Monday, September 3, 2007

Vaccines—DTaP

The DTaP vaccine is recommended for missionaries entering the MTC. “Full vaccination” for school consists of 4 or 5 doses, administered into the muscle, a minimum of 4 weeks apart for the initial series (3 doses), with subsequent boosters at least 2 years apart. (The CDC states that giving boosters too often will increase negative reactions, and frankly the potential reactions for this vaccine are scary enough already!) Most vaccination schedules recommend giving this vaccine at 2m, 4m, 6m, 15-18m, and giving a booster at 4-6y. However, so long as the final dose (the booster) is given after age 4, only 4 doses are needed. Efficacy for the combined vaccination is 80-85%.
The DTaP is NOT approved for use in children over 7y. However, both the tetanus and diphtheria vaccines require boosters to maintain efficacy, so the Td or Tdap are approved for children over age 10. Boosters should be given every 10 years throughout life. Be aware that there is no approved vaccine for diphtheria or tetanus for children between the ages of 7-10 years, and that there is NO pertussis vaccine approved for children over age 7. (A pertussis vaccine for older children was recently approved in Canada though, and may be in the USA soon.)

The DTP has been generally agreed to be one of the more dangerous routine vaccines on the market. More than half of reported vaccine reactions have been to the DTP, with fever and prolonged inconsolable crying topping the list. Many people also attribute *SIDS to this vaccine. The new version—the DTaP (with acellular pertussis, rather than the whole-cell pertussis of the original)—has fewer side effects, but inevitably still carries risks. The vaccine contains aluminum (toxic), formaldehyde (eww!) and thimerosal (mercury—toxic). To my knowledge, there is NOT a thimerosal-feee version of this vaccination like there are of all the others. However, unlike some other vaccinated diseases (such as chicken pox), these diseases have risks of their own, and can be extremely severe.

The highest risk group for diphtheria is children between the ages of 2-5years. Diphtheria is transmitted via touch or respiratory droplets, so is highly contagious. It is considered treatable, but the current treatments cannot mend the damage caused by the disease—they can only stop additional progression. Diphtheria can be difficult to diagnose in the early stages because it often looks like a simple cold; in the later stages however, heart damage is common, and often a tracheotomy is needed to allow breathing. [Does this scare anyone else? You can’t catch it early, can’t fix the problems it causes, and may end up with a busted heart or a hole in your neck just to survive the thing.] There is a 5-10% death rate in diagnosed cases. There is no telling what the actual infection rate is. Getting diphtheria will NOT provide immunity against getting it again. The vaccine is considered about 95% effective.

Tetanus bacteria cannot live in oxygen (they are anaerobic), so they thrive in deep wounds. One fairly effective way to protect yourself against tetanus is to be sure to thoroughly wash any deep wound—flowing blood will oxygenate the area, and substantially reduce the risk of developing tetanus. This is not always possible however, because potentially infectious wounds include burns, dental infections, crushing wounds, puncture wounds, and ear infections. If acquired, the tetanus bacteria produces a poison which blocks the nerve signals that relax the muscles. The result is strong and painful muscle spasms which can even break bones. In the United States, 30% of tetanus victims die, usually from suffocation when their chest muscles become rigid. Getting tetanus will NOT provide immunity against getting it again. The vaccine, although it requires boosters every decade, is considered over 95% effective.

Pertussis, also called Whooping Cough, is not a pretty disease either. Its name results from the fact that heavy mucous in the airways inhibits breathing, often causing the victim to ‘whoop’ as they cough. The disease usually lasts 2-4 months. Children under the age of 1 year have the greatest risk, with 75% of cases occurring in children under 10. A case of Pertussis often will include nosebleeds, bruised ribs, pneumonia, bronchitis, ear infection, and hemorrhaging in the eyes. The virus is transmitted by respiratory droplets, so even brief exposure to an infected person can lead to infection. Natural infection will provide the patient with immunity.
The CDC says that the pertussis vaccine is 70-90% effective (meaning that is the percent of people who develop antibodies and immunity), and it has reduced infection rates by 98%.

It seems to have been the whole-cell pertussis portion of the DTP vaccine that caused most of the negative side effects. These effects included convulsions, shock, high fever, swelling of the brain, brain damage, cardiac distress, and respiratory distress. In 1996, the switch was made to using the DTaP, which has acellular pertussis, and the number of negative reactions has dropped drastically. The pertussis toxin remains the most dangerous portion of this vaccine, but vitamin A improves the body’s response to it.

An interesting study showed that infants die at 8x the normal rate within the first 3 days after receiving this vaccination. *SIDS is more common within the first 3 weeks after any DTP (the original or a booster). Both apnea (stopped breathing) and hypopnea (shallow breathing) are documented reactions to the DTaP vaccine, and some doctors feel that is the reason for the increased death rate.

*SIDS, or Sudden Infant Death Syndrome, is the label they use when they don’t really know why the child died. There are theories ranging from uneven growth of vital organs (with one causing another to stop functioning) to toxins in old mattresses to sleep apnea/stopped breathing. Personally, I think that the apnea/hypopnea theory makes a lot of sense.


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My Conclusions
These are three REALLY ugly diseases. The vaccine carries risks, but so do the diseases—and in my opinion, the diseases are worse than a wisely administered vaccination (meaning dosing up on vitamin C, vitamin A, etc). Diphtheria and Tetanus do not even bestow natural immunity, so there is no benefit whatsoever to acquiring the disease. These all have fairly high rates of severe side effects or death.
This is a vaccine I do believe in. As always, it should not be combined with other vaccines, and should be preceded and followed by immuno-boosting vitamins and herbs.

4 comments:

alisaterry said...

Incidentally, if a disease cannot provide immunity, neither can a vaccine. That's why there is no vaccine for the common cold and why the flu vaccine has to be given every year.

The whooping cough portion is especially useless and there are high frequencies of outbreaks even in highly vaccinated communities. The theory is that, like most diseases, the virus that causes whooping cough is simply mutating.

Carrie said...

According to the Vaccine Book, only the Tripedia (Sanofi Pasteur)brand of the DTaP vaccine still contains mercury, however it does have the least amount of aluminum (170 micrograms). In the U.S. we mostly use the Daptacel brand (Sanofi Pasteur) and Infanrix (GlaxoSmithKline). Daptacel tends to be the best choice because it is the middle road with the aluminum (330 micrograms) while Infanrix has 625, almost double Daptacel.

The only shots that still contain mercury are flu shots (Fluarix & Fluvirin), and the Tetanus only, DT, and dT.

~GINGER~ said...

I've been informed that women in their third trimester "should" get the DTaP. What are the risks to pregnant women and their babies?

Jenni said...

Here are the CDC recommendations about vaccinations during pregnancy http://www.cdc.gov/vaccines/pubs/preg-guide.htm

In the details section, it essentially says that this should be given to pregnant women in case they are behind on their tetanus boosters. In other words, hey, we have you in the office today, let's give you a shot while you're here in case you haven't kept current. They do not offer any particular reason for vaccinating during pregnancy beyond attempting to maintain boosters.
(Personally, I believe this is why they recommend all the shots for kids at such young ages too--because that's when they go in for well baby checks and because they do not trust us as parents to bring our kids in at extra/other times for shots.)

Personally, I would not get any vaccine while pregnant. ANY vaccine. Because it WILL to go the baby. That's how pregnancy works--everything mom has will go to the baby. I DO get my tetanus boosters every ten years. I keep track of when I've gotten them and I go in when one is due--when I am NOT pregnant.

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