Vaccine recommendations changed in California

If you live in California, the Dept. of Public Health has recently changed vaccine recommendations for the Tdap (tetanus-diphtheria-pertussis) booster (emphasis mine):

The Department of Public Health on Monday expanded its vaccination recommendation to include children age 7 and older; adults age 64 and older; women before, during and immediately after pregnancy; and anyone who may have contact with pregnant women or infants.

You can inquire at your doctor's office or your local health department branch.

Why the expansion? Well:

A third Los Angeles County infant has died of whooping cough, public health officials announced Tuesday.

The confirmation of the death -- the sixth pertussis-related death this year in the state -- comes a day after the California Department of Public Health expanded criteria for those who should be vaccinated against the highly contagious disease amid what is shaping up to be the worst outbreak in 50 years.

“This expanded set of recommendations is an appropriate response to the epidemic in Los Angeles County and statewide,” Dr. Jonathan E. Fielding, the county’s public health director, said in a statement. “Vaccination is our best defense against pertussis. This is a disease that is especially dangerous for infants under six months of age, who are not old enough to have received the number of vaccine doses needed to be protected against whooping cough.”

So far this year, nearly 1,500 cases of whooping cough have been reported statewide, about 289 in Los Angeles County, including 184 laboratory-confirmed cases, officials said. All of those killed by the disease were infants.

From an interview with Dr. Cynthia Cristofani:

Pertussis is the formal name for whooping cough, and it's a disease that is now preventable and unfortunately is still very much with us, and there's several reasons for that. One is that the original childhood vaccines didn't confer lifelong immunity, so the kids who got properly immunized in childhood because they had conscientious parents, by the time they were teenagers, forget it. They're a reservoir of continuing infection in the community.

[...]

Whooping cough is a particularly miserable disease. ... You cough and you cough and cough, and you cannot stop. Eventually you manage to inhale a little air, and that's the whoop. And if you don't inhale any air, you may pass out. If you do, you're likely to make the noise of the whoop and throw up, and then a few hours later or even an hour later you do it all over again. These spells happen many, many times a day, and they'll also wake you up in the middle of the night. So these people are sleep-deprived, miserable. They never know when the next attack is going to get them. ...

Just the mechanics of the cough will hurt. Adults get rib fractures. It takes a pretty brutal cough to break your ribs. Little kids will get hernias; they'll get rectal prolapse; they'll get bleeding around the eye; occasionally they get bleeding in their skull; they'll bite their tongues. They do all kinds of damage just from the mechanics of the cough, never mind the fact that these people are suffocating and miserable.

What about those who can't be vaccinated?

They are highly dependent on everyone around them to be immune, and certainly one of the major public health recommendations is that people who have contact with infants should get vaccinated because they're dependent on all of us not to give it to them. ...

But the real problem with young infants is they're too young to vaccinate themselves; they don't get a good response to the vaccine in the first several weeks of life. And of course most of their mothers have no immunity, because the average woman of childbearing age in this country has no immunity to whooping cough, so she has no antibodies to share across the placenta. And so those babies are completely vulnerable, and they're the ones who are most likely to die of whooping cough.

Which is what is happening in California.