ScienceSkepticism

Beyond Anti-Vax: The Pertussis Problem (A Dragon*Con tale)

If you had asked me a month ago why I should get a pertussis booster, I would not have known. I am a mostly healthy 30-something, I work out, I get annual physicals and I have no fear of going to the doctor. At no point did I ever hear that I should get a pertussis booster shot or why it was important.

This is the story of the effort we made at Dragon*Con to help contain the pertussis epidemic. But I don’t want to bury the lead Scott Sigler gets pokedwith my narrative so I’ll cut to the most important point: If you have not gotten a pertussis booster in the past five years, you almost certainly need to get one. There is no excuse. Get your pertussis shot. Go, now. It’s important.

And I promise, the needle will be much smaller than this.

If you want to know the details as to why, and what we are trying to do to solve the problem, read more after the fold:

You should first know that pertussis is nasty. If you get it as an adult, it’s not typically life-threatening but it ain’t no fun either.

I know, right? Ew.

It’s sometimes called “whooping cough” or the “100-day cough” because it makes you cough so hard and for so long that you make a whooping sound trying to breathe. It can cause you to cough so hard that you turn blue from lack of oxygen or burst blood vessels in your face and eyes. So, for purely selfish reasons, it makes sense to protect yourself.

But it gets worse. The real danger of pertussis is to babies. Infants are not completely protected against pertussis until they have had at least three doses of the vaccine. The schedule for pertussis vaccination is typically at 2, 4 and 6 months so until 6 months, babies are still susceptible to pertussis and the primary way they can be exposed is from adults who may not even realize they have pertussis.

Another thing that’s strange about Pertussis: it comes and goes in waves. Unlike other diseases, it’s always exhibited spikes and valleys in infection rates. When the vaccination for pertussis was developed, it made a significant difference in the overall number of cases, but even with the vaccine, spikes of infection continued, just at a lower overall rate.

In 2010, there have been pertussis outbreaks in several states. California was hit the worst, with 4,017 cases reported as of September 17 and 9 deaths, all infants younger than 6 months. The highest infection rate is among infants but there are also many cases among adolescents and young adults.

It’s easy, as skeptics, to rail against the anti-vaxxers as a reason for this increase in preventable illness. There may be some relation between the movement to not vaccinate and the pertussis outbreak but it isn’t the biggest problem. In California, pertussis rates are about the same in counties with high childhood vaccination rates and low ones. And the latest C.D.C. Vaccination survey reports that immunization rates for children remain high. The bigger problem is that the number of adults who are immunized against pertussis via the booster shot is very low; nationwide, it’s about 6%. Most adults don’t even realize they need the booster shot.

About three weeks before Dragon*Con, in a regular conference chat with the Skepchicks, someone threw out the idea to host a pertussis clinic at Dragon*Con. I thought this was a crazy, impossible idea, but then I remembered that when I was in Las Vegas this year for TAM, I had met Dr. William Atkinson. Bill is a Medical Epidemiologist in the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention in Atlanta, Georgia. He has worked for CDC for 23 years, with most of this time spent in immunization-related activities. His current principle responsibility is the development of technical and training materials for immunization providers; he teaches doctors and nurses how and when to give vaccines.

I contacted Bill without a whole lot of optimism. We had so little time.  But what happened next was a series of coordination the likes of which we have never seen at Skepchick HQ.

Bill jumped at the idea. He recognized that Dragon*Con gave them the opportunity to access their target demographic: males, aged 20-39. He had all the right contacts and put us in touch with the local State health board, who said they could provide us with nurses and vaccines during Dragon*Con, all free of charge. We were too late to get on the Dragon*Con premises so we rented out a space in an adjacent mall. We put out a call on Skepchick to help fund the rental, plus signage and advertising, and met our goal in less than two days.

We then had a huge empty clothing store in a mall that we needed to turn into a clinic and to get people’s attention. Skepchick art crew, Jill and Amy, immediately got to work making clever, cool, sci-fi- and fantasy-based posters that we used to promote. Local Atlanta Skeptics stepped up to volunteer and help the nurses at the clinic itself. Elyse and the Women Thinking Free Foundation went into overdrive, getting tattoos, stickers, posters and banners made. Somehow, miraculously, it all came together and we had an incredible turnout.

We vaccinated 203 people at Dragon*Con.  The breakout:

  • 118 (58%) male, 85 female
  • 85 (41%) GA residents, 117 out-of-state, 1 international (UK) – was that you, Tracy? :)

Age distribution:

  • 11-19 years: 4
  • 20-39 years: 135 (66%)
  • 40-59: 61
  • 60-64: 3

We hit our primary target (males 20-39) pretty much on the nose. We also handed out hundreds of flyers, postcards and brochures, educated people with the posters and hopefully had a ripple effect of educating a large proportion of people about how important this vaccination is.

Also? We had a blast. And hopefully now I’ve educated you on how important this vaccine is. So, if you haven’t already, please go get vaccinated today!

A few follow ups:

Bill came to speak to the Atlanta Skeptics in the Pub last weekend and here’s a recording of his talk and the Q&A after. Also check out the video that Ashley (Healthy Addict) did covering the clinic:

As well as the Dr. Rachie Reports segment that she did for the Skeptic Zone podcast

And you can check out all the photos I collected of the clinic on my Flickr stream.

Masala Skeptic

Maria Walters (a.k.a. Masala Skeptic) has spent a lot of time in ‘furrin parts,’ including Hong Kong, Trinidad, and Pittsburgh. Although her passport is from India, she’s spent most of her adult life in the United States. She currently lives in Atlanta and has an unhealthy affection for science fiction, Neil Gaiman and all things Muppet.

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28 Comments

  1. One thing left out, especially in the NYT piece by Tara Parker-Pope, is that the islands of vaccine refusal serve as a reservoir for pertussis. While overall vax rates may be high among children, these islands of refusal help reduce herd immunity.

    But you’re absolutely right about boosting. Adults under 65 who haven’t had a tetanus booster in the last ten years are eligible for the TDaP vaccine.

  2. I wish Skepchick had a ‘print’ feature that would let us make print copies of articles without the side bars and ads. I’d like our employees to read this, but we have it filtered internet at work, and would like to post it in the break room.

  3. Maria, you must be psychic. I was just about to email asking if anyone had done a round-up like this because I’m drafting the initial email to my local health department to suggest a clinic and wanted to include all this material. I think it will help convince them we can do this. Thanks!

  4. I am irked. I’ve been trying to get my pertussis booster for some time, but I’m allergic to the Tetanus vaccine and it does not appear that vaccine manufacturers make just the pertussis as a single shot.

    So I’m SOL, and so are people who come into contact with me. As much as I love to coo over other people’s babies, I’m staying far, far away now. It blows.

  5. Bill mentioned that issue at his talk, Janiece. Apparently giving separate tetanus and pertussis boosters would entail an expensive overhaul of manufacturers’ production lines (I believe he either implied or said it would take “building a new factory”).

    HJ

  6. The husband and I are getting our TDaPs tomorrow. This is pretty troublesome, because I’d consider myself to be fairly well educated (in the layperson sense) when it comes to vaccines and public health, but I still had no idea until recently that adults need a pertussis booster. I’m happy to rail against the antivaxxers as much as anyone, but I’m pretty sure just plain old ignorance of the need for a booster is also a big part of the problem.

  7. I was also completely unaware that adults needed the pertussis booster and I work in health care (luckily not with children, although I imagine whooping cough carries some increased risk for the elderly as well, especially those with respiratory conditions).

    I got my tetanus booster last year (because I knew about that one) and was apparently given the tetanus/diphtheria shot without any discussion about the options.

    When the skepchicks made me aware that I was lacking the pertussis one, I asked my doctor about it and she told me there was nothing we could do until I’m due for the tetanus/diphtheria one again in ten years.

    I’ll stay away from your babies. : (

    I’ll also keep spreading the word to adults who haven’t been “boosted” yet. There’s still hope for some of you!

  8. @Elyse:

    Mine was definitely a Td and I had a big rashy, lumpy reaction to it. At the time, my doctor suggested I get the shot every 12 years instead of every 10, unless I step on a rusty nail or something. She definitely didn’t want to give it to me again. Maybe it’s because of my reaction to it?

  9. Why is it that a pertussis booster isn’t available on its own? Surely there must be a lot of such problems described here with the tetanus shot. (I myself had a moderate-class reaction, with a fever and inability to move the arm at all for two days, but it wasn’t an allergy just an annoyance.) I understand the theory behind the TD or TDaP, but with these outbreaks you’d think they’d want as easy a way as possible to get people their boosters, even if it has to be without the other vaccines.

  10. Thank you so much for doing this! I did advertise at the class I teach (Calculus III, so nerd central given my campus), and hope some of them took you up on the offer. I was one of the proud 85 women who got vaccinated.

  11. I got my tetanus booster five years ago, just before the Tdap came out. This weekend I hope to add it to my annual influenza vaccine.

    I will also be dragging the children who live at home to get their flu shot. Though I will have to bug son who moved out to get his. I now know his class schedule, I think I will threaten to meet him after a class and drag him to the campus health clinic!

    Only for the flu shot. All of them got the Tdap a couple of years ago.

    Son who moved out was dragged to the get the flu shot before school started last year… and he watched his dorm mates get sick and miss classes while he stayed healthy.

    I loved the photos of the Blink angel! Not an orc, but just as awesome! Thanks for the pictures.

  12. I completely agree – get vaccinated if you can!

    (However, this is not available in all countries. Also, many, perhaps most, infectious diseases show a similar pattern of cyclical epidemics. As one wave of infection goes through, it leaves the population largely immune, there’s “herd immunity”, so there’s less disease for a few years. As the number of people (as a proportion of the population) who are susceptible to the disease increases – as immunity wears off (as it does for pertussis after the disease or after vaccination), and susceptible babies are born – herd immunity is lost and there’s another wave of disease…

    You may be interested in my blog posting at http://peterenglish.blogspot.com/2010/08/whooping-cough-how-real-is-california.html

  13. I work at a college and we have an annual flu shot clinic each year for the students and employees. Thanks to you Skepchicks I asked a few questions at work and now we are also going to offer Tdap boosters as well!

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