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Response to whooping cough comments
Dear Howard, Ruth and
all,
The whooping cough
vaccine referred to by Dr Long (pertussis WC) is usually administered as part of
a tetanus-diphtheria-pertussis vaccination, and not often given to persons over
age 5 years. It has been associated with local reactions at the site of
vaccination, but the rate of local reactions is comparable to that when only the
diphtheria and tetanus components are given. Severe or systemic reactions
are much rarer, and indeed less frequent than the serious and sometimes fatal
complications which arise from whooping cough (pertussis) itself.
A newer acellular
pertussis vaccine, for which the rate of reactions is much lower, has been
available for several years, and has been shown to be safe and immunogenic in
both children and older persons.
Dr Long's reference to
herd immunity is important, because, by reducing the spread of whooping cough in
the community (through having a highly vaccinated population) the likelihood of
infecting those too young to be vaccinated, and in whom the disease is most
likely to be serious, is reduced.
Having said this, there
are persons for whom pertussis vaccination is not recommended, and state-of-the
art advice is available from, for example, the American Committee on
Immunization Practices (ACIP).
My apologies to any list
members who are irritated by this off-topic comment, but I do feel strongly
about the importance of immunisation.
Mark
Hanlon
Children's Hospital at
Westmead
Australia
Ruth and list,
First, I
believe whooping cough vaccine fear is often justified.
I am an epidemiologist and public health doctor who returned to being a
family doctor because I could not stomach treating society to the detriment of
the individual (and seeing society, too, worse off for the dictates). After long
experience, I advise my patients (contrary to the answer they wanted on my FP
Board exam last summer) to NOT have another pertussis (WC) shot if there
is fever or was after the first one. This is heresy for herd immune rates, but
saves individuals great grief and risk
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