Tag: Dissatisfied Parents Together

Does Getting the DTaP Vaccine Make You More Susceptible to Pertussis?

Wait, why would anyone think that getting vaccinated would make you more likely to get a vaccine-preventable disease?

Because there is a new pertussis outbreak in California and folks don’t understand how attack rates work…

Does Getting the DTaP Vaccine Make You More Susceptible to Pertussis?

We know that the latest pertussis vaccines aren’t the greatest, having issues with waning immunity.

They don’t actually make you more likely to get pertussis though, at least not relative to being unvaccinated.

“Because of linked-epitope suppression, all children who were primed by DTaP vaccines will be more susceptible to pertussis throughout their lifetimes, and there is no easy way to decrease this increased lifetime susceptibility.”

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

What the above quote that anti-vaccine folks are misusing is actually saying is that kids who got DTaP vaccines will be more susceptible to pertussis compared to those who got DTwP, the older version of the vaccine. That’s what the whole article is about!

It is not that they will be more suspecptible to pertussis vs someone who was unvaccinated.

Dr. I: Anti-vax folks are misinterpreting that statement, not understanding that it means relative to kids who got DTwP. They think that you are saying that it is the DTaP vaccine itself that makes it more likely that a child will get pertussis, in general. Even relative to someone who is unvaccinated. I know it shouldn’t be necessary, but can you provide a simple quote to clarify this?

JDC: You are of course correct. I was asked to write-up the talk that I have given many times in the US and in many other countries. In the talk, right at the beginning, I mention that today there is 20 fold less pertussis than there was in the pre-vaccine era and that illness in vaccine failures is much less severe that illness in unvaccinated children. I also remember how wrong they were 30 years ago R/E alleged reactions to DTwP.

And if you read his latest article, The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future, especially if you read more than the abstract, you discover that’s what he is saying.

But what about linked-epitope suppression?

In “linked-epitope suppression,” memory B cells out-compete naive B cells for access to the Bordetella epitopes because they are more numerous and their receptors exhibit a higher antigen affinity. Linked-epitope suppression applies as the immune response to novel epitopes is suppressed by the strong response to initial components if they are introduced together.

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

Basically, the DTwP vaccine included many more epitopes or targets for antibodies to bind to than the newer DTaP vaccine. That’s why it worked better. And you don’t get a good response to non-vaccine epitopes or antigens.

Still, you at least have some memory B cells and antibodies after getting the DTaP vaccine, which is why the idea that getting vaccinated makes you more susceptible to pertussis is silly. You are still protected, even if the protection isn’t perfect.

That’s why Dr. Cherry recommends that folks continue to get vaccinated and protected!

“We should be more vigilant than we have been in the past to recognize and treat pertussis in all age groups so that transmission to young infants is reduced. Most important (although not discussed in this review) is to ensure that all pregnant women receive the Tdap vaccine between 27 and 36 weeks’ gestation with each pregnancy. Also, we should consider routinely administering Tdap vaccine every 3 years to all adolescents and adults who were primed with a DTaP vaccine. This suggestion is contrary to that in the current Advisory Committee on Immunization Practices recommendations. However, from the data available, this approach could be expected to decrease the circulation of B pertussis in adolescents and adults. Also, Tdap should be administered to all adolescent and adults exposed to B pertussis during a school or other group outbreak.”

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

He does recommend that we work on new pertussis vaccines though.

“Future cohorts would benefit from the development and use of live vaccines and less-reactogenic DTwP vaccines.”

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

But why are we using a vaccine that doesn’t work as well as the previous vaccine we had?

“Despite the fact that in all but 2 of the efficacy trials the DTwP vaccines had greater efficacy than did the DTaP vaccines being studied, DTaP vaccines were licensed and used in many countries throughout the world; DTaP vaccines had replaced DTwP vaccines. The urgency to adopt DTaP vaccines was driven largely by antivaccine activist groups such as “Dissatisfied Parents Together.” During the rush to adopt DTaP vaccines and tetanus, diphtheria, acellular pertussis vaccines for adults (Tdap), much of the history relating to human pertussis was overlooked.”

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

But the DTwP vaccines weren’t safe, right?

“The results of a number of controlled studies between 1979 and 2004 indicated that no risk of severe neurologic disease after DTwP vaccinations existed. It was noted by myself and Shields (a pediatric neurologist) that what was being called pertussis vaccine encephalopathy was not an encephalitis-like event but, instead, the first seizure or seizures of infantile epilepsy.”

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

No, the cases of encephalopathy that were being reported were not caused by the DTwP vaccine. And neither did the DTwP vaccine cause SIDS, as was also reported at the time.

“Since 1997, the DTaP vaccination policy has created a cohort of people (the number of which is expanding yearly) who are more susceptible to repeated clinical illness with B pertussis infection than are DTwP-vaccinated children. There is no feasible way to make this cohort less susceptible.”

JD Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future

And now, after helping create the current DTaP vaccination policy, anti-vaccine folks want to scare folks away from using the vaccine. Don’t let them. Don’t skip or delay this vaccine and leave your kids susceptible to getting diphtheria, tetanus, and pertussis.

More on Does Getting the DTaP Vaccine Make You More Susceptible to Pertussis?

A Shot at the Dark – DPT vs DTaP

Everyone knows that the DPT vaccine caused a lot of vaccine injuries, right?

“I got interested in the topic of vaccines way back in medical school. A friend of mine convinced me to read a book about vaccines, and it ended up being a very anti-vaccine book. It was all about an old vaccine called the DTP vaccine that we don’t use anymore. But the book talked a lot about the risks and the dangers of that vaccine. The author of that book was calling for that vaccine to no longer be used.

A number of years later, it turns out that they did discover that vaccine was causing a lot of very severe, life-threatening, even fatal side effects, so they did end up taking that vaccine off the market.

So it kind of opened my eyes to the fact that there are some very severe, fortunately very rare, side effects to vaccines, and I wanted to learn more about this issue. I started reading a lot more books.”

Bob Sears, MD on The Vaccine War

After all, it was after reports of those vaccine injuries, including seizures and encephalitis, that led to:

  • lawsuits and many pharmaceutical companies to stop making vaccines
  • the DPT: Vaccine Roulette special airing on TV
  • Barbara Loe Fisher, believing that her child was damaged by the DPT vaccine, forming the Dissatisfied Parents Together organization (she later changed the name to the National Vaccine Information Center), and writing the book DPT: A Shot in the Dark (this is the anti-vaccine book that Bob Sears is talking about above)
  • the National Vaccine Injury Compensation Act passing in 1986, creating the National Vaccine Injury Compensation Program and the Vaccine Court
  • the DTaP vaccine replacing the DTP vaccine

But were those reports true?

And did they ever really discover that the DPT “vaccine was causing a lot of very severe, life-threatening, even fatal side effects,” which led to them “taking that vaccine off the market” as Dr. Bob said?

A Shot at the Dark

It is easy to think that they were true, as we don’t use the DTP vaccine anymore.

But was it ever “taken off the market?”

“During the period of transition from use of whole-cell DTP to DTaP, whole-cell DTP is an acceptable alternative to DTaP for any of the five doses. For the first four doses, whole-cell DTP combined with Hib vaccine (DTP-Hib vaccine) is an acceptable alternative to DTaP and Hib vaccine administered at separate sites.”

ACIP on Pertussis Vaccination: Use of Acellular Pertussis Vaccines Among Infants and Young Children Recommendations of the Advisory Committee on Immunization Practices

No, it was replaced by a newer vaccine – DTaP.

And actually, it is still used in some parts of the world.

The whole-cell DTP vaccine did cause more side effects than the newer DTaP vaccine, but we are talking about relatively mild side effects, like local reactions, pain, and fever. And while that it is good, it comes at a cost, a less effective vaccine.

What about epilepsy and encephalitis?

After all of the scare about the DPT vaccine, studies quickly showed that it didn't cause all of the bad side effects that folks say it did.
After all of the scare about the DPT vaccine, studies quickly showed that it didn’t cause all of the bad side effects that folks say it did.

One clue that the DTP vaccine didn’t cause many of the problems that were blamed on it, is that the same vaccine lawsuits that were succeeding in driving vaccine manufacturers out of business in the United States, were failing in the UK.

“Where given effects, such as serious neurological disease or permanent brain damage, occur with or without pertussis vaccination, it is only possible to assess whether the vaccine is a cause, or more precisely a risk factor, when the background incidence of the disease is taken into account. The question therefore is, does the effect occur more often after pertussis vaccination than could be expected by chance?”

Justice Jeremy Stuart-Smith

There is also the fact that many children who were originally thought to have been vaccine injured after their DPT vaccine are now known to have Dravet syndrome.

Without a diagnosis, Cossolotto said, she would probably still believe — erroneously — that the DPT shot caused Michaela’s illness. “I understand this is a genetic condition,” she said. “Having an answer does make a difference.”

Medical mystery: Seizures strike baby after routine vaccine

And then there are the reports and studies that found:

  • no association with brain injury, epilepsy, SIDS, or infantile spasms
  • no increased risk for serious neurological illness in the week after getting vaccinated with DPT
  • no increased risk for encephalopathy in the 90 days after receiving DTP and MMR vaccines
  • no difference in severe reactions after DPT vs DTaP, including encephalopathy, seizures, and allergic reactions

So no, the DPT vaccine was never really as dangerous as folks said or thought it was, despite what you might read or hear in anti-vaccine books or news reports.

What to Know About the Safety of the DPT Vaccine

Misconceptions about the risks and safety of the DPT vaccine created the modern anti-vaccine movement and unfortunately, continues to influence many people.

More on the Safety of the DPT Vaccine