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Monday, February 3, 2014

FDA Study Explains The Trouble With Pertussis Vaccine (Loop Op-Ed)


Caveat:  This article is slightly different from the one published in The Loop on January 30th - it has been revised to apply to our entire region, rather than specifically Vashon Island.  Enjoy & Share!

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Good people are people who do their best. There are a lot of good people in our region, and we are a diverse group. That’s why “respect for diversity” matters. Sometimes another person’s choice will boggle our mind. When it does, hopefully we’ll realize we are boggling someone else’s mind, too! And aim for tolerance. A not-so-easy goal.  

Sadly, over the past few years, our respect for medical diversity has faltered. What you do in the doctor’s office has become public fodder for evaluation, debate, and ultimately, judgement.   

This message mostly centers around pertussis (whooping cough) and the commonly held belief that by vaccinating, you can protect yourself AND those around you. This is known as Herd Immunity. Or, if you don’t want to feel like a cow, Community Immunity.

It’s a great idea, and for some disease/vaccine combos it works. But, according to a new, highly-credible FDA/NIH study, attaining herd immunity for Whooping Cough with the current acellular pertussis vaccine is almost certainly a pipe dream.

Vaccines in America are produced by private companies, government is tasked with approval and oversight, and public health departments are expected to inform the public. The trouble is, vaccine science is complicated, sound bites under-inform, and fear is a powerful force.

The most popular pertussis vaccine myths in our region are: (1) if you vaccinate, then you won’t catch pertussis or transmit it to others, and (2) if more people vaccinated, we could achieve herd immunity!”     

So, this is the question of the hour: “Why is there a resurgence of pertussis in the U.S. when American vaccination rates are higher than ever?” Answer: “Because the vaccine doesn’t do what we thought it did.”

This new and highly regarded study shows that baboons vaccinated with aP (acellular pertussis vaccine) were protected from severe pertussis-associated symptoms but not from colonization, they did not clear the infection faster than non-vaccinated individuals, and they readily transmitted B. pertussis to unvaccinated contacts.  Individuals vaccinated with wP (the older whole cell pertussis vaccine) cleared the infection faster but still transmitted to contacts.  Meanwhile, previously infected baboons were not colonized nor capable of transmitting pertussis to contacts.  

According to Tod J. Merkel, lead author of the study, “When you’re newly vaccinated you are an asymptomatic carrier, which is good for you, but not for the population.” Fellow scientist, Jason Warfel went on to state: "Although pertussis resurgence is not completely understood, we hypothesize that current acellular pertussis vaccines fail to prevent colonization and transmission."   

Surprised? You shouldn’t be. As Emily Willingham states, in Forbes magazine, “Although this work was in baboons and baboons aren’t people, it provides compelling evidence for what many experts suspected: Acellular pertussis vaccine just isn’t very good at preventing pertussis transmission.”  http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm

So, what’s the media to do? The past few years have been filled with stories such as The Stranger’s article by Goldy titled:  Stupid Fucking Anti-Vaccine Hippies, and the Seattle PI’s article, “What It’s Like To Have Whooping Cough At 31,” which quotes Julia Ioffe’s blog post, “I’ve Got Whooping Cough. Thanks a Lot, Jenny McCarthy.”  Lead editor of The New Republic, Julia ends her story with, “So thanks a lot, anti-vaccine parents. You took an ethical stand against big pharma....killed some babies and gave me...the whooping cough in the year 2013. I understand your wanting to raise your own children as you see fit, science be damned, but you're selfishly jeopardizing more than your own children. Carry your baby around in a sling, feed her organic banana mash while you drink your ethical coffee, fine, but what gives you denialists the right to put my health at risk...?”  

Thankfully, Julia Ioffe can now rest easy knowing that she probably caught pertussis from a cute, vaccinated, schoolgirl whose Mommy was completely unaware that her daughter was a walking, talking, bright-eyed little pertussis carrier. Or, her elderly neighbor who had an awful cough that just wouldn’t go away. Or her co-worker who coughed so hard she cracked a rib just before catching a flight to Atlanta for a business meeting. Or, her other co-worker who feels perfectly fine, just got the TdaP, and is visiting his newborn niece after work today? None of whom ever considered that they could have pertussis...because they were vaccinated.        

Does this mean you shouldn’t vaccinate for pertussis?  Of course not!  Tetanus only offers benefits to the recipient, so why not use the pertussis vaccine? If you wish to manage your health with vaccines. Of course, not everyone does. Some prefer to allow their children to experience pertussis naturally, watching for symptoms, working with their doctor, and staying home until they are no longer contagious. Remember, if both the vaccinated and the unvaccinated can be colonized by the bacterium and transmit it to others, then the obvious symptoms of the unvaccinated will at least raise a red flag. But, what if you or your child has a suppressed immune system, or asthma, or you’re just plain scared of the disease? By all means, take advantage of the personal protection the acellular vaccine offers you. Just don’t think you’re getting more than you’re getting.  

For now, no one knows 100% what’s happening and there is no viable vaccine option for creating herd immunity to pertussis. Until we know more, parents of newborns (and other vulnerable individuals) should continue to be cautious! This means, if you thought a person’s vaccination status automatically made them safe...think again.   

On the public front, let’s hope our doctors, public health nurses, public & private school administrators, media and activists will revamp their message to acknowledge the results of this game-changing study.   

~March Twisdale (an advocate for medical choice and informed consent who also is a parent with partially vaccinated children)

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Welcome to the conversation. Knowledge changes. People respond best when this truism is kept in mind. In community, March & Karen