I have been reading a lot about the pertussis outbreak that has been hitting California, where there are now over 8,000 cases of pertussis, and 10 infants who have died from whooping cough.  But pertussis is not only affecting those in California, the number of pertussis cases are on the rise across the country. The CDC reported that there were over 17,000 pertussis cases in 2009, and when the 2010 numbers are tallied the number will most likely be higher.

Pertussis is also probably under-reported so there are quite likely many more cases than the numbers show, and many cases of pertussis that may be missed as a diagnosis.

With that being said it is important to re-iterate the need for both infants, children, adolescents and adults to get their pertussis immunizations.

Whooping cough is an infectious disease and the best way to prevent disease is by vaccinating.  What we all forget is that infants are not immunized until 6 – 8 weeks of age, and that one immunization against pertussis does not provide immunity.

The reason that the DTaP vaccine is given at 2, 4 and 6 months of age is to confer adequate immunity after 3 doses, and that immune response is boosted again between 15- 18 months of age.

As young parents have their new baby immunized, they sometimes feel that their child is “protected” immediately, and that is not really the case.  It takes several doses of vaccine to confer adequate antibody and while a baby is building their own antibody the best way to protect them is by immunizing the older population. This is called passive immunity, which protects a newborn infant by preventing disease in those people who are around the new baby. Whether that is a grandparent, aunt, uncle, nephew, niece, or any of the numerous family members and friends that welcome a newborn, the pertussis (whooping cough vaccine) that is given to the general population protects the newborn baby.

The Tdap vaccine that is recommended for use in individuals from the age of 10–64 is the vaccine that is now in the news. So many adults “forget” that immunizations do not stop after you leave the pediatrician’s office.  Adults continue to need vaccines to protect themselves from diseases, including whooping cough.

It is amazing that many of my own friends cannot “remember” the last time they  had a shot, which likely means that they have not received the newer Tdap, which protects you from tetanus, diphtheria and pertussis. Doctors need to spread the word that adults also need immunizations, because that terrible persistent cough that you thought might never go away, could indeed, unknowingly be a case of pertussis, which might infect a newborn infant.

Just today the Advisory Committee on Immunization Practice (ACIP) recommended that the Tdap vaccine be given to even older individuals, who may come into contact with newborn infants. That means that seniors who are 65 or older are also encouraged to get vaccinated with a newer Tdap if they will be in close contact with infants under the age of 1 year.

While the country is seeing outbreaks we must become aggressive in keeping the pediatric population up to date on their vaccines, but in this case the vector may be the grandparent who long ago lost their immunity to whooping cough.

I can’t think of a better baby gift, so go get your Tdap and protect that precious newborn.

P.S.  A flu shot is important too, so get a “twofer” now.

That’s your daily dose for today.  We’ll chat again tomorrow.

Send your question or comment to Dr. Sue!