Straight Out Of Dickens, Ctd

A reader writes:

While there is no question that that vaccination denial has negative consequences on public health, there seems to be evidence that, in the case of whooping cough, the current trend isn’t driven primarily by the Jenny McCarthys of the world (though vaccination denial certainly makes the situation worse than it otherwise would be). It appears as if the primary culprit is a change in the vaccine designed to decrease harmful side effects. See here and here for reporting on this issue by Tara Haelle.

From the latter link:

I understand what [Julia Ioffe is] trying to do: she wants to use her experience with a vaccine-preventable disease to convey the irresponsibility of not vaccinating. And with almost any other vaccine-preventable disease covered by immunizations on the CDC recommended schedule, she would have a pretty good case. But not with pertussis. …

In 1997, a new vaccine called the DTaP (diphtheria, tetanus, acellular pertussis) replaced the previous DTP (diphtheria, tetanus, whole-cell pertussis). The DTP was highly reactive, causing a higher percentage of children to experience high fevers resulting in seizures. Although “febrile seizures,” as they’re known, don’t cause long-term neurological or developmental damage, they are frightening, and it’s understandable that parents and clinicians would seek a vaccine that didn’t cause them as frequently. The DTaP delivered that more attractive safety profile, with a vaccine made from pieces of the pertussis bacterium rather than the whole cell. The problem – though it wasn’t identified until pretty recently – is that the DTaP just isn’t as good as the DTP in preventing pertussis over the long haul, as I’ve written about in detail in Scientific American. In fact, rather than lasting about 10 years or longer, as the DTP did, the DTaP’s immunity may wane in as little as three to six years.

Previous input from readers here.