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Re: Response to whooping cough comments - Radiation parallel



Thank you for appropriate expansion on use of pertussis vaccine, Mark
Notice that I specified a difference from Public Health practice only when fever, and especially if fever had been associated with previous pertussis immunization.

My peeve is officious Public Health insistence on significant risk or expense to the individual while (often erroneously) proclaiming benefit to the herd. This is often true with radiation protection. If  37 to 148 Bq/meter3 (1-4 pCi/L) level of radon in homes reduces risk of lung cancer, as seems increasingly likely, then ALARA is causing much cancer. I predict that health physicists will become moe involved with getting that beneficial dose of radon to more people, as well as reducing the dose when it exceeds that threshold.

Howard Long
 
 

Mark Hanlon wrote:

 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 HanlonChildren's Hospital at WestmeadAustralia
-----Original Message-----
From: hflong@postoffice.pacbell.net [mailto:hflong@postoffice.pacbell.net]
Sent: Friday, May 03, 2002 2:47 AM
To: RuthWeiner@AOL.COM
Cc: michael.g.stabin@vanderbilt.edu; liptonw@DTEENERGY.COM; radsafe@list.vanderbilt.edu
Subject: Re: free speech -Medical parallels to radiation dose
 
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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