Like most parents who received the vaccine alert this spring, I thought my child would be ousted from school without the whooping cough (pertussis) vaccine or “Tdap” booster. The letter, like many others across California, did not explain that parents have a choice in this matter. California is one of 20 states that allow vaccine exemptions for personal beliefs as well as medical and religious beliefs. For this particular exemption, California requires a signed, blue exemption form available only at the school office. There is intense pressure from parents, schools, and the medical community to dutifully follow immunization recommendations without question. This is a tragically missed opportunity to help people make educated choices based on individual concerns, conditions, and risks.
There are many unanswered questions about pertussis and the vaccine that deserve attention before inoculation. The incidence of pertussis is cyclical, with summer or fall peaks occurring every 3-5 years in the United States. Vaccinations for pertussis have been widespread since the 1960s, with children getting repeat doses between two months and six years of age. Vaccination rates remain high in California, yet the number of pertussis cases last year rivals numbers from 1947. This begs the first question – why are the current vaccines not protecting us?
The pertussis problem escalated into an epidemic after infant deaths mounted last year. Nine of the ten deaths were infants less than 2 months of age. According to an LA Times investigative report, many of these infants were not diagnosed or treated with pertussis which contributed to their deaths. Even after diagnosis, a couple of the hospitals did not react fast enough. While it is easy to point the finger at adolescents who aren’t recently vaccinated, the hospitals appear to lack sufficient diagnostics and treatment to prevent mortalities. A survey of San Diego County adults found that 42% of healthcare workers were not covered by Tdap. Both adolescents and adults can be infected with pertussis without any symptoms.
Even if we vaccinated entire adult and adolescent populations to wage war on pertussis, there is growing evidence that our vaccine may not be effective. The pertussis vaccination is approved based on inferences between different age groups with short-term testing periods rather than direct experience over decades. A nonprofit company in San Diego that analyzed 2010 CDC data found that 53% of California children 8 to 10 years old who were diagnosed with pertussis were up to date with vaccinations. Research in the Netherlands points to new, different strains of the bacteria that appear to have adapted to vaccination through gene regulation. Another suspect is the Tdap itself, with a safer, lowered concentration of the toxoid introduced in 2005 for adults and adolescents. In the mid-1990s, the acellular vaccine DTaP had replaced the original potent DTP after it was associated with possibility of brain damage. It is not clear how these changes in the vaccine have affected the prevalence of disease or long-term health effects.
It is unfortunate that one of the major supporters of Assembly Bill 354 (2010) was GlaxoSmithKline, one of the Tdap manufacturers.(21) Was this commercial thrust necessary? Major studies that influence our immunizations are also driven by institutions and researchers who receive grants from vaccine manufacturers. These corporate ties are an obscured conflict of interest that creates an unsettling foundation for the future of public health.
Unlike food nutrition labels, we are not well-informed about vaccine ingredients. The Tdap vaccine contains chemically inactivated pertussis toxin, but other components differ between the two manufacturers. GlaxoSmithKline makes BOOSTRIX which includes formaldehyde and polysorbate 80. Sanofi Pasteur makes ADACEL which includes formaldehyde, aluminum phosphate, glutaraldehyde, and 2-phenoxyethanol. The toxin in the BOOSTRIX vaccine was grown in a medium containing bovine (cow) extract or casein. Parts of the syringes contain latex rubber. Scientists do not know how these components interact with our immune systems to affect our long-term health. Contrary to some media reports, we do not have any conclusive evidence that proves or disproves a link between vaccines, autism, and other autoimmune diseases.
We all know that vaccines have saved countless lives. They are the weapon of choice at this point in modern medicine. But we cannot assume that every vaccine is equally effective for prevention or equally safe for long term health. Before we take a shot in the dark, let us consider the pertussis epidemic as a call to action for new methods and solutions that promote our individual health, safety, and freedom.
-Shari Cheves
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