Pertussis...It's not just WA state! 2012 numbers as of 2 days ago - Page 2 - Mothering Forums

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#31 of 51 Old 05-22-2012, 05:14 AM
 
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This is the kind of data I'm looking at when I say Dtap rates are low all over the country.  This is from 2009, so it's not completely up to date, but for example the national average for full dtap coverage is 83.9 percent.  

http://www.immunize.nc.gov/data/immunizationrates.htm

 

Especially for something like pertussis where there are additional challenges like waning immunity and a lower effectiveness rate that's not high enough for herd immunity to set in.

 

This talks about how the rate varies from county to county, even if the overall rate is high enough for herd immunity when it's significantly lower in too many communities it causes problems.

 

http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6004a1.htm

 

Basically if an outbreak can get a foothold in a community and gain enough momentum it can spread to other communities even if their vaccine rate is theoretically high enough, especially for a disease like pertussis.

 

I posted studies earlier that found a correlation between counties with lower vaccination rates and pertussis cases.  

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#32 of 51 Old 05-22-2012, 05:18 AM
 
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Here's some good data on vaccine coverage in minnesota.  Dtap has the lowest coverage of all the vaccines (another thing I pointed out earlier when the overall rate was used is that dtap tends to have a lower coverage rate because of a reputation for reactions holding over from the old whole cell vaccine).

 

http://www.health.state.mn.us/divs/idepc/immunize/stats/coverdata.html

 

Notice the disparity in various counties, just glancing down the table the dtap rate in a community might be as high as 95% or as low as 47%.  This is as of January 2011.

 

More worrying than the disparity in vaccine rates itself is that that disparity is largely NOT due to people like educated consumers on MDC who have made an informed choice for their child not to be vaccinated and are prepared adn equipped to deal with the possible consequences.  Lower vaccine rates are more correlated with poverty and variables like housing stress.  A child who hasn't had their full course of vaccines is more likely to have missed some due to poverty than an active choice their parents made.

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#33 of 51 Old 05-22-2012, 05:20 AM
 
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here's a study from 2009 talking about problems with vaccine coverage in colorado.  Note again they say that the biggest problem area is dtap.

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936967/

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#34 of 51 Old 05-22-2012, 05:46 AM
 
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The four states mentioned in the original article are Wisconsin, Washington, New York, Illinois, and Pennsylvania.  If you look at the latest Dtap data from the CDC these states all have sub 90 rates for vaccine coverage on Dtap for children, with the exception of wisconsin which is 95.  I could not find comparable data on coverage in teens and adults, but I imagine the numbers for those groups look worse, although it is pure speculation on my part.

 

A study I've posted here before that was published in Pediatrics found that children who were not vaccinated for pertussis were 23 times more likely to get sick from it.  It's not clear how much of a role vaccination plays in these outbreaks compared to the other factors that have been discussed, but getting yourself and your family fully vaccinated is still one of the most important ways to protect yourselves from pertussis.

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#35 of 51 Old 05-23-2012, 02:17 AM
 
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More worrying than the disparity in vaccine rates itself is that that disparity is largely NOT due to people like educated consumers on MDC who have made an informed choice for their child not to be vaccinated and are prepared adn equipped to deal with the possible consequences.  Lower vaccine rates are more correlated with poverty and variables like housing stress.  A child who hasn't had their full course of vaccines is more likely to have missed some due to poverty than an active choice their parents made.

 

That is really worrying. How do childhood vaccinations work in the US for the uninsured? I guess children in most (all?) states can get free medical care if their family can't afford it, or is that just naivety on my part? 

 

There are definite issues with the NHS, but I it is things like this which make me grateful for it. :) 

 

The WHO maintains an estimate of global vaccination coverage for a variety of countries and vaccinations here: http://www.who.int/immunization_monitoring/routine/immunization_coverage/en/index4.html

 

This is the table for the 3rd does of DTP country by country:

http://apps.who.int/immunization_monitoring/en/globalsummary/timeseries/tswucoveragedtp3.htm

 

They have the UK in 2010 at 96% and the US at 95%, and no evidence of a huge decline over the last 10 years. 


Mother of two living in UK. Daughter (2007) born in USA, son (2010) born here. I'm pro natural birth, midwife care, breastfeeding, co-sleeping, baby wearing and a keen advocate of cloth diapering. I'm a full time working research scientist (physical sciences) and I'm pro-vaccine.

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#36 of 51 Old 05-23-2012, 03:27 AM
 
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That is really worrying. How do childhood vaccinations work in the US for the uninsured? I guess children in most (all?) states can get free medical care if their family can't afford it, or is that just naivety on my part? 

 

 

Federally funded Vaccines For Children program (CDC) provides no cost vaccines for under/un-insured/medicaid and eligible children can receive everything ACIP recommends.

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#37 of 51 Old 05-23-2012, 05:40 AM
 
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That is really worrying. How do childhood vaccinations work in the US for the uninsured? I guess children in most (all?) states can get free medical care if their family can't afford it, or is that just naivety on my part? 

 

 

Federally funded Vaccines For Children program (CDC) provides no cost vaccines for under/un-insured/medicaid and eligible children can receive everything ACIP recommends.

 

What are the eligibility parameters for this program?

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#38 of 51 Old 05-23-2012, 05:44 AM
 
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There are various programs to help people who can't afford health care, especially for children, but there are a lot of gaps in the system, too.  That's assuming the people that do qualify for the program even know about it.  Even for people who do have health care a co pay can be a major barrier to preventative care.

 

I'm sure lots of people will read that and think I'm overreacting or overstating the problem, but I'm really not.  The statistics on vaccine coverage by various measures of poverty are very telling. I think it's difficult if you've had a life of some privilege (and by privilege I don't just mean rich, I mean things like white, raised by both parents, graduated high school, etc) to understand the decisions that families make in these situations, especially when poverty is so often linked to a lack of adequate information and education about things like health care.

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#39 of 51 Old 05-23-2012, 05:51 AM
 
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Vaccine for Children and eligibility parameters can be found here:

http://www.cdc.gov/vaccines/programs/vfc/default.htm

 

I don't know about state and local programs... I am not living in the US at the moment. 

 

Looks like that happens too, this is what came up first for me in google:

 

JACKSON, Miss. - In recognition of National Infant Immunization Week (NIIW), the Mississippi State Department of Health (MSDH) is offering free routine immunizations for infants and children through 18 years of age at all county health departments next week (April 23-27).

http://msdh.ms.gov/msdhsite/_static/23,12239,341.html

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#40 of 51 Old 05-23-2012, 06:19 AM
 
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Some cities offer free vaccination clinics, no questions asked. I know in San Diego they had such a clinic and anyone who walked in, no matter their immigration status, could get vaccinations. They had a lot of people from Mexico drive over the border for vaccines, which was part of the point. A lot of VPD's are brought over from Tijuana, and the health professionals were hoping that this would help. Its too bad that all areas do not offer something similar, for those who want vaccines but can't get them do to their marginalized status or finances.

 

I thought adults did not get the TDaP, but the TDP? Has that changed? It has been 10 years since I had my booster, so I am not up on the newest adult vaccines. I am pregnant now, so I doubt I could get it anyway.
 

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#41 of 51 Old 05-23-2012, 06:24 AM
 
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There are various programs to help people who can't afford health care, especially for children, but there are a lot of gaps in the system, too.  That's assuming the people that do qualify for the program even know about it.  Even for people who do have health care a co pay can be a major barrier to preventative care.

 

I'm sure lots of people will read that and think I'm overreacting or overstating the problem, but I'm really not.  The statistics on vaccine coverage by various measures of poverty are very telling. I think it's difficult if you've had a life of some privilege (and by privilege I don't just mean rich, I mean things like white, raised by both parents, graduated high school, etc) to understand the decisions that families make in these situations, especially when poverty is so often linked to a lack of adequate information and education about things like health care.

 

Thats why I was asking the eligibility parameters (thx slmommy for posting the link), I really hope ObamaCare gets through the Supreme Court - people need to be able to access basic healthcare.

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#42 of 51 Old 05-23-2012, 06:24 AM
 
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they have T, Td, and Tdap for adults. You can get it while pregnant if you wanted.

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#43 of 51 Old 05-23-2012, 08:00 AM
 
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I'm still confused, I think because I am so used to looking at Pediatric vaccines and not the adult vaccines. With kids they have pretty much one option, like the TDaP. There's no tetanus only option for children. But for adults they have multiple options? Theoretically if I went to get a pertussis vaccination they would give me 2 to choose from?
 

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#44 of 51 Old 05-23-2012, 08:06 AM
 
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Because adults need different boosters depending on how long it's been. You need a t more often than you need a d or a p. kids are getting vaccinated for the first time so they need it all.
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#45 of 51 Old 05-23-2012, 11:21 AM
 
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I'm still confused, I think because I am so used to looking at Pediatric vaccines and not the adult vaccines. With kids they have pretty much one option, like the TDaP. There's no tetanus only option for children. But for adults they have multiple options? Theoretically if I went to get a pertussis vaccination they would give me 2 to choose from?
 

 

If I am remembering right the only T is for 7+ and contains thimerosal. 

 

There are adult and pediatric versions of Td, I believe both contain trace thimerosal and aluminum.

 

Pedi DTaP has just aluminum, plus trace thimerosal depending on the brand. 

 

Adult Tdap is newer, and is only approved for 10-11 yrs+ depending on brand. I think tetanus rec is once every 10 years? 

P portion does not have a very good efficacy... T and D have much better. 

 

The two brands of adult Tdap are Adacel and Boostrix. There are no other options for adult pertussis vaccines.

 

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142764.pdf

http://us.gsk.com/products/assets/us_boostrix.pdf

 

Decavac is the adult Td

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM246215.pdf

I think there is also a no brand name Mass Biologics product too.

 

http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm

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#46 of 51 Old 05-23-2012, 11:51 AM
 
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The efficacy for pertussis vaccine is between 59% and 85%.  Studies have shown unvaccinated persons are 9-23 times more likely to contract pertussis.

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#47 of 51 Old 05-23-2012, 12:01 PM
 
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So assuming you are on the of 15-41% you would theoretically need another booster for P for coverage more than you would for the more effective T, although that is rec. every 10 years. T may wear off or need 10 yr boosters, but P is likely to never work in the first place is what I am saying.

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#48 of 51 Old 05-23-2012, 01:50 PM
 
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I was just clarifying what "the p part doesn't have much efficacy" meant for anyone who wanted more specifics.
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#49 of 51 Old 05-23-2012, 02:35 PM
 
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I stated "P portion does not have very good efficacy," not *much efficacy*... although I suppose "very good" is relative... I do not consider 59-85% to be "very good" compared to some other vaccines that have 95%.

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#50 of 51 Old 05-23-2012, 02:38 PM
 
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Sorry, is as quoting from memory, I can't see the post when I reply from tapatalk. Either way, just wanted to out the number in front of people, not quibbling with your characterization.
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#51 of 51 Old 05-23-2012, 06:14 PM - Thread Starter
 
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And you actually can get Tdap while pregnant. The CDC just changed their recommendations in the last 1-2 years. Anytime after 20 weeks. But being as it is such a new policy change I wouldn't like to be a guinea pig while pregnant. If I was to do it (which I was before I got my titer run and found I still had natural immunity from my probable case pertussis 4 years ago) I would do it immediately postpartum.

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