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Discussion Starter · #1 ·
http://www.imperialvalleynews.com/i...s-and-death-in-pediatric-pertussis-cases.html

Came across this today and wanted to share.

"The study found that infants were significantly less likely to have severe illness or die from pertussis if their mother had received the Tdap (tetanus, diphtheria and pertussis) vaccine during pregnancy.

“Prior studies have demonstrated that prenatal Tdap vaccination reduces the risk of whooping cough among infants less than two months of age,” Dr. Smith said. “However, this is the first study that CDPH is aware of that has evaluated the impact of Tdap vaccine during pregnancy on the outcomes of infants who do become infected with pertussis. This study provides more evidence that getting the Tdap vaccine is the best way for pregnant mothers to protect their babies from pertussis and its complications.”

CDPH’s Immunization Branch conducted the study among 690 California infants younger than two months of age who had pertussis. The study showed that infants with whooping cough whose mothers received Tdap vaccine during pregnancy were less likely to be hospitalized or admitted to an intensive care unit. Researchers also found that infants whose mothers received Tdap vaccine during pregnancy had significantly shorter hospital stays when hospitalization was needed. In addition, there were no deaths among infants whose mothers were vaccinated with Tdap."

Pretty compelling research!
 
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Considering the Tdap failed these pregnant women who were told they needed the vaccine during pregnancy to protect their baby from getting pertussis, not impressed. So the vaccine didn't actually prevent the disease like it's supposed to so let's look at it from another angle and find a positive to what the vaccine actually did do so vaccines can still look good! Ok. Scary considering how many pertussis vaccine boosters are recommended, and it's STILL not 100 percent (lots of pertussis outbreaks among vaccinated). Is there a source for the actual study? I'd like to see how they were able to conclude milder cases were due solely to vaccination during pregnancy.

From the article in the OP:

Sacramento, California - California Department of Public Health (CDPH) Director and State Public Health Officer Dr. Karen Smith today announced the results of a CDPH study that shows additional benefits of prenatal pertussis vaccination. Vaccination of pregnant women against pertussis (whooping cough) has been found to prevent whooping cough in their infants, however no vaccine is 100 percent effective and some infants of vaccinated women develop pertussis.
From CDPH website:

Pregnant Women are recommended to receive Tdap (whooping cough booster) during their third trimester of each pregnancy, even if they got it before pregnancy. The protection that expectant moms receives from Tdap also passes to their baby in the womb. This helps protect babies during the most vulnerable period, until they are old enough to get their first whooping cough vaccination at 6--8 weeks of age

Infants can start the childhood whooping cough vaccine series, DTaP (PDF), as early as 6 weeks of age. Even one dose of DTaP may offer SOME protection against fatal whooping cough disease in infants. Young children need five doses of DTaP by kindergarten (ages 4-6)

Students in 7th grade in California need to have met the requirement for a Tdap (PDF) booster - see http://shotsforschool.org

Adults are also recommended to receive a Tdap booster, especially if they are in contact with infants or are health care workers, but most adults have not yet received Tdap
http://www.cdph.ca.gov/HealthInfo/discond/Pages/Pertussis.aspx

Pregnant women are to get the Tdap during third trimester EVEN if they had gotten one before pregnancy! Then infants get 5 doses. Then 7th graders get a booster, and then adults are recommended another booster!

Wow, what an effective vaccine! Holy crap that's a lot of vaccinating when talking specifically of one disease, whooping cough.
 

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Discussion Starter · #3 · (Edited)
Not very impressed considering the Tdap failed these pregnant women who were told they needed the vaccine during pregnancy to protect their baby from getting pertussis, and guess what? They got pertussis so now let's look at how great the vaccine protected from serious outcomes. Scary considering how many pertussis vaccine boosters are recommended, and it's STILL not 100 percent (lots of pertussis outbreaks among vaccinated). Is there a source for the actual study? I'd like to see how they were able to conclude milder cases were due solely to vaccination during pregnancy.

From the article in the OP:



From CDPH website:


http://www.cdph.ca.gov/HealthInfo/discond/Pages/Pertussis.aspx

Pregnant women are to get the Tdap during third trimester EVEN if they had gotten one before pregnancy! Then infants get 5 doses. Then 7th graders get a booster, and then adults are recommended another booster!

Wow, what an effective vaccine! Holy crap that's a lot of vaccinating when talking specifically of one disease, whooping cough.
Yes the vaccine is not 100% effective and has a lower end efficacy compared to other vaccines but evidence like this that show the vaccine causes less severe illness even in people it doesn't protect completely is a big part of why I and many others still think the vaccine is worth it. (I believe even @Turquesa is in agreement on this point, for example). I think I read that in this study, 2% of the unvaccinated babies died. None of the babies whose mother received the vaccine died and none required intubation vs 11% of the unvaccinated babies which did require intubation.

Here's an abstract to the study https://idsa.confex.com/idsa/2015/webprogram/Paper52424.html
 

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Yes the vaccine is not 100% effective and has a lower end efficacy compared to other vaccines but evidence like this that show the vaccine causes less severe illness even in people it doesn't protect completely is a big part of why I and many others still think the vaccine is worth it. (I believe even @Turquesa is in agreement on this point, for example). I think I read that in this study, 2% of the unvaccinated babies died. None of the babies whose mother received the vaccine died and none required intubation. 11% of the unvaccinated babies required intubation.

Here's an abstract to the study https://idsa.confex.com/idsa/2015/webprogram/Paper52424.html
Let's keep remembering all this less severe illness crap that is being pushed, those that are LESS severe also are spreading illness!!!!!!!!!!!!! ALL over and to those babies too!

Less severe seems to mean, less likely to be treated promptly!

Glad you feel it's such a plus to be less severe! It's still the VPD illness! Like it or not or spin it anyone you can - the fact is it IS the ILLNESS! Doesn't mean who you spread it to will be LESS severe! GO for it! :frown:
 

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Reviewing the link to the "poster" in the abstract, there were several limitations. Maternal TDap vaccination data was difficult to obtain, having to rely on self-reporting of maternal vaccination in some cases, and they were missing maternal vaccination data on 40 percent of the cohort infant cases and were therefore excluded. That's a large group to exclude. If applied,'that group would have changed the outcome.

Also, there were birth certificate limitations as well.
 

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A couple things to point out. The conclusions lead the reader to believe that getting tdap during pregnancy is what protects the newborn.

"Infants whose mothers received Tdap vaccine during pregnancy were significantly less likely to be hospitalized or admitted to an ICU with pertussis (Table 2). •Among hospitalized infants, those whose mothers received Tdap vaccine during pregnancy had significantly shorter hospitalization stays (Table 2). •No infants whose mothers received Tdap vaccine during pregnancy required intubation or died from pertussis".

This sample size is was 41 compared to almost 400 unknown vaccination status. Its not surprising that there were no deaths among 41 and 2 deaths among neary 400. Not convinced on that alone.

Are hospital staffs intubation procedures influenced by the knowledge of the mothers vaccination status?

Breastfeeding status and subsequent passage of antibodies is not addressed although it alone has a significant impact on the recovery of an infant with pertussis.
 

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Discussion Starter · #7 ·
This sample size is was 41 compared to almost 400 unknown vaccination status. Its not surprising that there were no deaths among 41 and 2 deaths among neary 400. Not convinced on that alone.
Where are you getting those numbers from? 2 deaths out of 400 would not equal a 2% death rate.
 

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Discussion Starter · #8 ·
And it isn't surprising at all. None of the infants whose mothers were vaccinated got sick enough to have even required intubation. If the vaccine made no difference, we would expect at least 4 or 5 of them to have needed it.
 

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And it isn't surprising at all. None of the infants whose mothers were vaccinated got sick enough to have even required intubation. If the vaccine made no difference, we would expect at least 4 or 5 of them to have needed it.
Well they excluded 40 percent of their infant cohort cases due to lack of vaccination data, so it's very possible more may have required intubation or had even died whose mother was vaccinated. We have no idea what those other 40 percent of infant pertussis cases looked like since they were discarded.
 

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I have made my additions to the results in bold to help them stand out.

Of 487 reported infants [reported how and by whom?],

261 (54%) had complete maternal Tdap vaccination histories. [What constitutes a "complete maternal Tdap vaccination history"? It sounds like either got Tdap or it was recorded as declined. Is that true?]

[226 (46%) were discounted, almost half]

Of these [261 in case my comments confuse the issue], 193 (74%) were hospitalized,

80 (42% of those 193 that were HOSPITALIZED) were admitted to an ICU,

21 (11% of those 193 HOSPITALIZED) required intubation

and 6 (2% of those STUDIED [the 261]) died. [Were they hospitalized or not? Did the parents seek medical care?]

The rest is analysis of the numbers, but the actual numbers are not here for review.

In order to better understand the rest, I looked up statistical terms here : http://www.stat.berkeley.edu/~stark/SticiGui/Text/gloss.htm

I believe that CI = Confidence Interval. Not sure what OR means.

Confidence Interval. A confidence interval for a PARAMETER is a random interval constructed from data in such a way that the probability that interval contains the true value of the parameter can be speci before the data are collected.


Infants whose mothers received Tdap vaccine during pregnancy were significantly less likely to be hospitalized (OR 3.4; 95% CI 1.6-7.2),
fewer were admitted to an ICU (OR 2.7; 95% CI 0.9-8.7) and
none required intubation or died.

Among hospitalized infants, those whose mothers received Tdap during pregnancy had shorter hospital stays (median 3.0 vs. 6.0 days, p value 0.04).

When controlling for age in weeks, race/ethnicity, and year of onset, maternal vaccination with Tdap during pregnancy remained protective against hospitalization (OR 3.3; 95% CI: 1.4-7.8). [Age in weeks, I understand. Year of onset?]

Questions that occur to me that cannot be answered given the data provided are :

What were the age ranges of those whose mothers were vaccinated vs those who were not?

At what point in the illness was care sought?

How many mothers were vaccinated?

What are the actual numbers of "protected" and "unprotected" that were hospitalized, etc?

Questions this study doesn't attempt to answer :

Were the doctors and hospitals treating those whose mothers were not vaccinated more aggressively, because they had the preconceived idea that they were more vulnerable?

What was the cause of death, the straw that broke the camel's back, as it were, for those infants who died and did they receive medical care?



My conclusion : Like most studies posted, so much manipulation of the numbers has been done behind the scenes, leading the reader to specific, and possibly preconceived, conclusions.
 

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I think the prognosis for pertussis in young infants, as well as how much intervention is needed, comes down to if the child is breastfed and how quickly a diagnosis is made and proper advice/care can be given. Antibiotics might help if given really early, and they certainly would prevent secondary infections.

It is very conceivable that many of those who did not get pertussis vaccine in pregnancy had obstacles to receiving routine prenatal care. Those kind of issues would carry over to early infancy, and it is quite conceivable delays in diagnosis were an issue.

According to the abstract, the studied only controlled for age of infant, race and year of onset...it did not look at speed of diagnosis, or history of medical care.

In any event, it is possible this study shows the truth (or not - more studies needed) or it is possible this is a case of correlation does not equal causation.
 

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If this was all we had to go on for the issue, then yes, it would be a bit weak.

It's not all we have to go on though. This is backing up other studies.

We already had studies that showed that infants born to mothers given the vaccine during pregnancy are born with antibodies for it. However, showing the presensce of antibodies alone is not enough, and they need to show an actual protective effect too.

They also have animal studies involving baboons, who react pretty close to the same as humans for pertussis. In animal studies, they are able to control for other factors. They found that infants of mother baboons vaccinated in pregnancy were heavily colonized by the bacteria, but did not develop any symptoms of disease. Same for infants born to unvaccinated mothers but vaccinated right after birth. Infant baboons whose mothers were not vaccinated and who were not vaccinated themselves, on the other hand, became very sick, as expected.

But just because it works for baboons who experience pertussis pretty much the same way humans do doesn't mean we can be certain it will be true for humans too.

So there are studies showing that they do have antibodies and that it works for baboons, and now you have this which shows that the antibodies we know is there and the effect we can see for baboons does seem to be holding true for real life human babies in the real world.

Is it conclusive proof? Not yet, and I'd support more studies. As a body of evidence though, taken all together, it's a pretty good reason to strongly reccomend the vaccine during pregnancy.
 

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Discussion Starter · #14 ·
If this was all we had to go on for the issue, then yes, it would be a bit weak.

It's not all we have to go on though. This is backing up other studies.

We already had studies that showed that infants born to mothers given the vaccine during pregnancy are born with antibodies for it. However, showing the presensce of antibodies alone is not enough, and they need to show an actual protective effect too.

They also have animal studies involving baboons, who react pretty close to the same as humans for pertussis. In animal studies, they are able to control for other factors. They found that infants of mother baboons vaccinated in pregnancy were heavily colonized by the bacteria, but did not develop any symptoms of disease. Same for infants born to unvaccinated mothers but vaccinated right after birth. Infant baboons whose mothers were not vaccinated and who were not vaccinated themselves, on the other hand, became very sick, as expected.

But just because it works for baboons who experience pertussis pretty much the same way humans do doesn't mean we can be certain it will be true for humans too.

So there are studies showing that they do have antibodies and that it works for baboons, and now you have this which shows that the antibodies we know is there and the effect we can see for baboons does seem to be holding true for real life human babies in the real world.

Is it conclusive proof? Not yet, and I'd support more studies. As a body of evidence though, taken all together, it's a pretty good reason to strongly reccomend the vaccine during pregnancy.
Agree completely. This is one small piece to an emerging pile of evidence.

For example, this study from last year out of the UK showed that up to 90% of infants are protected against pertussis by vaccination of their mother during pregnancy.

All of this taken together is really compelling evidence that the vaccine given during pregnancy is very effective at protecting infants against pertussis.
 

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Discussion Starter · #16 ·

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Glad to know you are now considered pregnant -
within six weeks after the end of their pregnancy.
- so scientific!

Such a gold standard to base a "study" upon!

Data on maternal deaths is collected from various sources, including direct notification by individual maternity units, coroners, pathologists, midwives or members of the public, or though media reports.
Would those "members of the public" & "media" be the same as we have here, those who "claim" they have flu yet never are tested? Would that be????? antidotal??? :lol or just mom's who are "fuzzy" when need be or usable when the PRO agenda can? Which is it?

Odd how they have all these numbers yet we know (via the CDC) we do not have numbers!

What constitutes as a "study" when the PRO agenda is pushing their propaganda! :laugh
 

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Pers and Tea....the pile of evidence is still quite small.

It is no skin off my back it turns out that pertussis vaccine in pregnancy helps prevent pertussis or serious cases of pertussis in infants.

Indeed, I hope it does. It seems kind of sucky to take a vaccine risk during pregnancy (and lets face it - no long term studies have been done on the safety of pertussis vaccines in pregnancy) for naught. I hope it doesn't make people complacent about protecting infants from coughs: anyone coughing should be suspected of having pertussis - and infants should be kept away from them.

It also doesn't mean that another route might not be preferable. Pertussis is a complex issue and short and long term planning is necessary. *I* think it is best to try and avoid pertussis in infants by minimizing exposure to the public and then letting older kids get pertussis (All 3 of my kids had pertussis last summer. It was not fun, but not scary, either). This should offer them long term protection against pertussis, and allow the girls to pass antibodies onto their infants, should they have children.

Of course, you could try to vaccinate your way out of pertussis, but that doesn't seem to be working well.

As long as mothers are fully informed of the paths they can take and are free to decide, then cool.
 

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The fully informed part sounds pretty unlikely IMO @kathymuggle. Informed consent isn't the strongest point on the vaccine pushing side.
 
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