central American population, which correlates well with the Unicef data cited above.

Re:So there's 100 or so unimmunized?

[Opportunist]

Pages 4 and 5. Page 5, somewhere in the middle:

Almost all reported cases of tetanus are in persons who have either never been vaccinated, or who completed a primary series but have not had a booster in the preceding 10 years.

Page 7 goes into detail with vaccination.

Of course this is only a credible source if you're not convinced that the government and the center of disease control and prevention aren't in on this whole pro-vac conspiracy.