New for Back to School: Meningitis, Whooping Cough Vaccines

They offer stronger protection against two worrisome diseases, experts say

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HealthDay Reporter

THURSDAY, Aug. 18, 2005 (HealthDay News) -- Back to school often means back to the doctor for recommended vaccines.

But this year, health experts are touting breakthrough vaccines for meningitis and pertussis, also known as whooping cough.

In both cases, the vaccines are safe enough to be used by 11-year-old children, providing youngsters protection they have not had to this point, doctors say.

Vaccines have eradicated smallpox in the United States, eliminated wild polio virus and significantly reduced the number of cases of measles, diphtheria, rubella and other diseases, according to the National Partnership for Immunization. However, tens of thousands of Americans still die from these and other vaccine-preventable diseases.

More frustrating to doctors, 15 percent of adults still don't believe inoculations are necessary to prevent certain diseases. And a persistent rumor linking vaccination with autism has led some parents to keep their children from being immunized.

If diseases such as measles, diphtheria and whooping cough were to resurface unchecked, thousands of American children would die.

"We are pretty complacent about vaccine-preventable diseases, primarily because the vaccines are so effective we rarely see the diseases," said David Neumann, executive director of the National Partnership for Immunization. "It's kind of out-of-sight, out-of-mind."

The new meningococcal vaccine is an important advance because it has been proven to be effective over a longer span of time, said Dr. Paul Offit, chief of infectious diseases for Children's Hospital of Philadelphia.

"The problem was, the earlier vaccines didn't cause long-lasting immunity," Offit said. "Frequent boosting was required."

Meningitis is a viral or bacterial infection of the membranes and cerebrospinal fluid surrounding the brain and spinal cord. Every year, about 3,000 cases of meningococcal disease occur in the United States, according to the U.S. Centers for Disease Control and Prevention. The overall fatality rate is about 10 percent, but it's sometimes higher in young people.

The most dangerous result from the meningococcal bacteria is sepsis, or blood infection, Offit said. "One can be fine one minute, and dead four hours later," he said. "Antibiotics can't help you because they can't be administered quickly enough to be effective."

Meningitis kills fewer people, but can result in long-term permanent disabilities such as hearing loss and brain damage.

The disease is spread by coughing, sneezing, kissing or sharing drinking glasses. College freshmen living in dorms often skimp on sleep, further lowering their immunity to germs, experts say.

Symptoms include a fever of 101 degrees or higher, a stiff neck, a purple rash, vomiting and headache.

The CDC recommends giving the new vaccine to children at age 11; children at age 15, if they have not received the vaccine before; and college students living in the close quarters of dormitories.

The new pertussis vaccine also is a relief to doctors, as whooping cough is the only vaccine-preventable disease that has not been quelled. In 1998, there were 7,405 reported cases; in 2002, there were 9,771 in the United States.

Doctors believe the problem was with the vaccine, which could not be given to older children.

"The problem with the original vaccine is when given to kids over 7, it caused some pretty severe reactions," Offit said.

That meant that children would receive as many as five combination diphtheria-tetanus-pertussis shots by age 7, but afterward only receive a diphtheria-tetanus booster. Their vaccination against pertussis was good, but not perfect, as the vaccine's effectiveness deteriorated after five years.

There is a very low risk of death from pertussis, but it can produce a cough so strong that it breaks ribs.

This new form of the vaccine is safe for children aged 10 to 18, and gained U.S. Food and Drug Administration approval in May.

"The public health community is very excited by this new booster shot," Neumann said. "We're optimistic the incidence rates will be driven back down. The challenge will be to get those 11-year-olds back in for their booster shot."

That challenge extends to convincing all parents of the importance of vaccines, following a 1998 article that cited studies of 12 children with pervasive developmental disorder, primarily autism. Eight of the children exhibited behavioral problems that began after they received the measles-mumps-rubella vaccine, according to their parents and doctors.

A report last year from the Institute of Medicine collected all of the available evidence and found no connection between vaccines and autism.

But that has made little difference to many parents, Neumann said.

"We see no evidence for the alleged effects that have been linked with vaccines," he said. "Unfortunately, people who have heard the allegations about vaccines have discounted the science. The rumors persist."

More information

To learn more about vaccines, visit the National Partnership for Immunization.

SOURCES: Paul Offit, M.D., chief, infectious diseases, Children's Hospital of Philadelphia; David Neumann, executive director, National Partnership for Immunization, Alexandria, Va.

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