In case you haven’t noticed, our community is coughing its collective head off these days. Pertussis, also known as “whooping cough” (or “pooping cough” as a young patient recently called it), is the most poorly controlled bacterial vaccine-preventable disease in this country, and we are currently seeing widespread disease in our area.
It is not a matter to be taken lightly. Pertussis is highly contagious, and while it causes an awful and prolonged cough illness in the healthy population, it is well known to be a killer of the very young.
The incidence of pertussis varies widely from year to year, but the western states have experienced unusually high numbers of cases in the last several years. When public health experts examine what’s going on, there are two conclusions they are reaching. One conclusion is that the effectiveness of the current pertussis vaccine is waning more rapidly than expected. While the vaccine gives good protection to the 5-year-old who just received a booster dose, that protection has decreased significantly by age 10 years and beyond (nor does having the infection produce permanent immunity). Pertussis is thought to be spreading among the adolescent population, and then to everyone else.
The second conclusion is that with declining immunization rates, what is known as “Herd Immunity,” that is, the shared protection a community experiences from adequate immunization rates, is no longer reliably present. When vaccine rates are high, a single case doesn’t become an outbreak. If enough people fail to get the recommended vaccines, the disease spreads with a predictable risk to the health of everyone in the community.
If the best vaccine we have to prevent pertussis doesn’t produce truly long-lasting protection, then we depend on adequate immunization rates to prevent outbreaks. The ease with which pertussis has been spreading in Nevada County makes it clear that we have a problem.
The reasons people don’t get vaccines as recommended are multiple, but they all seem to boil down to two factors. Parents no longer fear the infectious diseases that vaccines prevent because they have never experienced them. And there is a wealth of truly bad misinformation regarding vaccine safety creating unfounded confusion and fear. Nonetheless, there is no controversy or ambivalence among public health experts about the safety and importance of vaccinations for disease prevention and community health.
You may have thought your decision not to vaccinate yourself or your child as recommended matters only to you, but it matters to all of us. Please reconsider. Your neighbors and their baby may thank you.
Drs. John Reeder, Michael Curtis, Joyce Czuprynski and Douglas Wagner and Kris Jessen-Mather, PNP, are with Sierra Care Physicians and Pediatrics.