The ACIP has been researching the problem for more than a year. The committee is in uncharted territory because this type of failure has never occurred with any other vaccine. In June the working group concluded that because the booster's protection against pertussis is so short-lived, adding more shots to the typical regimen would do little to reduce the overall prevalence of pertussis. The group therefore advised the committee not to change policy to include a second booster in adulthood but rather to increase the number of pregnant women who get their booster in the first place. The CDC estimates that currently only 6 percent of pregnant women receive the shot. Yet newborns, who cannot be vaccinated, are the most vulnerable to the dangerous effects of pertussis; improving the immunity of their closest contacts could be the best way to prevent pertussis deaths.
Given the current vaccine's faults, Clark says bluntly that in the general population “there's going to be a lot of pertussis.” But he adds that although pertussis cases are increasing, deaths are not; when vaccinated children develop whooping cough, they have milder symptoms. So the newer pertussis vaccines are still valuable because they reduce not just the likelihood of death and severe illness but also the health care spending—not to mention emotional trauma—that accompany those dire results. On that basis, Sawyer says, public health officials should urge the 90 percent of American teens and adults who failed to get their booster shot to receive one and thereby protect both themselves and the most vulnerable among us. “We do need a new vaccine,” he says. “But we can do a lot better with the ones we have.”
This article was originally published with the title The Pertussis Parable.