Mumsnet Talk

Just had a chat with a nurse friend and she says the numbers of newborns admitted to her hospital as very ill with Whooping Cough is rising, because people aren't vaccinating.

I fully understand that there are reasons why some people can't vaccinate, but I am just so fed up with trying to explain why vaccinating is a good idea to some of my friends who don't do it - or delay it - for spurious reasons like "she's so young, I can't bear to put poison in her just yet".

Or "it's a conspiracy by the pharma companies"

Or "the diseases aren't that bad, I remember having them when I was little and none of my friends died"

My anti-vac friends seem know all about the risks of vaccines and sod all about the risks of the diseases they're preventing! They also don't seem to have grasped how their actions may affect others.

It's very frustrating, and terribly sad when you hear stories like the ones my nurse friend told me today.

OK, rant over, just had to vent!

Vaccination rates (5-in-1) here

The uptake for the 5-in-1 (which includes pertussis/whooping cough) is actually quite high. The reason there is an epidemic is because immunity from the vaccine wanes much faster than originally thought so there are lots of older children and adults out there who may have been vaccinated but are no longer immune.

The vaccine is crap wrt efficacy, that's why people are a) getting WC and b) not vaccinating.

You also have the vast swathe of people of parenting age who weren't ever vaccinated against wc (less than 80% upto the early 90s). So at least 1in 5 (more in the older parent age range) aged between 23 and 38 missed the wc vaccination.

In the US and Aus (where there have been outbreaks) it seems the outbreaks have been caused by either waning vaccine immunity or the strain of whooping cough changing so the vaccine no longer protects as well as it used to (seems particularly true of aP - the vaccination given here now). Or maybe a mixture of both.

The Torygraph is blaming waning vaccine immunity

Adults and teens seem to be good sources for spreading the disease as a) they're less likely to whoop or be ill so it's harder to recognise b) a lot of people assume that as they have been vaccinated they can't get whooping cough and so again don't realise they have it.

All the more reason to hurry up and introduce a booster.

Effectiveness isn't too bad for the vaccine - about 85% iirc. Unfortunately immunity is waning faster than expected, not helped of course by people not vaccinating without good reason. It's probably a mixture of both factors.

If I had a newborn, I'd ensure that everyone in my household and in close and prolonged contact with the baby had a booster against wc.

Booster for 11/12 year olds I mean, don't think it's standard in the uk

There has been research into the idea that over time in populations where wc transmission rate is lowered (vaccinated populations) the severity of wc is increased. They've also looked at populations across the world and linked outbreaks to vaccine coverage and birth rate. These snippets, in addition to saintly and Elaine's posts, one can easily conclude that the reasons behind wc outbreaks are clearly not well understood.

There is no wc epidemic in the UK. And it is simplifying things boorishly to say the outbreaks we are observing are because the vaccines are imperfect.

For anyone interested in how the incidence of wc is affected by vaccination coverage, here is an abstract of some research where they compared countries with high coverage and others where coverage dropped after a scare (UK incl). I have no access to the full article, but I presume as most wc cases are young children (many unvaccinated) herd immunity is seen to have a striking effect on disease incidence.

My sister and I had whooping cough when v young, it was horrible.

DS is 3 and all his immunisations are up to date with the UK schedule. There is now a confirmed case of whooping cough at his nursery and we have had a letter telling us to have our children vacinated if they are not already. Does anyone know if DS needs further imms, and also if I could get whooping cough for a second time?

And it is simplifying things boorishly to say the outbreaks we are observing are because the vaccines are imperfect.

Well some disagree but whatever. I think most agree that whether it's down to evolution or waning immunity the aP is less effective than the wP which might be relevant if you are concerned about your individual child.

Therin - yes you can have whooping cough again, even after a natural infection. (Especially once whooping cough is out of general circulation when immunity tends to wane more rapidly).

For anyone particularly interested there's a lot on google but although this article isn't particularly about whooping cough, (although the current situation is commented on) - the research group this person belongs to always seems to produce very sensible work and is a good starting point.

Seventeen years ago my six week old son contracted whooping cough, it was a scary time particularly because the GP didn't recognise what it was. Ironically my four other children had been immunised and didn't contract whooping cough but assume ds most likely contracted it when I was taking them to and from school each day. It was never determined where ds picked it up from as he was the only case notified in that area in three months however it took me three visits to the GP and my insistence on a swab before ds was diagnosed so no doubt other cases weren't recognised at the time.

What you quoted me saying was in reference to the waning of vaccine-acquired immunity saintly, not evolution of disease resistance which would be a factor another factor causing wc outbreaks (which is why I referred to your post in my post) but not in the UK obviously.

I do find that bm seems so want to simpify things by highlighting waning vaccine immunity at the exclusion of all else. She could equally talk about coverage, but no, she would rather focus on one factor: the vaccination itself, and criticise that instead.

Therein: I would go to your GP and ask about checking immunity/getting some boosters. As saintly said you can get it twice, although your DS's source appears to be restricted to the nursery.

insanity, what a scary time for you. Sources of wc are frequently not found. You just reminded me. I've read in several sources that diagnosis of wc is much better nowadays, it's picked up better in adults in particular, which of course will have an effect on statistics.

There is a good website which plays recordings of whooping cough www.whoopingcough.net/welcome.htm I'm sure there's a non-whoop whooping cough file audio file on the site as well (it's more common for adults/teens not to whoop). Helpful if you're wanting to compare sounds.

To the exclusion of all else? it just happens that these outbreaks are being attributed to waning immunity from the vaccine.

Anyway, I thought this was interesting.

"The substantial majority of the cases are explained by this waning immunity," said Dr. William Schaffner, an infectious-disease specialist at Vanderbilt Univers"

"The proportion of cases involving children ages 7 to 10 -- most of them vaccinated -- rose from less than 10 percent before 2006 to nearly 40 percent this year, according to the CDC."

"The researchers found that the risk of getting whooping cough increases by about 42 percent a year after a child's last dose of vaccine."

"While some parents around the country have taken a stand against childhood vaccines, the outbreak is not being driven by unvaccinated children, according to the CDC. Most of the illnesses are in vaccinated youngsters, officials said."

The problem - in terms of this outbreak - really does seem to be particularly with the aP - whether it's waning immunity or change of strain. Interestingly they don't seem to be suggesting a return to the wP - because the aP is safer.

Well I thought it was interesting anyway

Me too saintly

That article mentioned that there is currently an inhalable pertussis vaccine in development. Another inhalable vaccine! They really do seem to be moving that way.

I don't see why you are surprised bm that research is continually developing vaccines that are safer and more effective.

Outbreaks of wc have always occurred in vaccinated populations bm. The severity is less and the interval between outbreaks is longer than in the pre-vaccination period. Wc vaccine immunity (wP and aP) had never been lifelong. The outbreaks in the States in your link are talking about the severist outbreak in 50 years (shows you how well the older imperfect vaccine was working). The only thing they mention changing is the vaccine in 1997. This new vaccine induced immunity for a shorter period. So, yes, the newer but less effective vaccine could explain this trend, and indeed they think this to be the case here.

Other factors in this or other populations could include diversity of virulence factors meaning the vaccine is less effective. I can think of other factors in the UK, such as immigrant populations bringing in wc. And although vaccination rates are high in children they are much lower in adults. What I'm saying isn't controversial - there are multiple factors at work. Did you not think my link was interesting too bm?

Oops, I also meant to say that although national vaccination rates are high for the 5:1, there are local and regional discrepancies where rates do drop below 90%. Just a thought.

Where have I said I'm surprised about continuing research? Iwas pointing out that yet another inhalable vaccine is in development. You have been on other threads about that.

I'm glad we're in agreement about the new vaccine. Yes, other factors may come into play but I putting the blame on 'people not vaccinating' as in the OP is a bit misguided.

I think we can safely say that people not vaccinating isn't helping the situation much

From above on the US outbreak:

"Most of the illnesses are in vaccinated youngsters"

Heaven forbid we should ever just admit that the ineffectiveness of the vaccine may be causing problems

At least we are all in agreement: boosters all round while we wait for an improved vaccine

Not sure how you got that from my last post BFG. I actually think it would make more sense to either vaccinate non-immune pregnant women and/or newborns in order to protect the most vulnerable rather than just continuing to vaccinate the masses with an ineffective vaccine.