Unable to receive whooping cough vaccine

My daughter is unable to receive the vaccination that protects against whooping cough, due to a reaction she displayed at her two months shot. Does she have any protection, since she did have that one dose, and what are her chances of contracting the disease. She had her four months shot and had no problems after receiving the suspension without whooping cough protection.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Whooping cough, pertussis, or the "100 day cough" is a disease characterized by severe cough episodes, occasionally seizures, and pneumonia. The coughing episodes can be exhausting especially to young infants such that they may stop breathing. The severe part of the illness may last 2-4 weeks, but the cough may linger for many weeks thereafter (hence the name the 100 day cough).

Currently, this serious illness may be prevented by immunization which is usually combined with the diphtheria and tetanus shot commonly known as the DPT. Over the years, much concern has arisen from the pertussis part of this vaccine. This is primarily due to the fact that of all the immunizations that children receive, the pertussis immunization has the most side effects associated with it. The most common of these is a high fever and fussiness. However, others include prolonged crying and rarely seizures.

But good news is on the way. A lot of research has been done to come up with another vaccine for pertussis which reduces or eliminates these side effects. The results of this research are already being used on children who have received their first three shots of the DTP. The fourth shot may be given as the DTaP. The little "a" stands for acellular and causes very few side effects. It eliminates the fever in most children as well as the more serious side effects. Now you may be asking, "Then, why don't we give that vaccine to all children?" Well, while research confirmed that this new vaccine was effective when given as the fourth dose, it had not been confirmed as effective when given as the primary series (i.e. the first three doses). About four months ago, several large studies from several different countries confirmed that the new vaccine not only significantly decreased the side effects, but it actually was more effective than the vaccine we are currently using. Currently, the FDA is working to approve the vaccine for use for the first three shots, and the American Academy of Pediatrics is working on a vaccine schedule to incorporate the new vaccine.

The very first pertussis immunization is more of a priming shot. In other words, it gets the body ready to develop immunity when it receives subsequent pertussis vaccinations. Therefore, your daughter has not received any significant immunity from the one shot. The chances of her acquiring pertussis are actually higher than you might think. This is due to the fact that the pertussis vaccination only lasts until the teenage years. The disease in older children and adults mimics just a regular cold, therefore, there are a lot of teenagers and adults who get the disease and don't realize it. However, while it causes only a nagging cough in adults, this highly contagious disease may be transmitted to younger children causing more significant symptoms in them. I suspect the new vaccine will eventually be combined with the tetanus shot that adults receive thus allowing them to extend their immunity through life through booster shots. Finally, I suggest you discuss with your doctor the possibility of your daughter receiving the DTaP. I do not know the nature of your daughter's reaction, but it may not preclude her from receiving this new vaccine.

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