School starts in a few days, and campuses unfortunately are breeding grounds for disease. Groups of kids are brought together in classrooms, restrooms, locker rooms, cafeterias and playgrounds. It's inevitable that these kids will share not just lunch treats but illnesses, too--everything from the common cold to more serious infections.
Recent outbreaks of whooping cough have occurred, and the highly contagious respiratory infection is now an epidemic in California. The Contra Costa Health Services had confirmed 40 cases of the illness, also known as pertussis, in its county as of earlier this summer. In 2009, there were 18 cases. According to the California Department of Public Health, there were six times as many whooping cough cases in the Bay Area between January and May compared to the same time period last year.
Although whooping cough initially resembles an ordinary cold, it may eventually turn into something more more serious and potentially fatal, particularly in infants, according to the Centers for Disease Control and Prevention.
Despite outbreaks of whooping cough and other infections, some parents refuse to have their children immunized, says Walnut Creek-based pediatrician Rahul Parikh, who practices at Kaiser Medical Center. In this Q&A with Patch writer Ayako Mie, Parikh explains how vaccinations save lives and keep communities safe.
Patch: Last month, a sixth infant fell victim to whooping cough in California. Some say whooping cough has become epidemic in California, with nearly 1,500 cases reported as of July. What are the reasons behind this?
Parikh: Several reasons, probably. One is waning immunity on the part of adults who have had the vaccine, which is why we are encouraging boosters for adults as well as kids. The second is that there has been a natural trend in whooping cough outbreaks for every four or five years, though this one is much bigger than the last one in the middle of the last decade. There is a role of parents refusing vaccines for pertussis (whooping cough) as well, but this is hard to measure.
When immunization rates in a community drop below a critical threshold (usually around 90 percent), the chance of vaccine-preventable diseases goes up substantially. The reason for this is something doctors call "herd immunity" in which a large enough population gets immunized to protect those who are too young to be immunized. Herd immunity is the key to keeping communities healthy from these illnesses. When it goes down, we are taking the chance of getting sick.
The only thing we can do is to make sure as many of us are vaccinated as possible to prevent this from spreading now and in the future.
Patch: Who are the people not getting vaccinations?
Parikh: Studies have shown that vaccine refusal is predominantly in more affluent communities among people with higher socio-economic status. Older parents also tend to be vaccine refusers more often than younger parents.
Patch: What do you say to people's worries about vaccinating their kids?
Parikh: First, I completely understand how confusing and emotional the information about vaccines has gotten over the past 10 years. It's hard to be a modern parent and have the time and energy to sit down and figure out what to do. But doctors and health professionals are here to help, and the good news is that when parents form a trusting relationship with their doctor, they're more likely to immunize their child.
Parents want to do the right thing for their children, but it's very hard because of all the "debate" out there, particularly about the alleged connection between vaccines and autism. The good news is that we have a decade of evidence proving no link between the two.
Parents often also express concern about the vaccine schedule or components in the vaccines used to keep them safe and effective. The schedule was designed and reviewed by experts, and a recent study showed that children who follow the schedule versus those who do not have no difference in their rates of neurological problems.
As far as components go, the main ones people bring up are aluminum and thimerasol (a mercury-based compound). In California, vaccines given to kids under age 3 are free of thimerasol. It's worth noting that a study in 2008 showed that despite our having removed thimerasol from shots in 2001, autism rates have continued to rise in California, suggesting that it's not vaccines causing autism.
Vaccines contain small quantities of aluminum (and have for a long time) to help them work effectively. While anti-vaccine folks have argued that there is too much aluminum in vaccines, and this may be "the smoking gun," the amount of aluminum in breast milk and formula is much higher than in vaccines. The aluminum in vaccines is also eliminated by the body very quickly.
Patch: Are there any vaccines that are not absolutely necessary? Chicken pox?
Parikh: If I have to choose against any disease and a vaccine that's been proven to be safe and effective at preventing it, I would take the vaccine any day. I've done it for myself and my family.
Patch: Who should be vaccinated?
Parikh: With very few exceptions, everybody should be vaccinated. It's the right choice for the health of individuals, families and communities.
Patch: Newborns are too young to be vaccinated against many diseases such as whooping cough (the first pertusis vaccine is given at 2 months, as are vaccines for other diseases). How can parents keep their newborns from contracting whooping cough or other illness?
Parikh: My wife and I are expecting a baby soon, and we have told our parents to get vaccinated for whooping cough. So, first, make sure anybody who is coming into close contact with your baby be immunized. Second, encourage other families in your community to immunize not just against whooping cough, but against other deadly and serious diseases as well. As individuals and communities, we can choose health or we can take our chances. My family is choosing health. I would prefer the same for my community and those that surround it.
Rahul K. Parikh is a pediatrician at Kaiser Permanente Medical Center in Walnut Creek. He contributes to publications such as The New York Times and Salon.com.
For more information about whooping cough, visit the website for the Centers for Disease Control and Prevention.