The Pertussis Vaccination - Report Example

The Pertussis Vaccination Your Name Institution’s Name The Pertussis Vaccination Pertussis, or whooping cough, is a highly contagious respiratory illness spread via Bordetella pertussis bacteria. Vaccination is the best way of preventing pertussis. There are vaccines available for everyone. There are an estimated 195,000 pertussis-related deaths and about 16 million pertussis diagnoses globally every year (Centers for Disease Control and Prevention, 2013). Since the pertussis vaccination was invented in the 1940s, it has prevented millions of death and has significantly influenced the epidemiology of the disease in countries where there is widespread vaccination. In spite of its widespread adoption, there have been negative events associated with the vaccine’s administration. Since 1994, the number of pertussis cases has more than doubled in Australia, reaching a peak of 38,000 diagnoses in 2011 (Carroll, 2014). There is growing evidence that the vaccine’s widespread use is not potentially harmful in the short and long term. Although immunization is still the best and only way of protecting against extreme cases of pertussis, the vaccine’s adverse effects have started a larger discussion about its effectiveness. One of the reported negative events associated with the pertussis vaccine is brain damage. The risk of permanent brain damage is about 2–6 per million doses (Upfal, 2007). This means there is no clear connection between brain damage and the vaccine (Upfal, 2007). There is no substantiation of an underlying relationship between pertussis vaccination and permanent neurological illness. The benefits of administering the vaccine outweigh the risks of not being vaccinated. Published literature indicate a causal connection between the pertussis vaccine and brain damage suggest that brain damage results from the pertussis toxin, which causes brain inflammation after administration (Upfal, 2007; Menkes, Sarnat & Maria, 2006). Since the toxin can cross the blood-brain barrier under the right conditions, brain encephalitis, or inflammation with convulsions, causes permanent brain damage. All the pertussis vaccines for children, teenagers, and adults contain pertussis toxins with unsafe additives aluminum and mercury (Menkes, Sarnat, & Maria, 2006). Research data indicate that the toxins can affix themselves to neuron membrane receptors and, through ADP-ribosylation, change the adenylate cyclase structure. In most instances, the blood-brain wall deters the entrance of the pertussis toxins into the brain. However, a fever, a concomitant viral illness, or a reaction to endotoxins in the vaccine can allow the toxins to enter the brain’s nerve cells (Menkes et al., 2006). This interference has been evident in pertussis encephalopathy where elevated Colony Stimulating Factor (CSF) antibodies titers to pertussis toxin have been shown (Menkes et al., 2006). From the research and case reports that seek to discover any links between the pertussis vaccine and long-term brain damage, the Institute of Medicine provided three conclusions: The administration of the vaccination leads to severe neurological disease and resultant unending neural damage in children who would not have otherwise suffered either chronic or acute neurologic disease. Secondly, the vaccines lead to severe neurological sickness in children with underlying brain abnormalities, which would ultimately lead to persistent neurologic illness even when there is no acute vaccine-initiated neural disease. Thirdly, the vaccination causes severe chronic neurological illness in children with various brain anomalies (Menkes et al., 2006). From the mid-1970s to 2000, various studies suggested that there was a connection between the pertussis vaccine and brain damage. Nonetheless, it has been difficult to prove that the vaccine does not cause brain damage at low rates. Professional and public anxiety about the efficacy of the pertussis vaccine arose from the National Childhood Encephalopathy (NCE) study conducted in the United Kingdom between 1976 and 1979 (Miller, Madge, Diamond, Wadsworth & Ross, 1993). The study showed that the risk of developing encephalopathy from the pertussis vaccine was one in 140,000 dosages, while the possibility of severe brain damage was one in 330,000 dosages. Out of 1,182 two- to three-year-old children with severe neurological illnesses in the study, only 39 had received the pertussis vaccine within the last seven days. Six of the children suffered from infantile spasms that were not related to the vaccination. The data in this study show that the pertussis vaccine rarely causes brain damage or encephalopathy. The randomized control trial of Olin, Rasmussen, Gustafsson, Hallander, and Heijbel (1997) revealed a single instance of encephalitis occurred 190 days following the vaccine administration amongst 82,892 vaccinated children. Golden (1990) conducted a study on the relationship between the pertussis vaccine and brain injury and concluded that population studies, especially the NCE study, failed to offer proof that serious neurological damage was caused by pertussis vaccines. Additionally, Golden noted that there was no credible data that children with a family history of convulsions or an individual history of neurological diseases would worsen more quickly if they received the triple vaccination, even though precaution was normally recommended. Third, the author noted that, although the vaccine does not lead to epilepsy, 1 in 10,000 children will suffer a febrile convulsion. Fourth, there was no definite link between the vaccine and infant spasms or the vaccine and sudden infant death syndrome. Lastly, Golden noted that, in instances where the vaccine had been blamed for causing brain damage or neurological harm, there were no direct connection. These studies show that there is no established connection between pertussis vaccination and brain damage. Brain damage is a common complication of whooping cough, especially in young infants. The concerns about encephalopathy resulting from the pertussis vaccine led to lower levels of immunization in various countries from the 1970s to 1990s. Although some studies suggested a connection between the vaccination and brain damage within seven days of vaccination, it was considered to be a rare occurrence. It is not clear whether the cases of brain damage increased as a result of a pre-existing condition or the vaccine. Most studies have not been able to show a connection. In their study, Ray, et al. (2006) focused on pertussis immunizations given to 2,197,000 children from 1981 to 1995. The authors discovered that the risk of encephalopathy was not greater in vaccinated children compared to the unvaccinated control patients. Kuko-Sakai and Kimura (2004) revealed that “acellular Pertussis-containing vaccines” have fewer reactions than the “whole-cell Pertussis vaccine” (p.650). They noted that in Japan, “incidences of encephalopathy/encephalitis and status epileptics/frequent convulsions, febrile seizures/provocation of convulsions, and sudden deaths were significantly lower with acellular pertussis vaccination than with whole-cell pertussis vaccination.” (p. 650). According to the authors, the administration of the acellular pertussis vaccine has enabled pertussis to be well controlled in Japan. Moore, Le Saux, Scheifele & Halperin (2004) screened over 12,000 admissions from 1993 to 2002 for neurological disorders and examined whether pertussis vaccination caused encephalopathy or encephalitis in patients. The authors found no such evidence. They found that only seven cases resulted within one week after administration of the pertussis vaccine, but a more probable cause for the condition was found in every case. They did not find any attributable case of encephalopathy or encephalitis after administration of more than 6.5 million dosages of the vaccine. All the reviewed studies show that there is no established causal connection between the pertussis vaccine and brain damage. The benefits of the pertussis vaccine on the other hand are widely recognized across the globe, for instance, preventing serious diseases such as whooping cough, diphtheria, and tetanus, and saving lives. Pertussis is highly infectious and particularly serious for children under one year of age. Vaccination helps prevent pertussis and is recommended as part of routine children immunization. Pertussis complications include hypoxic encephalopathy (lack of oxygen supply to the brain), which can cause brain damage and possibly death. The benefits of administering the vaccine outweigh the risk. In the past, some countries stopped giving the pertussis vaccine. For instance, bad publicity about the vaccine led the Japanese to stop using it in 1975 (Offit & Bell, 2003). In 1972, three years before the vaccine was stopped, there were 400 instances of pertussis that resulted in ten deaths. In 1978, three years after the vaccine was stopped, there were 13,000 cases of pertussis that resulted in 113 deaths. The alarming effects of discontinuing the pertussis vaccine led Japan to resume giving it in 1981. The vaccine was also discontinued in England from the mid-1970s to early 1980s due to its association with brain damage. Many children died from severe pertussis as a direct result of stopping the vaccine (Offit & Bell, 2003). This shows that administration of the vaccine enhances the benefit-to-risk ratio. Pertussis vaccination saves millions of lives globally every year. Pertussis is life-threatening for infants and newborns and can be serious for people of all ages who are not vaccinated. Failing to vaccinate can cause serious complications such as seizures, brain damage, and possibly death. Pertussis vaccination has been associated with permanent brain damage. However, most studies have reported no link between the two, and, hence, the relative risks of the vaccine are minimal. Because the vaccine prevents serious illnesses and deaths, its benefits outweigh the risk of possible brain damage. References Carroll, L. (2014). Whooping cough vaccine loses its effectiveness. The Sydney Morning Herald. Retrieved from http://www.smh.com.au/national/health/whooping-cough-vaccine-loses-its-effectiveness-20140414-36np3.html Centers for Disease Control and Prevention. (2013). Pertussis (whooping cough). Retrieved from http://www.cdc.gov/pertussis/countries.html Golden, G. (1990). Pertussis vaccine and injury to the brain. Journal of Pediatrics., 16(6), 854– 861 Gustafsson, L., Hallander, H.O., Olin, P., Reizenstein, E., & Storsaeter J. (1997). A controlled trial of a two-component acellular, a five-component acellular, and a whole-cell pertussis vaccine. New England Journal of Medicine, 334(6), 349–355. Kuno-Sakai, H., & Kimura, M. (2004) Safety and efficacy of acellular pertussis vaccine in Japan, evaluated by 23 years of its use for routine immunization. Pediatrics International 46, 650–655 Menkes, J., Sarnat, H., & Maria, B. (2006). Child Neurology. Philadelphia, PA: Lippincott Williams & Wilkins. Miller, D., Madge, N., Diamond, J. Wadsworth, J. & Ross E.(1993) Pertussis immunisation and serious acute neurological illnesses in children. BMJ. 1993 Nov 6;307(6913):1171-6. Moore, D., Le Saux, N., Scheifele, D. & Halperin, S.(2004) Lack of evidence of encephalopathy related to pertussis vaccine: Active surveillance by IMPACT, Canada 1993–2002. Pediatrics Infectious Disease Journal, 23, 568–571 Offit, P., & Bell, L. (2003). Vaccines: What you should know. Hoboken, NJ: John Wiley & Sons. Olin, P., Rasmussen, F., Gustafsson, L., Hallander, H., & Heijbel, H. (1997). Randomised controlled trial of two-component, three-component, and five-component acellular pertussis vaccines compared with whole-cell pertussis vaccine. Ad Hoc Group for the Study of Pertussis Vaccines. Lancet, 350 (9091), 1569–1577. Ray, P., Hayward, J., Michelson, D., Lewis, E., Schwalbe, J., Black, S., Shinefield, H., Marcy, H., Huff, K., Ward, J., Mullooly, J., Chen, R., & Davis, R. (2006). Encephalopathy after whole- cell pertussis of measles vaccination. Lack of evidence for a causal association in a retrospective case-control study. Pediatric Infectious Disease Journal, 25, 768–773. Upfal, J. (2007). Australian drug guide (7th ed.). Melbourne, VIC: Black Inc. Read More