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Whooping Cough Numbers are Up–Is the Vaccine to Blame?

January 27, 2014 by James Bogash

It seems like the spotlight has been on whooping cough the past few years, making it sound like the country is on the brink of an epidemic. The stones to throw, conveniently, are at those evil non-vaccinators.

First, we all need a little background.  Pertussis, aka whooping cough, gets it’s name from the inspiratory “whoop,” or that dreadful sound someone makes sucking the air back into his or her lungs after coughing all of it out.  It is caused by the bacteria Bordetella pertussis and is diagnosed based on these criteria:

  • A cough illness lasting at least 2 weeks without another diagnosis, and including one of the following–
    1. Paroxysms of coughing, OR
    2. Inspiratory “whoop,” OR
    3. Posttussive vomiting, OR
    4. In infants under one year of age, apnea (with or without cyanosis).
    5. Lab confirmation of Bordetella presence.

    Back in the 1940’s, when the first pertussis vaccine was created, about 100,000 cases per year were occuring (highest record number of cases was in 1934 at 260,000 cases and the lowest was in 1976 at 1,010 cases) .  The initial vaccines used where whole cell pertussis vaccines (Included in the DAP vaccines).  These vaccines contained actual portions of the bacteria, but were associated with injection site reactions, high fevers and hours of persistent screaming.  Beginning in 1991, the aceullar vaccination (included in the TDaP vaccine) was introduced here in the US and slowly replaced the whole cell vaccination.  This vaccination, while elliciting a smaller immune reaction, was associated with less side effects.

    Since then, a small problem has been building quietly in the background…

    The numbers are going back up.  In 2013, just over 24,000 cases were reported. And, since it seems like the easy answer, everyone is blaming the unvaccinated. At times like these, all fingers point to those evil parents who choose not to have their children vaccinated. Comment sections following articles on diseases for which we have vaccinations for (influenza, measles, whooping cough, chicken pox, etc…) refer to these parents as selfish and then suggest that these parents should just lock unvaccinated children in the celler so they don’t get other kids sick.

    Which always seemed strange to me. After all, if the vaccination is supposed to protect against a disease, why would a parent worry about the vaccinated child coming across an unvaccinated child? Seems like discrimination to me.

    In response to the resurgence of whooping cough, others are calling for more booster shots to strengthen immunity against pertussis. Great financial boon for the drug companies on this one.

    But I digress. Back to this particular article. Researchers used a primate model to see just what the acelluar pertussis vaccination was doing. Here’s what they found:

    1. Vaccination did indeed protect from getting a severe infection, although it did not shorten the course of the illness.
    2. Those vaccinated with the accellular vaccination readily transferred the infection to others.
    3. The immune response was different with the accellular vaccination over the infection itself or the whole cell pertussis vaccination

    To put it plainly, the switch to the acellular pertussis vaccination led to a reduced severity of infection, but did nothing to prevent the spread of whooping cough. On the contrary, less severity of illness may even have led to underdiagnosis and infected carriers roaming the streets spreading further infection.

    Not that I have any well thought out approach to how to dampen this rise in whooping cough cases (besides, of course, generally treating our immune system correctly in the first place), but I write this article to quelch the pro-vaccine people blaming the non-vaccinated as well as demonstrating that merely throwing more vaccinations at the problem is not the answer (although it WILL generate more revenue for the drug companies).

    Filed Under: Vaccination Tagged With: pertussis, vaccination, whooping cough

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