Whooping it Up

There is a pertussis epidemic in California and it is taking its heaviest toll among infants, so state health authorities are trying to boost immunization in a population group thought to pass along the disease — adults.
The California Department of Public Health (CDPH) is now shipping free pertussis vaccine to all birthing hospitals in the state, as well as county and municipal health departments. The department is encouraging not only new mothers and fathers to get immunized but also other family members, healthcare workers, child care workers, and anyone else who might have contact with infants.
The CDPH projects that California is on track to suffer its worst pertussis outbreak in 50 years. The state declared a pertussis epidemic on June 17. Through the first 6 months of the year it counted 1337 cases compared with 258 for the same period in 2009.
The incidence rate for children younger than 1 year was 38.5 per 100,000 — the highest rate among any age group. Of these children, 89% were younger than 6 months, which is too young to be fully immunized.
So far, the epidemic has claimed 5 lives — all Latino infants younger than 3 months who had not received any pertussis vaccine, according to the CDPH and the US Centers for Disease Control and Prevention (CDC). Pertussis rates for infants are higher for Hispanics than other ethnic groups in California.
As always, public health authorities stress vaccination as best way to protect against the disease. The CDC recommends that children receive the diphtheria, tetanus, and pertussis (DTaP) vaccine at ages 2 months, 4 months, 6 months, and 15 to 18 months, with a booster shot at age 4 to 6 years when they enter school. Infants need the first 3 shots in the series to achieve maximum protection, according to the CDC. Children aged 11 or 12 years should receive a dose of Tdap, the booster shot for adolescents and adults. Adults who did not receive Tdap as a preteenager or teenager also should get a dose.
California does an above-average job of immunizing young children. In 2008, the coverage rate for 3 or more doses of DTaP among children 19 to 35 months of age was an estimated 97.8% for California compared with 96.2% for the nation, according to a survey by the CDC. The immunization rate for California Latinos was even higher, at 98.1%.

There is a pertussis epidemic in California and it is taking its heaviest toll among infants, so state health authorities are trying to boost immunization in a population group thought to pass along the disease — adults.
The California Department of Public Health (CDPH) is now shipping free pertussis vaccine to all birthing hospitals in the state, as well as county and municipal health departments. The department is encouraging not only new mothers and fathers to get immunized but also other family members, healthcare workers, child care workers, and anyone else who might have contact with infants.
The CDPH projects that California is on track to suffer its worst pertussis outbreak in 50 years. The state declared a pertussis epidemic on June 17. Through the first 6 months of the year it counted 1337 cases compared with 258 for the same period in 2009.
The incidence rate for children younger than 1 year was 38.5 per 100,000 — the highest rate among any age group. Of these children, 89% were younger than 6 months, which is too young to be fully immunized.
So far, the epidemic has claimed 5 lives — all Latino infants younger than 3 months who had not received any pertussis vaccine, according to the CDPH and the US Centers for Disease Control and Prevention (CDC). Pertussis rates for infants are higher for Hispanics than other ethnic groups in California.
As always, public health authorities stress vaccination as best way to protect against the disease. The CDC recommends that children receive the diphtheria, tetanus, and pertussis (DTaP) vaccine at ages 2 months, 4 months, 6 months, and 15 to 18 months, with a booster shot at age 4 to 6 years when they enter school. Infants need the first 3 shots in the series to achieve maximum protection, according to the CDC. Children aged 11 or 12 years should receive a dose of Tdap, the booster shot for adolescents and adults. Adults who did not receive Tdap as a preteenager or teenager also should get a dose.
California does an above-average job of immunizing young children. In 2008, the coverage rate for 3 or more doses of DTaP among children 19 to 35 months of age was an estimated 97.8% for California compared with 96.2% for the nation, according to a survey by the CDC. The immunization rate for California Latinos was even higher, at 98.1%.

Similar to the rest of the country, however, California falters when it comes to vaccinating children aged 11 and 12 years. In 2008, the percentage of children aged 13 to 17 years who had received at least 1 dose of Tdap since age 10 years was 44% in California and 41% nationwide. A bill is pending in the California state legislature, however, that would allow the state to require middle-school children to be vaccinated against pertussis.

The immunization rate among adults nationwide is even worse, at 6% (the corresponding rate in California is not available). It is the lack of vaccine coverage among adults that California is attacking in the midst of its pertussis epidemic.

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