Don't Pass It On

Want to make a nurse happy? Just say, "While you're in my record, how long has it been since my last tetanus booster? Long enough that it was before they recommended an adult pertussis booster?" Oh, do the eyes ever light up.

Four days after getting a DTaP (diphtheria, tetanus, and pertussis) vaccination, my shoulder is still a little sore. Pain lasting that long at the injection site is unusual, as is the overall joint involvement I got to go through. (Pro tip: don't be me. There's a reason I call myself defective. This is how my body treats me.) Still, it was entirely worth it.

Why? Well, there's this:

The pertussis epidemic continues in California, which has seen 5,658 confirmed, probable, and suspected cases as of this week.

That is the most cases seen in the state since 1950, when there were 6,613, according to the California Department of Public Health (CDPH).

The rate of illness -- 14.5 per 100,000 population -- is the highest since 1959 (16.1 per 100,000).

Of the cases with hospitalization information, 10% required admission. Three-quarters of hospitalizations occurred in infants younger than 6 months, and of those, three-quarters were Hispanic.

Nine babies have died, including eight younger than 2 months -- the age at which pertussis vaccination starts -- and one 2-month-old who had been born prematurely and who had received just one dose of the tetanus, diphtheria, and pertussis vaccine (Tdap).

There's also the fact that it's not just California that's seeing increased vulnerability:

Fewer Minnesota toddlers are getting scheduled shots for major diseases, a new report says, because of declining health insurance coverage and rising parental skepticism about immunizations.

The report by Children's Hospitals and Clinics of Minnesota cited federal data showing a decline in the childhood immunization rate from 80.5 percent in 2007 - when the state ranked seventh nationally - to 76.9 percent in 2009.

"Any drop, even 1 percentage point, will get our attention," said Patricia Stinchfield, an immunization specialist at Children's. "What is 1 percentage point in Minnesota? 4,000 kids. That's 150 classrooms of kids that are not vaccinated."

The report concludes that Minnesota's childhood immunization rate fell to 20th among states in 2009.

And while I may not hang around many babies whom I could infect if I caught pertussis, it's a disease that sucks for adults as well. Then there are those who can't be vaccinated because they're already in fragile health:

Carrie, of course, is not otherwise healthy. She’s prone to seizures, one of the rare complications of pertussis. She also has that problem with swallowing.

Think back to the last time you had a bad coughing fit. It’s gross, but think about the saliva and the mucus. Think about the last time you threw up. Now imagine all that together, along with gasping for air–and not being able to swallow.

If Carrie gets pertussis, she’ll almost certainly get pneumonia. Well, she will if the doctors can keep her from choking to death first. There’s a very good reason that pneumonia is a common complication of pertussis, even without Carrie’s problems.

I don’t know whether she’s strong enough to survive it. Honestly, I’ve been too cowardly to ask. Matt and his wife will know, though. They’ll have been thinking these same things, trying not to let their worry show, as they try to keep her entertained while she’s home from school. Other parents at the school will have been thinking similar thoughts. As I mentioned earlier, Carrie’s school has a large population of medically fragile students. Some of them won’t have had the vaccine for sound medical reasons. How many of them could survive pertussis?

Yeah. No matter how many times I said, "Ow," lifting something over the past few days, no matter how much my hips hurt, it was entirely worth it to know that I'm not passing on something much, much worse to someone else.

So the next time you go to your doctor, have a happy little chat with your nurse, won't you?