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Pertussis (Whooping Cough) Disease & Vaccine Information

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Pertussis: The Disease

Pertussis, commonly referred to as whooping cough, is a highly contagious respiratory disease caused by the Bordetella (B.) pertussis bacterium. B. pertussis bacteria attach themselves to the mucus membranes of the respiratory tract and cause inflammation in the body.1 The major symptom of B. pertussis whooping cough disease is uncontrollable coughing.2

Symptoms of B. pertussis at its onset are similar to the common cold, or an allergy attack with stuffy or runny nose, dry cough, loss of appetite, fatigue and, sometimes, a low fever. After one to two weeks, the disease usually progresses to bursts of spasmodic coughing (paroxysms) with large amounts of mucous, gagging and vomiting with or without a whoop that becomes worse at night.3 During the day, the child or adult may look and feel fine with the exception of frequent coughing spasms. A final recovery stage with only occasional coughing fits may last for weeks or even months.4 Learn more about Pertussis…

Pertussis Vaccine

In the U.S. today, pertussis vaccine is administered only in a combination shot (DTaP, Tdap) that contains vaccines for diphtheria (D), tetanus (T), and pertussis (whooping cough) (P). The CDC’s Advisory Committee on Immunization Practices (ACIP) currently recommends administration of a pertussis containing vaccine (DTaP) at two, four, and six months old; between 15 and 18 months old; and between four and six years old. Another booster dose is recommended at 12-13 years of age (Tdap).5 While the ACIP also recommends that pregnant women receive a dose of Tdap vaccine during each pregnancy, between 27 and 36 weeks gestation, regardless of a previous history of Tdap vaccine,6 this recommendation contradicts the information provided by the vaccine manufacturers. The product insert of both Boostrix and Adacel, the two available Tdap vaccines in the U.S., state that the safety and effectiveness of vaccination has “not been established in pregnant women”.7 8

The whole cell pertussis vaccine was created in 1912 and licensed in 1914. In the 1940’s, the pertussis vaccine was combined with diphtheria and tetanus to become the DPT vaccine and licensed for routine use.9 This vaccine was replaced with a purified, less reactive acellular DTaP vaccine in 1996.10 (DPT was available in some doctor’s offices in the U.S. until about 1999). DPT is still given to infants and children in many developing countries because it costs only pennies to manufacture a dose.11 Learn more about Pertussis vaccine…

Pertussis Quick Facts

Pertussis

Pertussis, commonly referred to as whooping cough, is a respiratory disease caused by the Bordetella (B.) pertussis bacterium. B. pertussis bacteria attach themselves to the mucus membranes of the respiratory tract and cause inflammation in the body. 12 Only a lab test will positively confirm the exact organism causing the whooping cough symptoms. 13

Only a lab test will positively confirm the exact organism causing the whooping cough symptoms. Pertussis whooping cough is highly contagious. Whooping cough disease circulates all year long, however, in North America, more cases are diagnosed in the summer and fall. 14

In 1922, there were 107,473 pertussis cases reported in the U.S. with 5,099 deaths. 15 In the United States, deaths from pertussis infections dropped by more than 75% between 1922 and 1948, the year beforethe DPT vaccine was licensed. Mortality associated with pertussis declined dramatically in the 1940’s as living conditions improved. 16 Continue reading quick facts…

Pertussis Vaccine

There are currently 9 different pertussis vaccines licensed in United States. 17 DTaP/Tdap vaccines packaged in single dose vials contain reduced bioactive pertussis toxin, less endotoxin than the DTP vaccine, and may contain trace amounts of mercury, along with an aluminum adjuvant. Depending upon the vaccine manufacturer, vaccines containing pertussis may contain varying amounts of inactivated pertussis toxin, filamentous hemagglutinin (FDA), pertactin, fimbriae, formaldehyde, polysorbate 80 (Tween 80), gluteraldehyde, 2-phenoxoyethanol, aluminum and thimerosal (mercury). 18

DTaP/Tdap vaccines packaged in single dose vials contain reduced bioactive pertussis toxin, less endotoxin than the DTP vaccine, and may contain trace amounts of mercury, along with an aluminum adjuvant. Depending upon the vaccine manufacturer, vaccines containing pertussis may contain varying amounts of inactivated pertussis toxin, filamentous hemagglutinin (FDA), pertactin, fimbriae, formaldehyde, polysorbate 80 (Tween 80), gluteraldehyde, 2-phenoxoyethanol, aluminum and thimerosal (mercury). IMPORTANT: Parents should monitor their children carefully day and night for at least 72 hours after vaccination. 19 Pertussis vaccine has been documented to cause high fever; severe local reactions at the site of the injection; high pitched screaming and uncontrollable crying; collapse/shock (hypotonic/hyporesponsive episode); lethargy (excessive sleepiness); convulsions with or without fever; and brain inflammation (encephalopathy). 20

Pertussis vaccine has been documented to cause high fever; severe local reactions at the site of the injection; high pitched screaming and uncontrollable crying; collapse/shock (hypotonic/hyporesponsive episode); lethargy (excessive sleepiness); convulsions with or without fever; and brain inflammation (encephalopathy). As of August 1, 2019, there had been 5,503 claims filed in the federal Vaccine Injury Compensation Program (VICP) for injuries and deaths following pertussis-containing vaccination, including 855 deaths and 4,648 serious injuries. Continue reading quick facts...

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References

1 CDC. Pertussis - Bordetella pertussis Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

2 Medline Plus. Whooping Cough. July 30, 2018

3 CDC Pertussis – Signs and Symptoms. Aug. 7, 2017

4 Ibid

5 CDC Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Apr. 27, 2018 / 67(2);1–44

6 Ibid

7 FDA Boostrix Product Insert. Apr. 25, 2016

8 FDA Adacel Product Insert Sept. 29, 2017

9 Institute of Medicine. Pertussis and Rubella Vaccines: A Brief Chronology (Appendix B, pp. 320) In: Adverse Effects of Pertussis and Rubella Vaccines. The National Academies Press 1991.

10 CDC Pertussis Vaccination: Use of Acellular Pertussis Vaccines Among Infants and Young Children Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Mar. 28, 1997 46(RR-7);1-25

11 Patel MK, Patel TK, Tripathi CB. Diphtheria, pertussis (whooping cough) and tetanus vaccine induced recurrent seizures and acute encephalopathy in a pediatric patients: Possibly due to pertussis fraction. J Pharmacol Pharmacother 2012; 3(1): 71-73.

12 CDC Causes and Transmission. Aug 7, 2017

13 CDC Diagnostic Testing. Aug. 7, 2017

14 CDC. Pertussis - Epidemiology Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

15 CDC Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998. MMWR. Apr. 02, 1999 48(12);243-248

16 Chow MYK, Khandaker G, McIntyre P. Global Childhood Deaths From Pertussis: A Historical Review. Clin Infect Dis. 2016 Dec 1; 63(Suppl 4): S134–S141.

17 FDA Vaccines Licensed for Use in the United States. Mar. 29. 2018

18 CDC. Vaccine Excipients & Media Summary (Vaccine Ingredients).Appendix B.The Pink Book, 13th Edition, June 2018

19 Institute of Medicine Committee to Study New Research on Vaccines. DPT Vaccine and Chronic Nervous System Dysfunction: A New Analysis. Executive Summary (pp.1-2) Washington, D.C. The National Academies Press 1994.

20 NVIC. Do You Know How to Recognize a Vaccine Reaction? Aug 27, 2018