3 reasons to still give your kids whooping cough vaccine
New report shows pertussis vaccine lacking, but still serves as protection for specific populations
I, along with many others in the medical field, have suspected for a long time that we need a better pertussis vaccine.
Aside from flu, I can’t think of any other disease for which we vaccinate where we are excited if only a few outbreaks happen here and there. Yet, despite relatively high vaccination rates at recommended times, we continued to see outbreaks of pertussis occur across the country.
A recent study, published early online for Pediatrics showed that the effectiveness of the new vaccine might even be worse than I thought. The study looked at the medical records of children diagnosed with pertussis. They looked to see if they had the newer, acellular vaccine as children and how long it had been since they received their Tdap (Tetanus, diphtheria and pertusiss) booster. This booster is usually given at age 11.
The most striking statements in the article is how quickly immunity from the vaccine decreases over just a few years after receiving the Tdap booster. The first year yields about 69 percent effectiveness. The second through fourth years decrease like this: 57 percent, 25 percent and 9 percent. We only give boosters for Tdap every 10 years.
The effectiveness was so bad that the authors concluded the study by saying: “We expect future pertussis epidemics to be larger as the cohort that has only received acellular pertussis vaccines ages. The results in this study raise serious questions regarding the benefits of routinely administering a single dose of Tdap to every adolescent aged 11 or 12 years.”
Will I stop giving pertussis vaccines to my 11 year olds? Would I skip it for my kids?
The answer to both of these questions, for now, is “No.”
Here are 3 reasons why:
1.There are very smart members of a group called the Advisory Committee on Immunization Practices (ACIP) that review vaccines and make new recommendations every year. These folks understand vaccines and the statistics surrounding their effectiveness better than anyone else in the country. They are not afraid to make changes that are based on very minute details (like whether you can be vaccinated with different brands of vaccines over time and they still work). There is no question they will review this study.
2.We have another disease for which we continue to vaccinate even though the vaccine strategy isn’t perfect and we continue to prevent thousands of severe cases and death from flu every year. Do we continue to look for better strategies and products for vaccination for both flu and pertussis? Yes. Do we throw out what we have because it isn’t perfect? No.
3.Even if the vaccine effectiveness wanes quickly, that one year of protection could be important for specific populations. Pregnant moms not only need to be protected from contracting the disease, they pass antibodies to their babies if the vaccine is given at the right time during pregnancy. Because of this, it is now recommended that pregnant moms receive the vaccine with each pregnancy. Perhaps we should consider giving a booster shot to all close contacts with the baby no matter when their last booster was given.
Reading this study and the subsequent articles I saw was disheartening. I have seen babies struggling to breathe and subsequently die from pertussis. It’s awful.
Undoubtedly, we need a better vaccine and strategy. For now, I’ll continue to do the best I can until we have something better.
Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . View more from The Doc Smitty at his Facebook page.He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.