It takes a village: Pertussis

There's something I really don't mention enough here: vaccination.

I'd like to share a story with you, the story of a beautiful little girl named Kaliah and her young and loving parents.

Kaliah's mother Chelsea had a little cough when she gave birth, but it didn't alarm anyone in the hospital.  It should have.  A few days later, Kaliah sneezed and her mother rushed her to a clinic and demanded they be tested for pertussis, against the protests of a health worker who was sure it was nothing.  It wasn't.  Kaliah was hospitalized and lost.  Clearly, someone should have investigated the cough Chelsea had when she gave birth.  And the health worker never should have given her trouble when she insisted on being tested.  But now nothing can be done.  At least not for them.  

This isn't uncommon.  Pertussis is insidious, and frequently has very few symptoms until the first coughing fit, at which point it may already prove fatal for an infant.  Because of this insidious onset, the presenting illness is frequently underestimated, delaying treatment, and killing infants.

But everywhere new babies are being born and none of them can be vaccinated against this disease which kills newborns at a shocking rate.  40% of those hospitalized for pertussis are under 6 months of age (63% of infants <6 months require hospitalization), and up to 1% of them will die (Vincent Iannelli, MD).  

What can we do?  There is only one thing.  Tdap/DTaP vaccination for everyone old enough.  Pertussis is an illness caused by the bacteria Bordetella pertussis which can result in pneumonia, malnourishment, encephalopathy, and seizures.  DTaP is a vaccination for children that prevents Tetanus, Diphtheria, and Pertussis.  The Tdap is a booster vaccination for adolescents and adults.  Plenty of people know to get their TD booster every time they have a big cut (or every ten years), but many people don't know they also need a pertussis booster every 10 years, and the only way to get it is in the Tdap.  The "a" in these vaccines refers to "acellular," which means this vaccine contains an inactivated pertussis toxin to stimulate immune response rather than whole cell, which was in a prior version of the vaccine.  The acellular version carries a reduced risk of side effects and the vaccine is 80-85% effective at preventing infection in individuals.  In Newfoundland, no one who has received the Tdap vaccination has EVER gotten pertussis (Dennis A. Brooks, MD; Richard Clover, MD).

But, that DTaP vaccine can't be given until 8 weeks (2 months) of age.  And, for families with reduced access to healthcare, some infants may not receive the vaccine for some time.  The best and only way to prevent the spread of pertussis is to vaccinate everyone who is old enough and has access to the vaccine.  More pointedly, the best way to make sure another beautiful infant like Kaliah doesn't wheeze and starve to death is for you, yes you, to go to your doctor and ask to receive the Tdap adult pertussis vaccine every ten years and make sure your children are also up to date.  Kaliah got this infection from her mother.  But her mother got it from someone else--maybe someone she walked past at the grocery store.  It could easily have been anyone.  Make sure next time it isn't you.  

It should be noted that, because the Tdap/DTaP is a combination vaccine, there may be an increased number of people who cannot get it compared to single ingredient vaccines.  That is simply because the number of people who may be sensitive to any one of three (pathogen) ingredients will invariably be higher than the number of people who may be sensitive to a single agent.  If you have no history of a reaction to this vaccine or its ingredients in other vaccines, there is no reason to suspect this will be a problem for you.  But if you don't get it, it will be a problem for my family.  My mother has a sensitivity to the Diphtheria toxoid which is in this vaccine.  She is thus unable to receive the vaccine and is a potential disease vector.  So, this is very real to me.  My family depends on your family.  My beautiful nephew is now 6 months old, vaccinated, and more or less out of danger.  But any other children in my family will be at risk because Grandma cannot be protected.  Please help me keep my family, and babies everywhere, safe and alive.  

Please talk to your doctor about Tdap/DTaP today.