During the first week of May 1999, it was reported that there have already been 18 confirmed cases of Pertussis, or Whooping Cough in Wellington this year - 12 of them during that week. Since then there have also been reported outbreaks of Pertussis in Southland and Auckland Hopefully, this may be just a 'cluster' of cases, but there is the strong possibility that it may be the beginning of an epidemic predicted for the latter part of 1999. Whooping cough flares up on a three to six year cycle, the frequency and seventy of these outbreaks relating directly to immunisation coverage. Unfortunately, immunisation rates in New Zealand have fallen by 10% over the past 3 years so that just over 60% of children are completing their courses of 'jabs'.

Where is the medical literature proof of this? One small study done in Northland over 10 years ago? And why is it that WHO is quoted as a verifiable source of information on IMAC’s site? According to the WHO website, New Zealand has a 100% vaccination rate. In the past, the Health Department has calculated the immunisation rates, based on returns from doctors, and the number of vaccines sent out yearly to be administered. Where is this data? And why is it not put here for all to see?

This statement in not based on verifiable facts, is therefore anecdotal, and falls into the category of "scaremongering."

However, because vaccines have almost eliminated certain infections, some parents are re-examining their usefulness. Do we still need vaccines? Do their benefits outweigh their risks?

Here are some scenarios and statistics to help you decide.

Whooping cough is a respiratory infection caused by bacteria called Bordetella Pertussis. Pertussis is commonly known as 'whooping cough' because the major symptom is severe spells of coughing followed by a whoop sound before the next breath. The Pertussis bacteria is very contagious and is spread by coughing and sneezing. After incubating for 7 1- 10 days, the infection causes a runny nose and irritating cough which may then develop into the 'whooping' cough. The younger the child the more serious the effects of the disease. About 1 in 200 patients under the age of 6 months will die from the complications of pneumonia or brain damage.

Brain damage can be caused:-

• By interfering with blood supply to the brain during severe coughing spells
• By causing the infant to stop breathing
• By causing the blood vessels in the brain to rupture during coughing spells and bleed into the brain

Although a number of antibiotics can destroy Pertussis bacteria, the results of antibiotic treatment of patients with Pertussis have been disappointing. A few antibiotics can get rid of Pertussis bacteria from the nose and throat (and for this reason is usually prescribed to confirmed cases and their household contacts to reduce transmission of the disease). If treatment is started during the first two weeks of illness, coughing may not last as long - but antibiotics have very little effect on the intensity of coughing spasms once they have started.

True, And why is that? Because it has not been in the interests of the medical profession to do so. Quite apart from which, they wouldn’t know what to use, or where to start.

The Pertussis vaccine currently available for the New Zealand Childhood Immunisation Schedule is made of killed, whole Pertussis bacteria. Because the bacteria are dead, it is not possible to get the disease from the vaccine - however the body's immune system still makes a memory response to the dead bacteria. This means that if in the future the person is exposed to 'live' Pertussis bacteria, the immune system will recognise it and activate the 'ammunition' to defend the body from invasion! In New Zealand, Pertussis vaccine is most often used as a combined product containing diphtheria toxoid, Pertussis vaccine, tetanus toxoid and haemophillus B vaccine so that all four vaccines can be given as a single injection called DTPH.

Which, up until recently was a formulation called Tetramune. Which the Australians refused to use because of lack of effectiveness of the Pertussis component. (MJA, Vol 166, 20 January 1997)

This vaccine has a fairly high rate of mild side effects - up to 50% of children experiencing pain, swelling and redness at the injection site. In addition the vaccine commonly causes low grade fever, fretfulness, drowsiness and more rarely vomiting in the 24 - 48 hours after immunisation. More rarely, the vaccine can cause high fevers (0.3 per cent) persistent crying (1%) and seizures (0.6%), These side effects are not permanent.

This is not true. There are several children in this country, who have ACC compensation for permanent disabilities following many of these symptoms after the whole cell vaccines. Nicki Turner knows this. She personally knows of one of these cases. That she doesn’t know others, doesn’t mean they are not there. I do. Because I was involved in some of the cases.

It is believed that the Pertussis component of the vaccine is the most likely cause of the side effect.

Because the side effects are not pleasant for the child or parents, there has been some resistance to it, especially by those with little or no experience of the severity of the disease. In fact vaccination against Pertussis was halted in Japan in 1975. The frightening consequences of discontinuing the Pertussis vaccine caused the Japanese to resume giving it in the 1980's (see below), and to develop an alternative Pertussis vaccine with dramatically lower incidence of side effects.

Please note that Japan considered it wise to discontinue the whole-cell pertussis vaccine, because of the high numbers of damaged children. They did not reinstate that vaccine, and even when the new acellular vaccine came on to the market, for some time it was only given to two year olds and over, until they felt comfortable with it being given to younger babies. Even now in Japan, many parents refuse the Pertussis vaccine.

Japan 1971 - 74

400

20

Japan 1976 - 79

13,000

113

Researchers identified the proteins in the Pertussis bacteria that are responsible for inducing immunity to Pertussis.

This is not necessarily so. There are two schools of thought on this issue.

The first school of thought, which you might call the old school, say that the old correlates, the antibodies, still are relevant. Two most recent examples of this are both in the same journal Infection and Immunity Dec 2000, Vol 68, no 12, pages 7175 – 7179, and July 2001, Volume 69, No 7 pages 4516 – 4220. Both essentially say that the old correlates about antibodies accurately reflects immunity. An earlier article is Vaccine, Volume 16, No 20, 1901 –1906, 1998, written by James Cherry. It is interesting that those defending the antibody theory are the ones who wrote the definitive articles about the antibodies in the first place.

The second school of thought was gaining thought in 1989, when in the New Zealand Medical Journal, 25 January, 1989, Mark G Thomas of Auckland School of Medicine, stated that Lau et all (NZ Med J, 1988;101:797 – 800) "Acknowledged that the exact relationship between the level of measurable antibody determined by ELISA and individual protection from the disease is unknown."

This anomaly was further sparked by studies done in Europe in the early 90’s, where as part of a trial of acellular vaccines, children were tested for antibodies, and followed during the trial. The problem arose that many children who had the supposedly correct antibodies, went on to get whooping cough. This problem had also come to light before, and had been discussed at meetings prior to the studies in Europe. So it was a well-known anomaly. This second group, who are the people looking at immunity, hold a somewhat different view to those who hole to the antibody view, who ironically are those with an interest in pushing vaccines.

The thinking of the group who are more interested in the pure immunology perspective is best shown by referenced quotes as follows:

Pediatric Infection Dis Journals 1999;18: 366-370,page 366: "The immunologic mechanisms of protection against clinical pertussis are poorly understood. Although several studies have suggested that antibodies to some pertussis antigens may be predictive of protection against pertussis, there is no generally accepted laboratory measure of immunity. Further in clinical efficacy trials of acellular vaccines, no clear correlation bas been found between serum antibody values and protection."

Of interest was that again, this study said "In the present study, no clear association was found between serum antibody values and clinical outcome." In other words, they still don’t know. Their conclusion was that "A better understanding of the immunologic correlates of vaccine-induced protection is needed for antigenic formulation of new combined vaccines." In other words, until we know that, we can’t figure out the best antigens to use.

From 1940 until 1990, an assumption was made that certain antibodies represented immunity. Which by 1990, there were enough exceptions to the "rule" to raise questions. As is shown by the body responsible for biological standardisations. In the June 1991 bulletin d’information newsletter of the International Association of Biological Standardization wrote, in an article entitled Pertussis:Evaluation and research on Acellular Pertussis vaccines that "at present there was no established serum antibody response for predicting or ascertaining protection in children, and that further studies were warranted…Establishing criteria for serological standards was considered a more difficult task until it was known which type of immunity conferred protections against disease and infection"

If this is true, and the immunologists don’t know what type of immunity confers protection, or the serological markers are, that indicate immunity, how can they identify the proteins that are responsible for inducing immunity?

Infection Diseases in Children, July 1996 on page 15, said about the European trials referred to above: "Not only did the studies fail to shed light on one of the more perplexing unknowns of pertussis vaccine research – that is, what are serologic correlates of immunity – but they also cast doubt on the fundamental concept: what exactly defines pertussis in clinical efficacy trials" and on page 20 "At least initially, the recent trial results confirmed the lack of correlation between antibody response to vaccine antigens and the protective efficacy of this product," said Erik Hewlett, MD, "leaving open the question of how to evaluate the new antigens for their contribution to immunity against pertussis either alone or in combination with previously tested preparations."

Strangely enough having said that, the same Journal then prints this, one month later.. August 1996, On page 28 "A study of whole cell pertussis vaccine in 1945 showed that the vaccine was safe,

Either the antibodies mean something or they don’t. You can’t have it both ways… Or could it be that the publishing of both views as fact, is indicative of the ignorance and assumptions medical people have regarding this issue?

Further to that, a comprehensive review of the literature on the pertussis vaccine shows that BECAUSE they did not know what the protein components were, up until the Japanese Accellular vaccine, they used the WHOLE of the cell, so that everything was there. Precisely because they did not know. The whole cell vaccine remained virtually unchanged from the time of its development by Drs Bordet and Gengou in 1916, to now.

The key component of this vaccine is the cell wall of the bacteria, which is an endotoxin. The other toxin in the vaccine is the Pertussis toxin. It is interesting that in the early debate on the vaccine it was considered that these two toxins were not only crucial in the immunising ability of the vaccine, but also the cause of neurological damage from the vaccine.

Pittman M: Pertussis toxin: The cause of the harmful effects and prolonged immunity of whooping cough. A hypothesises. Rev Infect Dis 1: 401-412, 1979.

When challenged in this manner about the relevance of antibodies, and therefore the efficacy studies, the medical profession generally fall back to the studies which have compared whether vaccinated as opposed to vaccinated children get whooping cough. However, two very good articles put paid to this argument.

The first is from the (DHHS, USA) published transcript of a Workshop sponsored by the Interagency Group to Monitor Vaccine development, Production and Usage, September 22-24, 1986, where in a presentation called "Perspectives on Pertussis Efficacy studies, Dr Fine essentially takes most of the studies looking at illness rates, household contacts, retrospective studies, etc… and exposes all the flaws in them, and how the statistical basis of all of them are meaningless. At one point he says "My guess is that unless you think a pertussis vaccine is totally useless it can’t help but influence your diagnostic suspicion, and, if then you tend to, for whatever reason, reduce the pertussis suspicion in the vaccinated individuals, it will artificially reduce the estimated incidence in that group, and thus increase your efficacy rate." He details all the flaws in various retrospective studies, going into the bias in the vaccinated groups, which he calls "ascertainment bias, diagnostic specificity and "enrichment" all of which can result in higher estimates of vaccine effectiveness. Not only does he doubt the results of many of these studies, he also says this:

This is a very valid point, especially with regard to the information on the IMAC site, because nowhere in this site, does Nikki Turner use NEW ZEALAND data to discuss the issue. She concentrates on studies done in different countries using different measure, different designs, and extrapolates them to New Zealand when in fact, the New Zealand situation is radically different, as you will see, as I go on.

The second consideration to review with overseas studies, relates to Dr Fine’s concerns, which were made in 1986. Out of date, you may say. Not so. Pediatrics Volume 102, No 4, October 1998 "The effect of Investigator Compliance (Observer Bias) on Calculated Efficacy in a Pertussis Vaccine Trial"

Conclusions "Our data suggest that observer bias can significantly inflate calculated vaccine efficacy. It is likely that all recently completed efficacy trials have been affected by this type of observer bias…" Which updates the same comments by Dr Fine 12 years earlier.

So when considering the heading of this section

New methods were developed to make and purify the Pertussis proteins. Vaccines made from these purified Pertussis proteins are called Acellular Pertussis Vaccines. They have been used in Japan and other countries for up to 15 years and will probably be used in New Zealand within the next few years - when the acellular vaccine, available in combination with other vaccines like diphtheria, tetanus and Haemophilus influenzae, has been rigorously tested and proven safe and efficacious.

This is not true. The 1994 gold standard book put out by NIH on Adverse reactions to childhood reactions has a long chart at the beginning, looking at vaccines, and the studies done. Most vaccines, when you look at decent scientific epidemiological/safety/controlled trials have two words next to them. "No data".

In the meantime, it is possible for parents making the choice and willing to pay, to purchase (through their doctor) one of the newer vaccines which contain acellular Pertussis, diphtheria and tetanus vaccines (DTAP). The Haemophilus influenzae b (Hib) vaccine would need to be given separately.

The table below compares the side effects of whole cell vaccine and acellular vaccine - the results of a large study in the United States.

1,025

4.878

Fever

6.6

1.5

Crying

20.5

6.1

Redness

9.5

3.5

Swelling

15.4

3.8

Pain

20.8

4.9

This figure has not been borne out by published data in this country.

I have studies which state that the severity and complications in both groups is equal. So which view is valid? Is it, like the matter of whether antibodies are relevant, the view of the beholder?

Australia has over a 90% vaccination rate and has a continuing whooping cough epidemic which has been rampant since 1993, and has not abated. However if you go to their website and review the archival material, you will find articles which clearly show that the vaccine simply doesn’t work. It is couched in careful wording, but even so, is pretty clear to the reader.

One of the reasons that whooping cough appears to be far less common these days, is that most doctors wouldn’t know common whooping cough if it bit them on the bum. That is evidenced by this article in the British Medical Journal. Here are some extracts taken from throughout the whole body of the article. They do not run on after one another:

URL : http://bmj.com/cgi/content/full/310/6975/299

BMJ 1995;310:299-302 (4 February)

Douglas Jenkinson, general practitioner ^a

And my guess is the only reason he got this published was this little sentence:

"Parents of children with the disease or in contact with it should be reassured that serious illness with complications is unlikely, but education should ensure that parents understand that a high immunisation rate is the only practical means of reducing damage and deaths in those too young to be immunised.

This is a matter of conjecture in this country. Theoretically that should be the case, but only time will tell if that is the reality.

There is a common statement in the so-called "pro-choice" information which argues that Pertussis disease was declining before the introduction of the vaccine - due to improved hygiene and sanitation.

The Annual Reports by the Director General of Health, to the New Zealand Appendices to Parliamentary Journals 1932 H – 31states:

Their emphasis, not mine.

1933 2-H.31 "Certain infectious and other diseases such as scarlet fever, diphtheria and acute rheumatism, and syphilis, are know to sometimes affect the heart and blood-vessels, but their potency and influence has definitely waned."

Journal of Epidemiology and Community health, 1981, 35, 139-145 says:

"In assessing the rise and fall of any communicable disease, it is essential to examin its backgroun of secular and cyclical trends. Historically, the dominant ond obvious fact is that most, if not all major communicable diseases of childhood have become less serious in all developed countries for 50 years or more. Whooping cough is no exception. It has behaved in this respect exactly like measles and similarly to scarlet fever and diphtheria, in each of which at least 80%of the total decline in mortality, since records began to be kept in the United Kingdom in 1960, occurred before any vaccines or antimicrobial drugs were available and 90% or more before there was any national vaccine programme. These facts establish beyond doubt the governing role of non-specific, environmental, personal and secular variable in these infections. The increase in whooping cough in the United Kingdom has been accompanied by increases in measles, mumps, scarlet fever, chickenpox, respiratory viral infections and notable in rubella, in an epidemic which is the largest for 30 years….In the United Kindom and in many other countries, whooping cough (and measles) are no longer important as causes of death or severe illness except in a small minority of infants who are usually otherwise disadvantaged."

Pediatrics Volume 63, No 6, June 1979, page 942. Dr Samuel Katz:

Pediatric Infectious Diseases, May 1983:

Int Symp Pertussis, DHEW, Pub no (NIH) 79-1830, 1978. Edward Mortimer, Introduction.

And as you will see as we progress through the New Zealand figures, the situation in New Zealand is very interesting. The Death Decline graph is even more pronounced than overseas. BUT in this country the Health Department did not keep track of how many cases there were, because they considered Hospital discharge numbers to be an accurate reflection of community load.

So here, we have to look at whether or not the numbers of cases in hospital has declined. If the vaccine has caused a decrease in cases overall, we will see a decline in the numbers hospitalised. And that has not happened. (New Zealand Family Physician1997 24 (6) pages 45 – 48) (See the graphs in this article.)

It is true that between 1900 and the 1940's when Pertussis vaccine was introduced, the incidence of Pertussis was declining. However, the introduction of the vaccine hastened the decline of the disease. There are four pieces of evidence that prove the vaccines efficacy.

Not in this country. New Zealand Doctor News, Page 14, 15 September 1994.

So what about before that?

Monthly Report of communicable Diseases in new Zealand, December 1987, Dr D. Bandaranayake:

Please note that in 1965, children had three doses schedule at 3,4, and 5 months. As a point of interest, in 1941 there were 600 hospital cases, and in 1982 there were 570 (NZ Medical Journal, June 1984.)

If hospitalisation is, as they say it is, an accurate measure of community infection, then there was not drop in whooping cough incidence in this country.

There were no clinical trials done in this country, therefore studies conducted elsewhere, for the reason that Dr Fine defined, are irrelevant to this country. And why is it that every study done on whooping cough in this country has found most children to have been vaccinated. If indeed the rates were as low as they are said to be, then not only should most children who get whooping cough be unvaccinated, but so should the hospitalised cases (not counting those too young to have completed any schedule)

New Zealand medical Journal, 26 August, 1992, in a study of children hospitalised in the Bay of plenty: of the 36 cases, 12 fully vaccinated, 4 had had two shots, 7 had had one shot, and of the 13 who had had none, 5 were under 5 weeks of age.

CDNZ November 1993, Otago outbreak, 28 documented cases. Article said that 82% were immunised p 146. When you look at the exact numbers, 23 were fully immunised, 4 h’had had at least 2 of 3 shots, and 1 was not vaccinated.

New Zeland Medical Journal, 22 March, 1996: "The control of Pertussis in New Zealand is not a simple issue, yet simplistic solutions are again being offered. The beauty of this is that their failure can be balmed unfairly on parents whose children are not vaccinated.

ESR information from pertussis notifications from 1.1.99 – 20.12.99.

A total of 913 cases were recorded. Of these 112 were unimmunised, 245 status unknown, 180 had received four immunisations, 275, had received three immunisation, 51 had received two immunisation, 50 had received one immunisations.

Important points:

There was no break down by ages, so of the unvaccinated cases, we don’t know how many were too young to receive vaccines

There is now no way to separate data such as this, because now, firstly, the data is not released when asked for, and secondly, it is kept differently, so that it is not possible to break it down. A letter from Dr Dell Hood states that the statistics kept by them now reads "Immunised" = full schedule only, and "unimmunised" = any child who has had fewer than the full schedule.

So therefore, by skilful statistical manipulation, which is now unable to be verified from raw data, and would not be definable by the number of shots children have had, the Health Department can say what they like, and we will never know if it is true or not.

But the evidence is quite clear. The Pertussis vaccine had made no difference to the incidence, or severity of pertussis in this country, as witnessed by the fact that hospitalisation are as common as they were before the vaccine, with one exception.

New Zealand Family Physician, December 1997, 24 (6) page 48, figure two. Whereas from 1950 to 1972, the highest numbers of babies under one discharged from hospital was 2 per thousand, in 1978, it was three per thousand, 1982 8 per thousand, 1986, 4 per thousand, 1990 3.5 per thousand, 1994, three per thousand, and 1996, 7 per thousand.

In other words, there has been a huge increase in the numbers of babies under one year of age, admitted to hospital. Some vaccine.

Stories about the 'dangers' of vaccines periodically appear in newspapers and magazines, and on television. These stories cause parents to question the safety of vaccinating their children. But parents forget the very reason for the existence of the vaccines. Vaccination has been successful in preventing many childhood diseases - so successful, in fact, that parents today no longer fear these diseases, instead they worry about the safety of the vaccine.

The above paragraph is NOT relevant to the discussion of Pertussis, since none of the comments apply to this particular disease.

There is another argument frequently found in 'pro-choice' literature - that in an outbreak of vaccine-preventable disease, there are more vaccinated, than unvaccinated children with the disease. This can be true and this apparent paradox is best explained by an example. First though, it is necessary to understand that no vaccine is 100% effective, and also not all vaccinated persons develop immunity (for reasons related to the individual). Most childhood vaccines are effective for 85% to 95% of recipients.

But only for three years after they have had the vaccine. After that, the so-called protectiveness diminishes to nothing.

Scenario 1
In a group of 100 children, all but 5 are fully immunised. There is an outbreak of a vaccine-preventable disease and every susceptible child becomes infected.

This is hypothetical crystal ball gazing, not related to scientific fact, and based on mathematical hypothesizing. Or scaremongering, whichever way you want to call it.

As you can see, this doesn't prove that the vaccine doesn't work (85 didn't get the disease!) - only that most of the children had been vaccinated, so those who were vaccinated and didn't respond to the vaccine outnumbered those who had not been vaccinated. If there were 50 unvaccinated children out of the 100, and every susceptible child became infected, then 50 unvaccinated children would became infected and only approximately 5 vaccinated children.

Scenario 2
If none of the children in a childcare centre of 150 children were immunised, and a whooping cough outbreak occurred, about 135 children would come down with the disease. On average, one child would get encephalitis (inflammation of the brain) as a result of the disease. If every child in the centre was immunised correctly with four doses of DTP, possibly one child at the centre every 170 years could get encephalitis associated with the immunisation.

Not true. The New Zealand experience has shown this to be absolute rubbish.

Peter, Georges, ed 1994 Red Book Report of the Committee on Infectious Diseases 23rd ed.American Academy of Pediatrics 1994

Plotkin, Stanley A v Edward A Mertues, ed. Vaccines 3rd ed. Philadelphia, PA WB Sanders Company 1999

N.Z. Ministry of Health. Immunisation Handbook 1996 Ministry of Health Wellington 1996

Offit, Paul A and Louis M Bell What every parent should know about vaccines McMillan New York 1998

During the first week of May 1999, it was reported that there had already been 18 confirmed cases of pertussis, or whooping cough, in Wellington - 12 of them during that week. Since then there have been reported outbreaks of pertussis throughout the country so that the outbreak has been reclassified as an epidemic and sadly there has been one death. Whooping cough epidemics tend to last for approximately 18 months and flare up in three to six year cycles. The frequency and severity of these outbreaks and epidemics relate directly to immunisation coverage (the percentage of fully immunised children). Unfortunately, immunisation rates in New Zealand have fallen by 10% over the past 3 years so that just over 60% of children are completing their courses of "jabs". To prevent outbreaks of diseases like whooping cough, immunisation rates would need to be up over 90%. So every parent who ensures their child's immunisations are completed, has not only done their best to protect their own child from the disease, but also has done their best to protect the community as a whole from the disease.

However, because immunisation has almost eliminated certain infections, some parents are re-examining it's usefulness.

Whooping cough is a respiratory infection caused by bacteria called Bordetella pertussis. Pertussis is commonly known as "whooping cough" because the major symptom is severe spells of coughing followed by a whoop sound before the next breath. The pertussis bacterium is very contagious and is spread by coughing and sneezing. After incubating for 7 - 10 days, the infection causes a runny nose and cold-like symptoms for 1-2 weeks, and may then develop into the "whooping" cough. The younger the child the more serious the effects of the disease. About 1 in 200 patients under the age of 6 months will die from the complications of pneumonia or brain damage.

Where is the evidence for this? Amazing how when we put information up without a reference, we are cut to pieces for it, but these people can spout figures with no references? The New Zealand data does not back this up as far as I know…

Brain damage can be caused by:-

• interfering with blood supply to the brain during severe coughing spells
• causing the infant to stop breathing
• causing the blood vessels in the brain to rupture during coughing spells and bleed into the brain

The pertussis vaccine currently available for the New Zealand Childhood Immunisation Schedule has been developed from part of the killed, whole pertussis bacteria. Because the bacteria are dead, it is not possible to get the disease from the vaccine - however the body's immune system is stimulated to make a memory response to the dead bacteria. This means that if in the future the person is exposed to 'live' pertussis bacteria, the immune system will recognise it and activate the "ammunition" to defend the body from invasion! In New Zealand, pertussis vaccine is most often used as a combined product containing diphtheria toxoid, acellular pertussis vaccine and tetanus toxoid vaccine so that all three are given as one vaccine known as DTaP vaccine. 
Until August 2000 the pertussis vaccine used in New Zealand was called "whole cell pertussis vaccine" (wP) and was believed to cause many of the reported side effects such as fever and crying. (see Table 1)

The majority of side-effects I heard about, were a lot more serious than that…

Because the side effects were not pleasant for the child or parents, there was some reluctance to accept the need for it, especially by those with little or no experience of the severity of the disease. In fact vaccination against pertussis was actually stopped in Japan in 1975. (see Table2) The frightening results of discontinuing the pertussis vaccine (soaring rates of whooping cough disease and it's consequences) caused the Japanese to resume giving pertussis vaccine in the 1980's, using an alternative pertussis vaccine, with dramatically lower incidence of side effects. At first this vaccine was only licensed for children 2 years of age and over but since 1989 has been used in Japan for babies as young as 3 months old.

But the key thing here is that parents are allowed to chose WHEN the schedule starts. And many Japanese still chose not to have it at all.

At this point I think a historical lesson is in order. This is an article, written in a medical journal by a paediatrician, who had certain things to say about scaremongering tactics. Since, in my opinion, Nikki Turner has been guilty of such tactics time without number, I think maybe a history lesson may be of use here…

Pertussis – A blast from the past. From the horse’s mouth…

The epidemics of pertussis in Britain, Japan and Sweden are often used as finger-pointing and justification for the vaccine. The 15 deaths in Britain in the 10 years from 1972 – 1982 are used as proof that non-vaccinating parents were hysterical murderers. Never mind that Gordon Stewart analysed the deaths and found most children were too young to be vaccinated, or had pre-existing immune compromising health problems, or congenital defects. According to the doctor below, they were probably also treated incorrectly.

But the most interesting analysis of the British experience is not so much the few deaths, but the actions of the Health Department.

AT the height of the last epidemic, the New Zealand Health Department put an advertisement on television about whooping cough. It featured a tiny baby, with tubes in its nose, coughing, coughing coughing. And many mothers rang me concerned because their plunket nurses had told them that this wee baby was still in hospital months later, with severe long-lasting effects all because people didn’t vaccinate. There are two points to consider here. First, the advertisement was highly misleading. This baby, firstly, was too young to have even been offered the first DPTH. Her name was Eve, and she was born prematurely. She did not stay in hospital the way the Plunket nurses made it sound, at all. And she got better. The other thing about the advertisement was the method used to make the baby look as pathetic as possible. Lean the baby back, and just put a hand behind the head – make sure the little fists are flailing in the air. IT IS THIS TYPE OF SCAREMONGERING WHICH THE FOLLOWING ARTICLE DEALS WITH SO WELL.

For a start, no baby in the midst of a whooping cough fit should be held that way. There is a certain method, which your grandmothers knew, which shortens the cough, and helps the baby get up the pooling mucus which is causing the cough in the first place. But would the medical profession know that? I doubt it. Or any other method than their own, for that matter…

"A pre-recorded phone-in service was installed by the DHSS to "inform" parents about the vaccine. Anybody calling this number was greeted with a blood-curdling series of spasms of coughing, followed by a diatribe on the imminent dangers of brain damage, lung damage and demise. The message ended, like a bad commercial, with a high-pitched hysterical exaltation; ‘If your child has not been vaccinated, do not delay. There is an epidemic. Get your child vaccinated now!" This was followed by another paroxysm and what sounded like a last gasp.

"Either the vaccine is 100% safe, in which case all normal babies can have it, or it is not, in which case we should not be afraid to say so. The exclusion of a significant number of outwardly normal babies on account of their birth or family histories appears to be a subconscious attempt to shift the onus of responsibility if something goes wrong to the vaccinator instead of the vaccine. A few calls came from parents genuinely worried about possible reactions, but even more distressed by the accusations of community doctors or health visitors that their attitude was endangering other people’s babies.

"The one message to come across clearly, on a poster, was the awesome ‘Whooping cough is a Killer’. With 13 deaths and 65,772 survivors this is overstating the case. Nevertheless, television viewers were regaled with the sacrificial vaccination of some Very Important Little Persons, whose sheltered existence might be expected to render a chance encounter with a Bordetella pertussis an unlikely eventuality. Just as the uptake of pertussis rose from 30% to a modest 45%, a red-faced DHSS ran out of supplies and the campaign of terror came to an abrupt halt. That it had been uncalled for and the cause of much anxiety is beyond dispute. The public should not have been brought into the debate, and the whole campaign ought to have been conducted through the profession, and the time spent by countless family doctors and paediatricians on reassurance could have been put to better use."

In developing the newer vaccine, researchers identified the proteins in the pertussis bacteria that are responsible for inducing immunity to pertussis. New methods were developed to make and purify the pertussis proteins. Vaccines made from these purified pertussis proteins are called acellular pertussis vaccines. They have now been safely used in Japan and other countries including USA and Australia, for up to 15 years.

Australia and America have not used the Acellular vaccine for a period of 15 years. Only Japan has. It is time IMAC learned to be precise. Australia and USA only recently introduced Acellular vaccines. USA firstly, for the fourth dose only.

Table 1: Complications of Pertussis Disease (Whooping Cough) Compared with Whole Cell Pertussis Vaccine

0.6 - 8%

0.0003 - 0.09%

Encephalopathy

0.09 - 4%

0.0001 - 0.003%

Shock-like State

0.005- 0.03%

Deaths

0.1 - 4%

<0.002%

CNS Sequelae

0.6 - 2%

0.0002 - 0.0006%

Table 2: The following is an example of what happens when you stop using pertussis vaccine.

Japan 1971 - 74

400

20

Japan 1976 - 79

13,000

113

Table 3: The table below compares the side effects of whole cell vaccine and acellular vaccine - the results of a large study in the United States (a more detailed comparison chart is available from the Immunisation Advisory Centre).

1,025

4.878

Fever

6.6

1.5

Crying

20.5

6.1

Redness

9.5

3.5

Swelling

15.4

3.8

Pain

20.8

4.9

Peter, Georges, ed 1994 Red Book Report of the Committee on Infectious Diseases 23rd ed.American Academy of Pediatrics 1994

Plotkin, Stanley A v Edward A Mertues, ed. Vaccines 3rd ed. Philadelphia, PA WB Sanders Company 1994

N.Z. Ministry of Health. Immunisation Handbook 1996 Ministry of Health Wellington 1996

Offit, Paul A and Louis M Bell What every parent should know about vaccines McMillan New York 1998