Originally Posted by junomama
When you say lowest efficacy rates, do you mean specifically for the pertussis (aP) portion of the vaccine? Or are the diptheria and tetanus portions equally ineffective?
Along those lines, it's been my understanding that the pertussis portion of the vaccine is what causes most of the reactivity. Is that correct? Would the DT vaccine be a less reactive option if one chooses to go that route? Or does the DT vaccine have its own set of problems (eg. thimerisol)?
Well...as far as the effectiveness of the T and D portions go...it's really an unknown. Tetanus is extremely really really rare...even though almost 50% of the population isn't technically immune. So that portion of the vax could be water for all we know, and no one would notice, coz it's just too rare to tell.
The diphtheria portion certainly isn't overtly failing all the time like the pertussis part is, but it's so underdiagnosed...who knows there, either? The CDC admits that diphtheria (yes, the toxogenic strain) is still circulating in the US, getting misdiagnosed as s.pneumo causing sinus infections and tonsillitis type stuff...and about half of us aren't immune to that one, either.
BUT...back in the day diphtheria used to cause really awful green and black membrane growths in people's throats, and we don't have ANY of that happening in the US at all. So either the bacteria has evolved to be less virulent, or the vax is a whole, whole lot more effective than anyone knows (as in, even antibodies to the toxins in quantities too low to show up as existing are still effective for preventing severe disease.)
It's really an unknown. Although you'd think if the answer was that the vax was just that good, we'd see the occasional unvaxed kid getting a nasty case of diphtheria every once in a while. But it never, ever happens. Ever. So who knows? It's a mystery.
But yeah, it's the pertussis portion that causes the bad reactions...and the only issue I know of with the dT is that it's nearly impossible to find without thimerosal. But honestly, I'd risk one shot with thimerosal over the pertussis toxoids. But...
Pertussis is the one disease that your baby might actually catch out of all three.
So it's a tough one. I do think there's a chance that if no one vaxed babies for pertussis, there might be 30 or 40 pertussis deaths a year instead of 10 or 20.
Or maybe not, too. Maybe those first couple of shots don't do anything to prevent pertussis. Nobody really knows. As weird as it sounds, it's never been studied.