Pertussis In My Town. Now what?
Sep 11, 2012

Two things happened last Friday that reminded me of why I started contributing to this blog.
First, I received a note from our school nurse, saying that my daughter was not compliant with the state immunization requirements and needed to provide documentation of her Tdap booster.  The second was a phone alert that I received from the school alerting parents to the fact that there are confirmed cases of whooping cough (also known as pertussis) in our area.
Although my daughter is compliant (the nurse had never received the immunization records we submitted when we registered), I appreciated the work that was being done to ensure overall immunization compliance, especially in regards to the Tdap vaccine which helps prevent against a dangerous pertussis infection.
Last year I learned a lot about pertussis as I followed the CA epidemic, which ultimately claimed the lives of 10 infants.  This year, I’ve covered the rising number of whooping cough cases, to include the current epidemic in WA, as well as many other states across the country. Fairly recently I read of a NC infant who died as a result of pertussis.  And in the past few years I’ve come to  know many parents who have lost their children to pertussis.
So, needless to say, when it comes to pertussis, I understand the concerns.  This is why I was so grateful to see the school nurse and our local Health Department trying so hard to get the message out to the parents.
But today, as I think about why I started contributing to this blog, I’m wondering…do the parents in my community realize how dangerous pertussis can be?  Do they even know what it is?  Do they know that immunity to a disease like pertussis wanes over time? That even if their children were fully immunized as infants that they need a Tdap booster around ages 10-11 to help extend their immunity? While preteens usually do not get as sick from pertussis as young children, coughing fits can still occur for 10 weeks or more and the prolonged illness can cause lengthy disruptions in school and even sometimes require hospitalization. Pertussis spreads easily through the air when an infected person breathes, coughs, or sneezes and a person can spread the disease while having cold-like symptoms and for about 2 weeks after coughing starts.
I’m also concerned that many of these parents and other adults in our community are not current on their immunizations either.  Do they know that adults need a Tdap booster too?  One of the biggest concerns with pertussis is that it often goes undiagnosed, resulting in infected adults and children unknowingly spreading the disease to others.  Do they understand that young children are at the greatest risk for serious consequences and even death as a result of a pertussis infection?  Do they realize that we can try to protect those too young to be vaccinated by ensuring that everyone around them is up to date with their adolescent and adult Tdap boosters?
But the reality is that vaccination does not guarantee immunity, because no vaccine is 100% effective.  This is what concerns me about a largely unvaccinated community.  Though a vaccinated individual is more likely to have a milder case than an unvaccinated individual, their risk of contracting pertussis in the first place depends on exposure.  And the fewer vaccinated people there are in a community the greater the chance that the disease has to spread, even to a few people who are in fact vaccinated.
Unfortunately, our school nurse was concerned about our school’s compliance rate.  While some of the children without documentation may be vaccinated, the fact is that there are lots of students without documentation.  Who knows how many are unvaccinated?  While some parents may have not vaccinated their child because they  have a religious or medical exemption, that documentation needs to be provided to the school.  However, I suspect that most of the parents are simply unaware that their child is in need of a Tdap booster.  It may be that they had planned to get the vaccine but forgot.  It may be that they haven’t been vaccinated because they didn’t have time to go to the doctor.  Or perhaps they didn’t feel pertussis was that dangerous of a disease and the vaccine was not that important.  It may be that they are not aware of the school’s requirements and the current concern about pertussis in the community.  Whatever the reasoning, now is the time for parents to start paying attention and taking action.
Parents can start by reviewing the information available from the Centers for Disease Control and Prevention (CDC) that outlines the dangers of whooping cough and the importance of vaccination.  They may also be interesting in hearing from students as well – students like those in this Shot By Shot video below who have suffered with pertussis.
[youtube=http://www.youtube.com/watch?v=UoNGYu3Ni2Y&feature=player_embedded#!]
 
As parents, I believe we must do all that we can to protect our children.  So I urge everyone (to include parents, grandparents and adolescents) to go and get their Tdap booster today.  It’s simple and you may even find that it can be administered right at your local pharmacy. And if your bringing your kids for their school immunization, why not get one yourself.   After all, you are your child’s greatest role model. 


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