You Can't Protect Another Person From Pertussis

We’re told the way to prevent infant whooping cough deaths is to vaccinate everyone else. (This is an updated 2015 piece)

Every year, more than 600 children under the age of 13 die in car accidents; that’s a terrible fact. What would you say if your doctor, your child’s doctor, your state senators and everyone in the media told you that they had the solution to prevent these untimely deaths? What if they said it was completely within your power to save these children, and only a selfish science-denier would refuse to follow their advice to save 600 children’s lives each year?

Are you ready for this genius idea?

Buckle your own seat belt.

Wait. Don’t I mean buckle the child’s seat belt?  

Nope. Buckle your own seat belt to save 600 children’s lives from car accidents each year.

Makes zero sense, right? Buckling your own seat belt would have zero impact on the number of accidents or the children who die in accidents each year. At best, buckling your seat belt means that you, and only you, are less injured in an accident than you’d be without it.

Yet, we’re told that the answer to preventing the seven annual infant whooping cough deaths that happen in this country, on average, for the last seven years, is to vaccinate ourselves, vaccinate our baby’s older siblings, and vaccinate their grandparents for pertussis. 

This misguided advice is just as irrational as buckling your own seatbelt to save someone else from dying in a car accident.

How the Newer Pertussis Vaccines Work

Here’s why the expert advice to vaccinate yourself to protect others from whooping cough is unfounded:  the pertussis vaccines used in the United States do not contain pertussis bacteria. The DTaP vaccine, which is used in kids under age seven years, contains full doses of diphtheria toxoid, tetanus toxoid, and inactivated or detoxified pertussis toxoid vaccine, while the Tdap for older kids and adults has a full dose of tetanus toxoid, a ⅙ dose of diphtheria toxoid, and ½ to ⅛ of a dose of inactivated or detoxified pertussis toxoid vaccine, depending on the brand. These newer vaccine versions, which were phased in during the 1990s, while the whole-cell versions of these vaccines were phased out, don’t confer immunity to pertussis bacteria. 

Notice that instead of whole cell bacteria, the newer vaccines contain inactivated or detoxified pertussis toxoid. This toxoid is the inactivated version of the nasty exotoxin that bacteria secrete during an infection that causes the symptoms of disease in the human body. These newer “acellular” (meaning not containing whole cell) vaccines also contain pertactin, fimbria, and filamentous hemagglutinin – all of the gook that a pertussis infection produces – in a failed attempt to stop pertussis bacteria from sticking to themselves and posting up in your throat.  

This is a key point: pertussis bacteria and pertussis toxin are not the same thing. Think of it like the difference between grapes and wine. Does anyone get arrested for driving after eating grapes? Of course not. Just because one is made from the other doesn’t make them the same thing.

The toxin secreted by pertussis bacteria is called an AB toxin because its B units (B is for binding) bind to healthy cells while its A units enter through membranes and wreak havoc on the body. It’s the B unit component that, through vaccination, the body can learn to recognize and briefly build immunity to. The current DTaP and Tdap vaccines are for teaching a body to fight when it encounters the B units of the toxin secreted by bacteria once enough of them are at work in the human body.

Did you pick up what I’m putting down here? These vaccines teach the body to fight pertussis after the body is infected – and by then it’s too late to stop vaccinated people from being contagious to a newborn baby. 

That’s because there is no toxin to fight off – and no B unit to even recognize – until the pertussis infection takes hold anywhere from 4 to 21 days after exposure. In the very best case scenario, DTaP and Tdap may be symptom-reducing vaccines, but they aren’t designed to prevent an infection from happening. They are not transmission-reducing vaccines and they sure don’t contribute to even the most warped idea of herd immunity. Pertussis toxoid B unit antibodies are of no use until an infection happens.

In other words, pertussis vaccines don’t confer “sterilizing immunity” to prevent infection from bacteria. Rather, they are “infection permissive” vaccines that only prevent the appearance of severe disease in the vaccinated host. This, of course, was not intentional, but was an unfortunate discovery many years after bringing the vaccines to market.

By virtue of their design, the DTaP and Tdap vaccines only work after someone is already well infected with pertussis, and the current hope is that they keep people from getting as sick as they would without them. Sometimes it works, and sometimes public health admits the vaccines are nearly worthless, especially the Tdap. 

When exposed to a pertussis infection, a vaccinated person may develop a full-blown illness, or feel like they have a bad cold, or, if their antibodies are fresh and robust, they won’t feel sick at all – and that’s when relying on the vaccine to protect the community is the most dangerous. 

A study published in PNAS found that baboons vaccinated with acellular pertussis at two, four, and six months of age, who were then challenged with live pertussis at seven months, had asymptomatic pertussis infections that they passed along to unvaccinated animals. Plus, their throats and nasal passages were colonized for six weeks after exposure, which is twice as long as those vaccinated with the whole cell vaccines, and four days longer than even the unvaccinated baboons took to clear the colonization. Despite the propaganda all around us, there is no such thing as “cocooning” a new baby from pertussis by vaccinating everyone that comes in contact with the baby.

Are the Unvaccinated to Blame for Outbreaks?

The CDC knows that pertussis vaccines don’t prevent infection, which is why they never blame unvaccinated people for pertussis outbreaks. In fact, their Pertussis FAQ page says, “Even though children who haven't received DTaP vaccines are at least 8 times more likely to get pertussis than children who received all 5 recommended doses of DTaP, they are not the driving force behind the large scale outbreaks or epidemics.”

Of course I can’t let that “at least 8 times more likely to get pertussis” line slide by without comment. If unvaccinated kids were eight times more likely to get pertussis they arguably would be the driving force of outbreaks! 

I emailed the CDC for the source of that nonsense statement and they responded with a study called, “Association of Childhood Pertussis With Receipt of 5 Doses of Pertussis Vaccine by Time Since Last Vaccine Dose, California, 2010.” In it, researchers found that unvaccinated children made up 7.8% of the 682 pertussis cases and 92.2% were vaccinated. The researchers also had a control group where only 0.9% of kids were unvaccinated. So the big brains at the CDC divided 7.8% from the case group by 0.9% in the control group and got 8.7! The unvaccinated are at least eight times more likely to catch pertussis! Voila, am I right? 

No. The only proper mathematical conclusion to draw from that finding is that the kids in the pertussis group were 11.8 times more likely to be vaccinated than not. Besides, even if unvaccinated kids were eight times more likely to catch pertussis, which was not a finding in the study, would you ever take a vaccine to only reduce your risk by a factor of eight? Wouldn’t you want a risk reduction factor of 100? Or 1,000?

Besides, public health has known since at least 2013 that circulating pertussis is markedly different from what’s in the vaccine because pertussis bacteria mutated to become pertactin negative, also called pertactin-deficient, or PRN-deficient. At the end of that year, the CDC held a meeting, the now-deleted but archived-elsewhere notes for which are entitled, “Meeting of the Board of Scientific Counselors, Office of Infectious Diseases, Centers for Disease Control and Prevention, Tom Harkins Global Communication Center, Atlanta, Georgia, December 11-12, 2013, ” where Dr. Anne Schuchat, Director, NCIRD, made a startling admission.

Read that last sentence. “Moreover, when patients with up-to-date DTaP vaccinations were compared to unvaccinated patients, the odds of being infected with PRN-deficient strains increased, suggesting that PRN-bacteria may have a selective advantage in infecting DTaP-vaccinated persons.”

A National Center for Immunization and Registry Diseases Director admitted that vaccinated kids are lightning rods for contracting infections from the mutated pertussis strain that made up 85% of infections in 2013. Quite the opposite of “unvaccinated children are eight times more likely to contract pertussis.”

What About the Old Pertussis Vaccines?

The old whole cell DTP vaccines of 1949-1996, that are still used elsewhere in the world but were phased out of use in the US from 1996-1999, were likely responsible for the lower rate of diagnosed pertussis cases decades ago. But Israeli researchers knew in 1999 that daycare children vaccinated with whole cell DTP were developing contagious pertussis infections without symptoms.  

It’s important to note that the old whole cell DTP wasn’t preventing infant pertussis deaths, either. In the three years spanning 1992 to 1994, when DTP was still in use in the US, there were 32 total pertussis deaths, 25 of them in infants under 6 months old. Thankfully, there are medical advancements to save infant lives when infected with pertussis and treated early, including oxygen, suction, hydration and relatively newer antibiotics.

Why are Babies Still Dying of Pertussis?

The LA Times wrote an investigative article covering eight infant pertussis deaths that occurred in California from January through September 2010, which was the month the article was published. 

From the article:

"Despite the patients' multiple visits to clinics and hospitals, doctors typically

failed to make a swift, accurate diagnosis. 'In several cases, the infants were treated only for nasal congestion or mild upper respiratory infection,' Dr. John Talarico, an official with the California Department of Public Health, wrote in a recent letter to healthcare providers statewide. 'By the time these infants developed severe respiratory distress, it was too late for any intervention to prevent their tragic deaths.'

'All of those should've been diagnosed earlier. And a couple of them, even after they were diagnosed, the healthcare providers didn't take it serious enough,' said Dr. James Cherry, a UCLA pediatrics professor. 'Delayed hospitalization contributed to fatal outcomes.'"

That’s right. All eight infants died because they were dismissed by the attending doctors. That’s not a pertussis epidemic. That’s an epidemic of malpractice.

What About Maternal Vaccine Antibodies?

Are pregnant mothers who get the Tdap vaccine passing pertussis toxoid antibodies to their babies? Yes, but very few, and they don’t last very long. A 2014 JAMA study examined the amount of vaccine antibodies in the blood of babies born to a few dozen mothers who were vaccinated with Tdap between 30-32 weeks gestation and determined the number to be 68 EU per ml, with EU being ELISA Unit, which is an antibody measurement. 

Maybe that sounds alright until you read this Journal of Infectious Diseases study from 2000 that says 68 EU/ml isn’t in the ballpark of what’s needed to prevent a raging pertussis infection at the time of exposure – the protective number is at least 246. That study also found the average measurement of people who developed severe pertussis to be 79 units, so blithely telling new mothers they can rely on 68 units to protect their newborns sounds downright dangerous. 

Are you thinking that some antibodies are better than no antibodies? In the JAMA study, the newborns’ antibody counts dropped rapidly in the weeks following birth, leaving them with only 20 units per ml at the two-month check-in, at which point one has to wonder if vaccinating pregnant mothers with a big dose of aluminum and unnecessary tetanus booster, in the name of preventing pertussis, is worth the risk.

Between being vaccinated with the acellular DTaP, the whole cell DTP, or enduring a pertussis infection, only those who had a natural infection have long-lasting immunity, and don’t spread contagious disease, for up to 20 years. That’s the old-fashioned mother-to-baby pertussis immunity the US hasn’t seen for 70 years.

In conclusion, vaccinating yourself for the B unit of the pertussis toxin is not going to stop your body from allowing the pertussis bacteria to enter. It’s not going to stop the bacteria from developing into an infection. It is not going to stop you from spreading pertussis. And it’s not going to protect an infant in your home or community from contracting pertussis – that would be like buckling your own seat belt to protect your sister’s new baby in a car accident.