SFIC Blogs

February 19, 2010

The Wakefield MMR Controversy and the Importance of Coalitions

Andrew Resignato, SFIC Director

By now you have heard that the controversial paper linking the MMR vaccine
to autism has been retracted by the journal Lancet which published it a
decade ago.

http://www.nytimes.com/2010/02/03/health/research/03lancet.html

In the UK Wakefield's research has been deemed dishonest and unethical.
His new "monkey study" which has been touted by Jenny McCarthy and Jim
Carrey as a "gamechanger" has been withdrawn by the Journal
Neurotoxicology.

So how did his original study involving just 12 research subjects cause
such a controversy, lead to a fear and backlash against vaccination, and
cause large outbreaks of measles and mumps? The answer can be quite complex
but here are some major factors that drove the scare and continue to cause
people to question vaccines:

1. Autism diagnoses continue to rise and the reasons are generally
unknown.

2. Many people of varying political ideology no longer trust larger
institutions in society like "Big Business" (vaccine makers) or "Big
Governement" (vaccine regulators).

3. People's knowledge and ability to interpret scientific results are weak

4. The Internet has lead to the proliferation of more information to the
masses as never before. Not all of that information is accurate.

5. Some people believe celebrities over doctors

And this is why Coalitions are still so relevant. Coalitons can act as
health education organizations that do not represent soley government or
business but are indenpedent entities. Coalitons must help decipher
scientific information for the public and provide objective, science-based
information for the communities they serve. Coalitons like SFIC, can also
serve as sounding boards for the people who are responsible for making sure
communities are protected from disease by appropriately immunizing them.
This includes health care, school, child care, public health, and social
service personnel. These people must be armed with the most up-to-date,
accurate, and useful information - Coalitions can help do that.

Since vaccines were developed they have been questioned by society. This
questioning will not and should not end. But it is up to us to make sure
people are provided the best, most complete, and useful information when
making all health care decisions including vaccination. We have more work
to do!

June 1, 2009

Pertussis: A Forgotten But Deadly Disease

A new study released in the Journal Pediatrics has confirmed what many of us in public health already knew: children whose parents refuse to have them vaccinated are more likely to get and spread pertussis. Some people are likely to say so what. Is pertussis really that common or serious? The answer to both those questions is yes.
 

Recently, my organization was contacted by a woman named Mariah Bianchi. Mariah is a mother, a health care worker, and a San Francisco resident. In 2005, Mariah gave birth to her second child, Dylan. In her words, “He was a healthy, beautiful baby and the easiest delivery a mother could ask for.”
 

Up to a couple weeks before and during the delivery Mariah had a low-grade fever, runny nose, and severe cough. “Our pediatrician casually mentioned pertussis and despite being a nurse, I did not know much about it.,” she said. So on the day of discharge she asked her doctor and was told that pertussis, also known as whooping cough, wasn't seen anymore, that viral infections are going around this time of year and could cause the symptoms she had. “I went home hoping hand washing and breastfeeding would help protect Dylan from getting this ‘cold’,” said Mariah.
 

When she returned from the hospital her cough continued. Within the next few weeks, she sought second and third opinions about her condition which seemed to be worsening. She was eventually tested for pertussis. At the same time Mariah noticed that her baby would fall asleep during feeding.  The child’s doctor wanted to get an x-ray of Dylan’s lungs to make sure he didn’t have pneumonia.
 

Less than twenty-four hours later Dylan was unable to breathe on his own, his immune system was failing, and his heart and kidneys were shutting down. Pertussis was quickly taking over his body. The very next day, after failed efforts of resuscitation, Dylan died of complications from pertussis which he had caught from his mother.

Mariah said, “I will never forget holding him in those last moments helpless… powerless…lifeless.”
 

Mariah is now actively working with the Coalition and speaking out about her experience because, as she says, “I don’t want to see any family suffer the way mine has.”
 

Unfortunately, this tragic story has become a familiar one with over 40 deaths of children due to pertussis complications over the last decade in California alone. Across the U.S. there are similar stories including the latest one in Idaho in April.
 

In fact, pertussis is a lot more common than most people and even health care providers realize. Just type pertussis in an internet NEWS search and you will read about outbreaks and sometimes deaths occurring currently throughout the U.S. Pertussis is one of the only diseases that we routinely vaccinate for in which the incidence (new cases) has been on the rise over the last decade.
 

There may be two reasons for this increase. The first is that many people are skipping or delaying vaccination for their children. The second reason is that the immunity from the disease that many adolescents and adults received from their childhood vaccines has worn off (immunity lasts between 5 -10 years). These people serve as a large reservoir for the disease, which is frequently undiagnosed or misdiagnosed. In adults, pertussis is a seriously uncomfortable and long-lasting illness (up to 10 weeks of coughing). However, when adults spread it to young children the results can be debilitating and deadly, as Dylan’s example confirms. 
 
Children should be up to date on their immunizations to provide full protection and prevent the spread of this deadly and highly infectious disease. The risks from diseases like pertussis outweigh the risks from the vaccine. In addition, a vaccine called Tdap (Tetanus, diphtheria, acellular pertussis) is now available for people ages 10 to 64 which will boost their immunity and protection from pertussis. Unfortunately, this vaccine has gotten little fanfare or attention resulting in low uptake. Those who will come in contact with young children are especially urged to get a Tdap vaccination. Tdap is also recommended as a replacement for routine tetanus vaccinations. As more people receive a Tdap the reservoir of disease in adolescents and adults should decrease and ultimately prevent the spread to very young, vulnerable children.
 
With some more awareness and action we can reduce the prevalence of pertussis and prevent Mariah and Dylan’s story from repeating itself.