The Pertussis Vaccine Saves Lives Anna Mitchell Brother Griffin ENG 252-1 6/1/2013 Mitchell 1 Pertussis Vaccines Save Lives In the year 1999, little to nothing was commonly known about the Pertussis vaccine, or even the disease itself. Women were not counseled to receive this vaccine when they became pregnant, and were not instructed to procure the vaccine for their children. Because of the lack of information available, women were unaware of the risks to them and to their small or unborn children. Also in 1999, a woman by the name of Linda Mitchell gave birth to a healthy baby boy. She named him John-Lawrence, after a dear friend of her husband. John was a healthy, happy baby; but not for long. At less than a month old, little John-Lawrence came down with a prolonged cough. After several tests, including false negative results, John was diagnosed with Pertussis. Although medical teams at the local Children’s Hospital did all that they could, by that time it was too late for little John-Lawrence. On his two-month birthday, John passed away from the disease. Had his mother been aware of the potential dangers of Pertussis, she could have gotten vaccinated and saved the life of her son. However, since there was virtually no awareness of the Pertussis vaccine and its saving qualities, a life that had just started was lost. Today, there is much more publicity and awareness of the Pertussis vaccine, but there is still argument as to whether or not it is truly effective. However, studies and tests as early as the late 1980’s and the early 2000’s confirm that Pertussis vaccines are incredibly effective and lifesaving. Awareness of and access to the Pertussis vaccine must be raised and made available to adults and children alike to prevent more loss of young life due to this horrendous and fast-acting disease. To understand the importance of the Pertussis vaccine, the public must first be made aware of what Pertussis is and what it does. The Centers for Disease Control and Prevention, or the CDC, tells us on its official website that Pertussis, commonly called Whooping Cough, is an Mitchell 2 infection caused by the bacteria Bordetella pertussis, which develops and attaches to the upper respiratory system (CDC). The infection causes major coughing fits in children and adults, although the symptoms are usually much less severe among adult patients. The coughing fits will impair the infected individual’s ability to breathe, causing the person to gasp for breath, creating a whoop sound, hence the name Whooping Cough. In severe cases, such as in little children, the coughing fits will trigger vomiting, and the afflicted child will be extremely exhausted after each fit. In the most severe cases, such as in the case of John-Lawrence, the lungs will start to swell and excess fluid will accumulate in the lungs and around other areas of the body. For instance, little John-Lawrence suffered from swelling in his face around one of his eyes due to this excess fluid. These conditions can and often do become fatal, especially in the cases of small children such as John. In older patients the symptoms are not usually life threatening, but can be as severe as passing out from lack of air or fracturing ribs due to violent spasms during a coughing fit (CDC). Because the early symptoms of Pertussis can seem inconsequential, many do not realize that they have contracted the disease. In fact, since adults and teenagers sometimes do not experience more severe symptoms than coughing fits, many get over the disease without ever realizing they had it; they assume that they are only suffering from allergies or a cold, and so they do not seek medical attention. However, just because those individuals’ symptoms may not be severe enough to threaten their own lives, it does not mean that they cannot pass on the disease to others who are more susceptible to the debilitating effects of Pertussis. In the case of John-Lawrence, for example, doctors told his parents that he could have caught the disease from someone who was coughing without covering their mouths passing by him on the street or in a store. Clearly, this is a highly contagious disease that should be tested for and treated. In the Mitchell 3 article, “Pertussis of adults and infants”, published in The Lancet Infectious Diseases, the authors explain that “Adults are a reservoir for infections in very young infants, in whom pertussis may be severe and life-threatening.” (Wirsing, 744). In addition to being easy to pass on, the disease can become contagious very quickly after the initial onset in an individual. In “Epidemiology of Pertussis”, published in Clinical Infectious Diseases, we learn that the time between onset of the disease and transmission to another person can be as short as one week (Thomas, 255). When small children are so susceptible to the disease, and the disease so easily passed along, something must be done to prevent adults from passing this deadly threat on to young children. Not only must adults must be made aware that vaccinations are available, and are necessary to the prevention of Pertussis-related deaths in children, but they must also be educated on the symptoms so that they may recognize the risk from the onset and get themselves tested and treated. In recent years, the outbreak of Pertussis has become a veritable epidemic. In the Pediatrics journal, an article titled “Report on the Task Force on Pertussis and Pertussis Immunization” lays out the Pertussis-related statistics found in 1988. The article states that worldwide there occur approximately 600,000 deaths from Pertussis every year, and that almost all of those deaths were infants who had not received a vaccination (Cherry, 933). Since 1988, the number of those infected has been rising. Throughout the world, more and more cases of Pertussis are being reported, and more and more infant deaths are occurring. These deaths are happening because awareness is too low, and number of vaccinations performed is even lower. In an article titled “Epidemiology of Pertussis”, published in Reviews of Infectious Diseases, we learn that in most countries, the policies concerning Pertussis vaccinations have such limited coverage as to render them useless in preventing an outbreak (Thomas, 255). In fact, according Mitchell 4 to the website for the Centers for Disease Control and Prevention, less than ten percent of adults worldwide have received the Pertussis vaccination (CDC). Unless something is done to raise awareness of the dangers of this disease, and to promote vaccinations on a larger scale, the epidemic will continue to spread to gigantic proportions. One might ask, if the vaccine is so important, why is its usage not more widely accepted? The answer is simple: parents have misconceptions about the disease and the vaccine, and they have been fed rumors about the vaccine by anti-vaccination movements. In recent years, the amount of publicity given to the disease and the corresponding vaccine has grown; however, throughout the United States and the world there are still far too many people who are not aware of how prevalent and dangerous Pertussis is. A simple Google search will lead readers to pages of questions and comments from parents who do not know how to recognize the disease or do not believe it to be very dangerous. Many of these unconcerned parents are not educating themselves on the severity of the disease, and so they prefer to just wait until the child gets over it, so to speak. Several comments on the babycenter.com website indicated that some parents are under the impression that it is beneficial for their children to get Pertussis because they will build up immunity (Comments). While it is true that contracting the disease can lead to immunity, few people realize that this only happens in cases when the infant actually survives the disease. Because the disease is so swift and aggressive, cases of infant survival without treatment are rare. If parents notice symptoms of Pertussis in their children, it is essential to get the children tested and treated. However, this situation could be avoided all together if parents procured the vaccination for their children in the first place. A common misconception among parents is that they themselves do not need to receive the Pertussis vaccine, because onset of Pertussis after childhood is rare. However, the number of Mitchell 5 reported cases of Pertussis in older children and adults is rising (Keitel, 118). In spite of this fact, many parents think that if there is little to no chance that they will contract the disease, then why bother with a vaccination? Even if they did get the disease, they most likely would not suffer from severe symptoms, so it becomes ‘no big deal’ for them to opt out of getting the Pertussis vaccination. What these parents fail to realize is that even if they do not contract the disease, their child could potentially get it from someone else. In addition, even if they do not suffer the full severity of Pertussis, they could definitely pass it on to their child, who would indeed suffer the full effects. However, if parents take responsibility and procure for themselves the vaccination, they can ensure that they do not pass on the disease to their child. In addition, if pregnant or nursing mothers get the vaccination, they can then pass on their immunity to their babies through their bodies or the breast milk their babies take nourishment from. By understanding the importance of getting themselves vaccinated and doing so, parents can better protect their children from the vicious disease that is Pertussis. Another common misconception in regards to the Pertussis vaccine is that the vaccine is ineffective, or even harmful, to children. There are many individuals who believe that vaccinations are ‘unnatural’ and should not come into a human body. Such individuals believe that man-made vaccinations do more harm than good. Many of these are the same individuals who believe it best to allow children to contract the disease in order to build immunity. Such ideas are incorrect. In her article “Acellular Pertussis Vaccines—A Solution to the Pertussis Problem?”, Kathryn Edwards states that “The vaccines have been found to be safe and immunogenic in infants and children.” (15). “Immunogenic” means that the vaccine causes an immune response, or in other words creates immunity to the Pertussis disease. In addition, in a study published in The Journal of Infectious Diseases and performed to determine the Mitchell 6 effectiveness of the Pertussis vaccine, several children under two years old were placed in a residential facility. Nine of these children were given the Pertussis vaccine, leaving 10 unimmunized. Only one child who was immunized developed typical symptoms of Pertussis, while six out of the ten unimmunized children showed typical symptoms (Aoyama, 483). Another study performed for the same reason, and published in The Journal of the American Medical Association, 112 individuals were immunized with the Pertussis vaccine while 173 were left unimmunized. Of the immunized individuals, only seven contracted Pertussis; in contrast, 93 of the unimmunized individuals contracted the disease (Schmitt, 37). It is clear from these studies that the Pertussis vaccine is indeed effective, which shows that the idea that vaccines are ineffective and harmful is simply inaccurate. In fact, neither study reports any negative or harmful side effects resulting from immunization, so the theory of harmful vaccines is disproved even further. While it is natural and healthy for parents to be suspect of medical procedures, they need to take the time to perform research and find legitimate sources of information. Too often, parents believe whatever drivel is broadcast by a biased talk show. This blind belief leads to misconceptions. In such cases as the Pertussis vaccine, these misconceptions can quite literally mean the difference between life and death. Parents need to be aware of the actual effectiveness of the Pertussis vaccine so that they can take responsibility for their own and their children’s health. Along with common misconceptions derived from different media sources, parents are constantly barraged by anti-vaccination movements. These movements are not fueled by those who see vaccines as unnatural with possible harmful effects, but by those who believe vaccines to be nothing more than a scam perpetuated by the government to rob innocent tax payers of their money and their health. There is clear evidence of the scope of these movements in the Mitchell 7 comments on the Baby Center page on Pertussis vaccines. One commenter insists that physicians are paid on some bizarre commission system, where they receive a bonus for every vaccination they administer. Therefore, according to this commenter, there is no real reason to get vaccinated. The only reason doctors recommend vaccinations is to get more money. This commenter shows a profound misunderstanding of the system of payment to health care providers in America. True, in the past doctors were paid on a fee-for-service system where doctors received more money for performing more tests and complicated procedures. However, that system of payment has become almost obsolete, replaced with the capitation system. This system assures doctors a flat monthly fee for services rendered to a patient. This method is meant to encourage performing more preventative measures, such as administering vaccinations, mammograms, and pap smears, rather than performing several unnecessary and expensive tests in order to get more money (Hagland). Under the capitation system, doctors gain no monetary reward for administering vaccinations, so that commenter’s argument is proved invalid. Another commenter insisted that Pertussis is caused by inhaling flame-retardant chemicals present in foam mattresses. This commenter provided a method of clearing such chemicals from a body which included scrubbing children with bar soap, since no other soap would effectively remove the chemicals from the skin. This is obviously untrue, as scientific testing has irrevocably shown that Pertussis is caused by bacteria attaching to the inside of the lungs. Clearly, such arguments against the Pertussis vaccine are nonsense. Unfortunately, however, many parents are drawn in by these anti-vaccine movements and are convinced to forego vaccination, with drastic results. Anti-vaccine movements throughout the world have convinced many to steer clear of the Pertussis vaccine. While some members of these movements may honestly believe that they are doing the right thing by achieving this, the results of their movements show otherwise. These Mitchell 8 movements cost at the least the security that comes from knowing that your child is immunized against a disease. At most, they cost individuals, and especially children, their lives. In a comparison between countries which had strong success in vaccination and countries where vaccination was hindered by anti-vaccine movements, those countries where vaccination was strong were found to be ten to one hundred times lower in prevalence of Pertussis (Gangarosa, 356). Another study published in The New England Journal of Medicine stated that without vaccination, there is a predicted seventy-one fold increase in the number of cases of Pertussis, with a four-fold increase in number of deaths (Koplan, 906). These statistics show the intense effect anti-vaccine movements can have on human life. Unfortunately, the United States has been fighting over the vaccine controversy since the 1980s, and will continue to do so unless parents make the effort to educate themselves and fight back against these movements (Cherry, 933). It is clear that anti-vaccine movements, while not credible, continue to have a negative effect on society. Parents need to see through these bogus claims and educate themselves with the real facts. Only then can parents realize the effectiveness and necessity of vaccinations, and only then will Pertussis cease to be the serious and dangerous problem it is today. In conclusion, when the facts are available, one can clearly see the dangers associated with the Pertussis disease. However, most often parents are not subjected to the truth of the matter, and so are blinded to threat posed to their children. Had Linda, little John-Lawrence’s mother, had the facts and potential dangers made known to her, one infant life could have been saved. For John, and for all of the infants and young children who have passed away like him because of Pertussis, awareness must be raised. Parents must be made aware of the dangers of Pertussis to their children. They must be taught to recognize the signs and symptoms of Pertussis, and to realize the importance of vaccinations. Unless they are made thusly aware, Mitchell 9 there will undoubtedly occur many more cases such as that of John-Lawrence. More families will be torn apart, more little lives will be lost. The only way to prevent it is to make people aware of the Pertussis vaccine. Parents worldwide must be made to understand that this vaccine is effective. It does, indeed, save lives. Mitchell 10 Works Cited Aoyama, T. "Efficacy of Acellular Pertussis Vaccine in Young Infants." The Journal of Infectious Diseases 167.2 (1993): 483-486. Print. "CDC - Pertussis: Signs and Symptoms." Centers for Disease Control and Prevention. N.p., n.d. Web. 2 June 2013. <http://www.cdc.gov/pertussis/about/signs-symptoms.html>. Cherry, James D., Philip A. Brunell, Gerald S. Golden, and David T. Karzon. "Report of the Task Force on Pertussis and Pertussis Immunization-1988." Pediatrics 81.6 (1988): 933984. Print. "Comments for Whooping cough| BabyCenter." BabyCenter | Homepage - Pregnancy, Baby, Toddler, Kids. N.p., n.d. Web. 10 June 2013. <http://www.babycenter.com/viewComments.htm?pageSize=15&startIndex=30&ccCont entType=ARTICLE&ccContentId=10911&ccOwnerId=>. Edwards, Katheryn M.. "Acellular Pertussis Vaccines: A Solution to the Pertussis Problem?." The Journal of Infectious Diseases 168.1 (1993): 15-20. Print. Gangarosa, E, A Galazka, C Wolfe, L Phillips, R Gangarosa, E Miller, and R Chen. "Impact Of Anti-vaccine Movements On Pertussis Control: The Untold Story." The Lancet 351.9099 (1998): 356-361. Print. Hagland, Mark. "Financial Incentives - How Does Your Doctor Get Paid? | Dr. Solomon's Dilemma | FRONTLINE | PBS." PBS: Public Broadcasting Service. N.p., n.d. Web. 29 May 2013. <http://www.pbs.org/wgbh/pages/frontline/shows/doctor/care/capitation.html>. Keitel, Wendy A.. "Cellular And Acellular Pertussis Vaccines In Adults." Clinical Infectious Diseases 28.s2 (1999): S118-S123. Print. Koplan, JP , SC Schoenbaum, MC Weinstein, and DW Fraser. "Pertussis vaccine--an analysis of Mitchell 11 benefits, risks, and costs." New England Journal of Medicine 301.17 (1979): 906-911. Print. Schmitt, MD, Heinz-J.. "Efficacy of Acellular Pertussis Vaccine in Early Childhood After Household Exposure." The Journal of the American Medical Association 275.1 (1996): 37-41. Print. Thomas, M. G.. "Epidemiology Of Pertussis." Clinical Infectious Diseases 11.2 (1989): 255-262. Print. Wirsing Von Konig, Dr CH, S Halperin, M Riffelmann, and N Guiso. "Pertussis of adults and infants." The Lancet Infectious Diseases 2.12 (2002): 744-750. ScienceDirect. Web. 29 Mar. 2012.