Blood pressure: Check. Cholesterol levels: Check. Blood sugar: Check. Heart rate: Check. Vaccinations: Huh?
Growing evidence suggests your childhood vaccination may not be protecting you as long as originally thought, which means your doctor might quiz you about a booster shot at your next visit.
The Centers for Disease Control and Prevention is expecting this to be the worst year of whooping cough, also known as pertussis, in five decades. Doctors in the Top of Utah are already seeing an increase.
“I am definitely seeing more cases of whooping cough in my clinic,” said Dr. Douglas Jones, president of Rocky Mountain Allergy, Asthma & Immunology in Layton.
“Utah has a high population of individuals who are not immunized or current with their immunizations and who are at risk.”
One reason for the increase may stem from a waning immunity to the TDaP vaccine.
But that’s only one theory.
CDC officials also say recent changes in the vaccine itself may be to blame. The changes involved going from a formula made from killed whole cells to one using parts of cells to reduce side effects such as fevers and injection-site swelling.
The highly contagious bacterial infection causes uncontrollable, violent coughing and frequent complications including cracked ribs, pneumonia and even death.
The CDC has reported nine infant deaths so far in 2012.
“It is unclear why we see outbreaks like we do with pertussis,” said Dr. Christine Nefcy, a pediatrician at McKay-Dee Hospital in Ogden.
“What we do know is that vaccination is the best means to prevent contracting this disease. The speculation is not regarding the effectiveness of the vaccine but rather the time interval between boosters.
“There are some studies that suggest a shorter interval, like five years, may be more appropriate between boosters, as some people’s immunity may start to wane after the five-year mark.”
Nefcy said although the symptoms can become severe, pertussis often goes unrecognized in older children and adults, causing the infection to spread. Those who do not get a booster shot put the smallest members of society at great risk.
“Some of the sickest children I have ever taken care of were infants with pertussis. I took care of a 2-month-old during my residency that had to be put on a heart-lung bypass machine because she had pertussis,” she said.
“Infants can develop pneumonia, seizures and encephalopathy. One percent of young infants will die from contracting pertussis.”
Dr. Allen Freestone, a family physician at Lakeview Hospital in Bountiful, said more of his patients are asking about the vaccine.
So far this year, he said, he has seen four confirmed cases of whooping cough in his adult patients. In addition, since the recommendation came out in 2006, he has been asking his patients if they would like a booster.
Jones said the boosters are said to be 92 percent effective.
However, given the current epidemic, the current recommendations of a single booster between the ages of 19 and 65 should be questioned, he said.
Normally, a pertussis booster is recommended for kids around 11 or 12 with the expectation that immunity would last into young adulthood, but this year’s outbreak suggests otherwise.
So far, 18,000 cases of 13- and 14-year-olds with pertussis have been reported to the CDC, and most of those children had received a booster shot. However, only 8 percent of adults have ever gotten the booster.
More studies are being done to try to figure out the appropriate timing and frequency of additional booster shots. In the meantime, doctors are stressing that everyone should protect themselves and those around them by getting a booster.
The CDC recommends TDaP (tetanus, diptheria and pertussis) vaccination for:
• 2-month-olds; 4-month-olds; 6-month-olds; 15- to 18-month-olds; and 4- to 6-year-olds. All five doses are needed for maximum protection. Ages 7 to 10 who are not fully vaccinated with TDaP should receive the vaccine instead of waiting for their 11- to 12-year-old checkup.
• 11- or 12-year-olds.
• 13- to 18-year-olds who missed getting the vaccine.
• Ages 19 and older who have not received a TDaP vaccine. These people should get a one-time dose of TDaP in place of the TD booster it is recommended they receive.
• Adults who have talked to a health care provider about what’s best for their specific situation.
• Pregnant women who have not been previously vaccinated with TDaP. These women should get one dose during the late second trimester or third trimester or immediately postpartum. By getting TDaP during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines.
Source: CDC, Dr. Christine Nefcy