I peeled back the lid on a can of worms last night that might come back to bite me in the ass, so instead of waiting for the shoe to drop, I'm going to throw it on the table for all to see. Despite the vague accusations from some who primarily post in other Kinja forums, I'm not anti-vax.
What planted that idea, which is never linked or explained beyond generalities, seventeen months ago, a Crosstalk member posted a photo of Jenny McCarthy, an incredibly short excerpt — some communities would call it a "stub" — and a link to New Republic post by Julia Ioffe titled, "I've Got Whooping Cough. Thanks a Lot, Jenny McCarthy."
In one thread, I replied that there have always been cases of whooping cough in the US, with the low being 1010 in 1976, then I included a chart illustrating that an upward trajectory began when the vaccine was reformulated in 1999 which became a spike when the first to receive the new formula would need a booster, a requirement that wasn't well known at the time.
What started my trouble though, was when I argued that Jenny McCarthy is being used as an easy scapegoat by lazy bloggers for righteous indignation clicks, which has the side effect of providing cover to the medical establishment for not spreading the word about boosters and to those who should have received a booster, but had not.
From " I've Got Whooping Cough. Thanks a Lot, Jenny McCarthy.", the story of a 31 year old woman who had been infected;
How responsible are these non-vaccinating parents for my pertussis? Very. A study recently published in the journal Pediatrics indicated that outbreaks of these antediluvian diseases clustered where parents filed non-medical exemptions—that is, where parents decided not to vaccinate their kids because of their personal beliefs. The study found that areas with high concentrations of conscientious objectors were 2.5 times more likely to have an outbreak of pertussis. (To clarify: I was vaccinated against pertussis as a child, but the vaccine wears off by adulthood, which, until recently, was rarely a problem because the disease wasn't running rampant because of people not vaccinating their kids.)
So thanks a lot, anti-vaccine parents. You took an ethical stand against big pharma and the autism your baby was not going to get anyway, and, by doing so, killed some babies and gave me, an otherwise healthy 31-year-old woman, the whooping cough in the year 2013.
In other words, the author had received their childhood vaccinations, but even the old formula wears off and it's been recommended that adults who did not receive a booster as an adolescent get one as an adult. This she had not known and has not been well-publicized.
If you search Gawker for the words mccarthy and vaccine, you get ten results. If you substitute vaccination into the search, you get another two, but either form combined with booster instead of mccarthy produces no results. The general interest bloggers have left their readers with no doubt that McCarthy was anti-vax and they've thoroughly debunked her theory, but a search of Gawker doesn't produce any results about the need for a booster shot.
Washington State has been particularly hard hit by whooping cough. Their rate of vaccination for kindergartners have been lower than most other states, but over the years several high schools have had to be temporarily closed. One study indicated that the immunizations we give kids wears off after three years, though it's now believed to protect most for five, while it's often a little longer until the teen booster. This would explain why 77% of teens diagnosed in 2012 were fully immunized. Lending credence to the theory that the reformulated vaccine may not be as effective, older teens who had received whole cell vaccinations as an infant with an acellular booster were getting sick at a lower rate than younger teens who had been given the reformulated vaccine every time.
Of course, this isn't all Jenny McCarthy's fault.
Maybe some people listened to her when she published her book in 2007, but no where nearly as many knew about her positions before lazy bloggers made her the beginning and end. Sure, if more young children were getting immunized the herd would be stronger, but whooping cough is also striking those who have had all their shots and a 31 year-old writer should hold herself and her healthcare provider accountable for her failure to get a booster instead of putting all the blame on the original co-host of MTV's Singled Out.
Because I said as much, though my kids and myself are fully immunized, that's why some have claimed in assorted Kinja community comments that I'm anti-vax.
From the CDC's Pertussis FAQ;
Q: Why are reported cases of pertussis increasing?
A: Since the early 1980s, there has been an overall trend of an increase in reported pertussis cases. Pertussis is naturally cyclic in nature, with peaks in disease every 3-5 years. But for the past 20-30 years, we've seen the peaks getting higher and overall case counts going up. There are several reasons that help explain why we're seeing more cases as of late. These include: increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity.
When it comes to waning immunity, it seems that the acellular pertussis vaccine (DTaP) we use now may not protect for as long as the whole cell vaccine (DTP) we used to use. Throughout the 1990s, the US switched from using DTP to using DTaP for infants and children. Whole cell vaccines are associated with higher rates of minor and temporary side effects such as fever and pain and swelling at the injection site. Rare but serious neurologic adverse reactions including chronic neurological problems rarely occurred among children who had recently received whole cell vaccines. While studies have had inconsistent results that the vaccine could cause chronic neurological problems, public concern in the US and other countries led to a concerted effort to develop a vaccine with improved safety. Due to these concerns, along with the availability of a safe and effective acellular vaccine, the US switched to acellular pertussis vaccines.
Q: I've heard about parents refusing to get their children vaccinated and travelers to the U.S. spreading disease; are they to blame for pertussis outbreaks?
A: Even though children who haven't received DTaP vaccines are at least 8 times more likely to get pertussis than children who received all 5 recommended doses of DTaP, they are not the driving force behind the large scale outbreaks or epidemics. However, their parents are putting them at greater risk of getting a serious pertussis infection and then possibly spreading it to other family or community members.
We often see people blaming pertussis outbreaks on people coming to the US from other countries. This is not the case. Pertussis was never eliminated from the US like measles or polio, so there's always the chance for it to get into a community. Plus, every country vaccinates against pertussis.
(Image of Singled Out, via Vogue)