Originally published on www.healthimpactnews.com
The Pertussis Vaccine Blame Game
It is a primitive bacterial vaccine licensed in 1914. 1 It has not been given to babies in America for 20 years.
It is the vaccine that had brain damaged so many children and caused so many vaccine injury lawsuits 2 that Big Pharma used it to blackmail Congress into giving vaccine manufacturers a partial product liability shield in 1986, which the U.S. Supreme Court made even bigger in 2011. 3
I’m talking about whole cell pertussis vaccine in DPT, a crude brew of whole B. pertussis bacteria heated and washed with formaldehyde 4 but still full of neurotoxic aluminum 5 and mercury 6 along with shock-inducing endotoxin, 7 8 as well as brain damaging bioactive pertussis toxin, 9 10 11 a toxin so lethal that researchers use it to deliberately induce acute experimental autoimmune encephalomyelitis (EAE) in lab animals. 12 13 14
Whole cell pertussis vaccine: the most reactive vaccine still given to infants and children in developing countries because it costs drug companies just pennies to make a dose of it. 15 Whole cell pertussis vaccine, the one that put pressure on the B. pertussis bacterium to mutate into vaccine resistant strains beginning in the 1950s. 16 17
Vaccinologists Beating the Drum to Bring Back Toxic DPT Vaccine
Now some vaccinologists are beating the drum to bring back that nasty old vaccine and give it to newborn babies in America. 18 19 They say they think the toxin-filled whole cell pertussis vaccine in DPT works a little better at preventing whooping cough a little longer than the purified acellular pertussis vaccine in DTaP. They want to “prime” little six to eight-week old babies with ALL the bioactive toxins in the whole cell pertussis vaccine’s crude brew. Apparently they think it is worth the risk to pretend like they have fixed the problem.
In the 1980s, parents of DPT vaccine injured children worked for more than a decade to get the less reactive DTaP vaccine licensed in America because we knew Japan had been using it since 1981 with no reported whooping cough outbreaks and far fewer serious reactions. 20 As public outrage about the reactivity of whole cell pertussis vaccine grew and DPT vaccine injury lawsuits piled up, in 1996 U.S. public health officials finally licensed a purified acellular pertussis vaccine for infants. 21 22 23
Liability Free Vaccine Industry Wants to Re-write History
But they never forgave parents of vaccine injured children for making it happen and, by 1998, they had branded vaccine safety advocates as “anti-vaccine.” 24 25 Now that the U.S. Supreme Court has declared FDA licensed vaccines to be “unavoidably unsafe” and handed drug companies a free “get out of jail” pass for vaccine injuries and deaths, 26 it is starting to look like the goal all along was to eventually bring back the old pertussis vaccine so the vaccine industry never again will have to spend another dime to improve a vaccine the FDA has licensed as “safe.”
The attempt to rewrite history has begun, and the strategy is to rehabilitate the bad reputation of whole cell DPT vaccine so the clock can be turned back.
Vaccinologists may want to rewrite history, but it is harder to do when the facts are so well documented in the medical literature. 27 For those who want to get educated about the history of pertussis and pertussis vaccination, the online Library of Medicine is a great place to start. 28
Pertussis Fact Number One: Described as the “100 day cough,” B. pertussis disease has been around since at least the 16th century, and it can be especially serious for babies who cannot breathe when the sticky mucous produced by the gram negative bacteria clogs their tiny airways. The World Health Organization estimates that globally 85 of children have gotten three pertussis shots, but every year there are about 160,000 children under age five who die from pertussis complications like pneumonia, and over 60 percent of these children live in Africa. 29 30 Mortality from infectious diseases is always higher where people live in poverty, with crowding and poor sanitation, industrial pollution, substandard nutrition, and lack of access to health care facilities. 31
In 2017, there were 15,808 cases of pertussis reported in America with 13 deaths, 32 although most cases of whooping cough are never identified and reported to the government. That’s because you can be infected with pertussis and show few or no symptoms, whether you have been vaccinated or not. 33 34
Pertussis Fact Number Two: After recovering from a pertussis infection, natural immunity is thought to last between seven and 20 years and artificial immunity has been estimated to wane as early as two years after getting vaccinated with either whole cell or acellular pertussis vaccines. 35 36 37 Vaccinated and unvaccinated people can get two or three pertussis infections during their lifetime, and immunity can be asymptomatically boosted after the first infection.
Pertussis Fact Number Three: As early as 1965 and all through the 1980s and 1990s, public health officials in the U.S. and Europe knew that whole cell pertussis vaccine in DPT was not preventing infections in many vaccinated children and previously vaccinated adults. 38 39 40 41 42 43 Just like before DPT vaccination programs, pertussis increases continued to be reported in cycles of three to five years, 44 45 46 47 48 49 including in the U.S. where 95 percent of children had gotten three to five DPT shots. 50 51
It was obvious more than 30 years ago that whole cell pertussis vaccine in DPT was not only highly reactive, but was marginally effective.
Pertussis Fact Number Four: Between 1986 and 1996, multiple clinical trials confirmed that the less reactive acellular DTaP vaccine demonstrated superior efficacy and effectiveness compared to the old and more reactive DPT vaccine. 52 53 54 55 Even so, whooping cough outbreaks continued in the 21st century both in countries that had made the switch to the improved one and in countries that stayed with the more reactive old one.56 57 58 59 60 By 2006, U.S. health officials recommended booster doses of acellular Tdap vaccine for teenagers. 61 Then, in 2010, the Tdap booster shot was found to be only about 66 percent effective. 62
Frustrated by continuing reports of whooping cough cases in vaccinated children, by 2012 the false narrative being forwarded in the U.S. media was to blame whooping cough outbreaks on acellular DTaP vaccine, 63 while also pointing a finger at a tiny minority of unvaccinated children and the availability of personal belief exemptions in state vaccine laws. 64 65
Vaccinologists in the U.S. piled on the acellular vaccine 66 67 68 69 70 and, when FDA researchers reported in 2014 that infant baboons given whole cell pertussis vaccine cleared pertussis infection more rapidly than those given acellular vaccine, 71 the drum beat to resurrect whole cell DPT began to get louder. 72 73 74 75 76
In July 2018, the obedient US media hyped a small study out of California promoting the idea that whole cell pertussis vaccine stimulates a broader type of immunity that lasts longer than acellular pertussis vaccine. 77 The by-now familiar refrain was that it would be better to give babies a couple of doses of the old admittedly more reactive whole cell pertussis vaccine followed up by booster doses of acellular vaccine.
The public was being softened up to accept the unacceptable.
Pertussis Fact Number Five: It is important to remember that both the old and newer pertussis vaccines only provide temporary immunity that wanes within two to five years. Vaccinated people can become “silent reservoirs” of subclinical pertussis infection and transmit whooping cough without even knowing it. 78 79 80
That is because there is a big difference between a vaccine that prevents infection and a vaccine that prevents disease and symptoms of infection. 81 This difference explains why pertussis vaccine induced herd immunity has always been a myth, an illusion created when asymptomatic boosting of pertussis immunity through natural infection occurs in highly vaccinated populations. 82 83 84 85
But wait, there is more.
Everybody knows about how the indiscriminate use of antibiotics has led to virulent antibiotic-resistant strains of bacteria, which evolved to evade those miracle drugs that do save lives when doctors prescribe them properly. Well, the same thing has happened with the B. pertussis bacterium, which started evolving to become vaccine resistant soon after public health officials and pediatricians prescribed multiple doses of whole cell DPT vaccine for all children.
As I explained in my 2016 commentary, Pertussis Microbe Outsmarts the Vaccines As Experts Argue About Why, bench scientists have been publishing scientific evidence for more than 20 years that vaccine-resistant B. pertussis strains began to emerge after whole cell pertussis vaccine was licensed in the late 1940s and beforeacellular pertussis vaccine was licensed in the mid 1990s. 86 Public health officials at the CDC and around the world admitted in 2014 that “most mutations in genes encoding acellular vaccine components arose in the period in which the whole cell vaccine was used.” 87
Pertussis Vaccines Don’t Contain Circulating B. Pertussis Strains
The science on that point is clear: The B. pertussis bacterium adapted to whole cell pertussis vaccination programs to survive, and now that evolutionary process is accelerating. 88 89 Today, none of the whole cell or acellular pertussis vaccines doctors routinely administer to children and pregnant women contain the mutated B. pertussis strains widely circulating and causing whooping cough in human populations. 90 91
The inconvenient truth is that mutated, vaccine resistant pertussis strains are being identified more often in vaccinated persons than in unvaccinated persons. 92
So why would any rational thinking person with an ounce of moral integrity suggest that subjecting newborn babies to the more reactive pertussis vaccine is the solution to preventing whooping cough, when none of the pertussis vaccines contain the new pertussis strains causing whooping cough today?
Vaccinologists and Basic Science Knowledge Gaps
After a century of pertussis vaccination programs, vaccinologists still do not know how pertussis infections – or many other infections – stimulate long lasting cell mediated and humoral immunity in the body. 93 That lack of basic scientific knowledge is why they don’t know how to make vaccines that provide long lasting artificial immunity and why they don’t have correlates for immunity to accurately measure what kind of immunity vaccines do or do not provide. 94 95
After a century of global vaccination, vaccinologists also admit they still do not understand why and how natural infections or vaccines cause complications that can lead to brain damage and death and they don’t know how to accurately identify who is more susceptible to harm. 96 9798 That is why they don’t know how to make vaccines that are free from serious side effects. 99 100
And after a century of laws requiring infants and children to get a growing list of old and new vaccines, there is little effort being made to find how many of those vaccines have caused or will cause microbes to evolve into more virulent, vaccine resistant forms. 101 102 103 104
Doctors and Patients Kept in the Dark
Vaccination is often hailed as the greatest achievement in the history of medicine, but doctors giving vaccines and people getting them have been kept in the dark about just how much is not known about vaccine risks and failures. So when a healthy child or pregnant women gets vaccinated and dies, or is never well again, doctors kept in the dark are conditioned to tell mothers kept in the dark that the vaccine or combination of vaccines just given had nothing to do with it.
Vaccine policy and law has preceded the science and it is especially true when it comes to pertussis vaccination. You only have to read articles in the medical literature about long standing problems with pertussis vaccine toxicity and potency tests to find out how much vaccinologists don’t know about the safety and effectiveness of pertussis vaccines. 105 106
Whole Cell DPT Vaccine: Most Reactive Vaccine on Market Today
For young parents, who may not be familiar with the bad side effects of whole cell DPT vaccine, you can learn more by accessing hyperlinked references to the medical literature at the end of this commentary. To give you an idea about what you will learn, following are a few facts about the old whole cell pertussis vaccine that stopped being given to infants in America in the late 1990s:
- In 1933, the whole cell pertussis vaccine was reported to kill infants without warning. 107
- By the 1960s, the medical community knew that whole cell pertussis vaccine could cause convulsions and brain damage in children. 108 109
- By 1981, there was little doubt that whole cell pertussis vaccine is the most reactive vaccine ever given to infants and children, second only to smallpox vaccine. 110 111 112
In 1982, the eyes of parents in America were opened by the award winning television documentary DPT: Vaccine Roulette, followed by parents founding the organization known today as the National Vaccine Information Center and the publishing of the book DPT: A Shot in the Dark in 1985. 113 The reactivity of DPT vaccine was out in the open and mothers were sharing their first hand experiences of how they watched their babies suffer terrible DPT vaccine reactions.
Between 50 and 80 percent of babies who get whole cell DPT shots run fevers, and experience pain, redness and swelling at the site of the injection, and many of them are more fussy or lose their appetite for a day or two. 114 If DPT vaccine reactions were confined to sore arms and legs or low fevers and a little extra fussiness, there would never have been a call by parents to make that old vaccine less reactive.
No, the fact is that, for nearly a century, whole cell pertussis vaccine has been notorious for causing far more serious reactions like high-pitched screaming (also known as the encephalitic cry) 115 and hypotonic/hyporesponsive episodes (also known as collapse/shock), 116 and febrile or afebrile convulsions (also known as seizures) 117 118 and brain inflammation (also known as encephalitis, encephalomyelitis and encephalopathy). 119 120 121 Between 25 and 60 percent of children who develop acute encephalitis or encephalopathy or have convulsions, including febrile convulsions – for any reason – are left with some kind of brain like personality changes, developmental delays and learning disabilities, ADHD, seizure disorders, lower IQ, speech, motor and behavior disorders and other disabilities. 122 123 124 125 126
The Science Is Clear: DPT Injures and Kills More Often Than DTaP
- A 1981 U.S. study funded by the FDA and conducted at UCLA found that 1 in 875 DPT shots was followed by a convulsion or collapse/shock reaction. 127 Some of the children in that study were left with neurological problems and low IQs.
- The 1981 British National Childhood Encephalopathy Study (NCES) estimated that the risk for a previously healthy child developing a serious neurological problem within seven days of DPT vaccination was 1 in 110,000 DPT shots and the risk of chronic brain dysfunction was 1 in 310,000 DPT shots. 128 Some of the children in that study were left with brain damage manifested by “neurologic, motor, sensory, educational behavioral and self-care dysfunctions.” 129
- In 1985, CDC officials reported that children who experienced a neurological problem after DPT vaccination had a 7 times greater risk if they had a personal history of convulsions and a 4.5 times greater risk if they had a family history of convulsions. 130
- In 1991 and 1994, two Institute of Medicine committees analyzed the scientific evidence and confirmed that DPT vaccine can cause acute encephalopathy and brain damage in previously healthy children. 131 132
- Most developing countries still use whole cell DPT and, in 2018, Brazil reported that adverse events following DPT and DPT-Hib shots account for more than 75 percent of reported childhood vaccine reactions; 133
- In the U.S. vaccine injury compensation program (VICP), DPT vaccine is the vaccine with the most injury claims filed, including for death, and it is the second most compensated vaccine injury claim, with influenza vaccine now in first place. 134
- DTaP vaccine still generates a significant number of adverse reaction reports 135 136 but, with few exceptions, multiple studies confirm that DTaP vaccine is up to two-thirds less reactive than DPT vaccine. 137 138 139 140 141
To all those doctors out there who think you have a problem with public trust in vaccine safety today, 142 143 just wait until you try to strong arm mothers and fathers in America to give their newborn babies that nasty old whole cell pertussis vaccine.
But wait, there is more.
In 2015, the World Health Organization issued a new pertussis vaccine position paper to give doctors in every nation their marching orders. 144 In that paper, global public health officials rejected nearly a century of scientific evidence documenting the toxicity and risks of whole cell pertussis vaccine. They said that, except for anaphylaxis, there are no contraindications to giving children any type of pertussis-containing vaccine.
No contraindications. No medical exemptions. Not for children who are sick at the time of vaccination or have suffered high pitched screaming, collapse, convulsions and brain injury within hours, not for children who almost died after vaccination.
Who paid for this scientifically illiterate position paper that cruelly devalues the lives of individual children? The four top funders of the World Health Organization are the U.S. government, the Bill and Melinda Gates Foundation, the British government and GAVI, the Vaccine Alliance, which includes the largest vaccine manufacturers in the world. 145
If this can be done with pertussis vaccine, it can be done with every future vaccine that Pharma is creating and governments will recommend and mandate, from cytomegalovirus and strep B to syphilis and HIV. 146 147 148 149
The End Game: Forced Vaccination, No Exceptions
This is the End Game being played out on the world stage that I have been warning since 1993 was coming, the day when every vaccine that the pharmaceutical industry creates and government health officials recommend will be forced on you and your children. 150 151 No questions, no mercy, no exceptions.
We, the people, are the barrier that stands between our children and grandchildren and the toxic whole cell pertussis vaccine the vaccine industry wants to bring back to America so they can rewrite history and turn the clock back.
Before the drum beat gets any louder, 152 it is up to each one of us to stand up and defend freedom of thought and speech and conscience in America so we can protect our right to know and freedom to make voluntary vaccine decisions for ourselves and our children.
Nobody Will Save You But You
Nobody will save you and your family from what is coming tomorrow except the action that you, personally, take today. Please share this commentary with your family and friends and make an appointment to speak with your elected representatives. Sign up to use the free online NVIC Advocacy Portal and join with other concerned citizens in your state who want to stop the liability free vaccine industry from continuing to exploit the health of our children and our nation.
It’s your health. Your family. Your choice.
Read the full article at NVIC.org.
3 National Vaccine Information Center. NVIC Position Statement on the National Childhood Vaccine Injury Act of 1986. May 2018.
5 Mold M, Shardlaw E, Exley C. Insight into the cellular fate and toxicity of aluminum adjuvants used in clinically approved human vaccinations. Sci Rep 2016; 6: 31578.
6 Burbacher TM, Shen DD et al. Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury or Vaccines Containing Thimerosal. National Center for Biotechnology Information, U.S. National Library of Medicine Apr. 21, 2005.
7 Geier DA, Geier MR. Clinical Implications of Endotoxin Content in Vaccines. Ann Pharmacother 2002; 36(5).
8 Brito LA, Singh M. Acceptable Levels of Endotoxin in Vaccine Formulations During Preclinical Research. Journal of Pharmaceutical Sciences 2011; 100(1): 34-37.
9 Steinman L, Weiss A et al. Pertussis toxin is required for pertussis vaccine encephalopathy. Proc Natl Acad Sci 1985; 82(24): 8733-8736.
10 Munoz JJ, Arai H. Biological Activity of Crystalline Pertussigen from Bordetella pertussis. Infect Immunity 1981; 33(3): 820-826.
11 Donnelly S, Loscher CE et al. Whole cell but Not Acellular Pertussis Vaccines Induce Convulsive Activity in Mice: Evidence for a Role for Toxin-Induced Interleukin-1B in a New Murine Model for Analysis of Neuronal Side Effects of Vaccination. Infect Immun 2001; 69(7): 4217-4223.
12 Linthicum DS. Development of acute autoimmune encephalomyelitis in mice: factors regulating the effector phase of the disease. Immunobiology 1982; 162(3): 211-220.
13 Sidey FM, Furman BL, Wardlaw AC. Effect of hyperreactivity to endotoxin on the toxicity of pertussis vaccine and pertussis toxin in mice. Vaccine 1989; 7(3): 237-241.
14 Changming L, Pelech S et al. Pertussis toxin induces angiogenesis in brain microvascular endothelial cells. J Neuroscience Research 2008; 86(12): 2624-2640.
15 Patel MK, Patel TK, Tripathi CB. Diphtheria, pertussis (whooping cough) and tetanus vaccine induced recurrent seizures and acute encephalopathy in a pediatric patients: Possibly due to pertussis fraction. J Pharmacol Pharmacother 2012; 3(1): 71-73.
16 Heikkinen E, Kallonen T et al. Comparative Genomes of Bordetella pertussis Reveals Progressive Gene Loss in Finnish Strains. PLos One September 2007; 9.
17 Schmidtke AJ, Boney KO et al. Population Diversity among Bordetella pertussis Isolates, United States, 1935-2009. Emerg Infect Dis 2012; 18(8): 1248-1255.
18 DeAngelis H, Scarpino SV et al. Epidemiological and Economic Effects of Priming With Whole Cell Bordetella pertussis Vaccine. JAMA Pediatr 2016; 170(5): 459-465.
19 Offit PA. Should We Bring Back the Whole Cell Pertussis Vaccine? Medscape Apr. 29, 2016.
20 Sato Y, Kimura M, Fukumi H. Development of Pertussis Component Vaccine in Japan. The Lancet 1984; 323(8369): 122-126.
21 Institute of Medicine. Pertussis and Rubella Vaccines: A Brief Chronology (Appendix B, pp. 320) In: Adverse Effects of Pertussis and Rubella Vaccines. The National Academies Press 1991.
23 CDC. Notice to Readers Food and Drug Administration Approval of an Acellular Pertussis Vaccine for the Initial Four Doses of the Diphtheria, Tetanus, and Pertussis Vaccination Series. MMWR Aug. 9, 1996; 45(3): 676-677.
24 Gangarosa Ej, Galazka AM et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet 1998; 351 (9099): 356-361.
25 Poland GA, Jacobson RM. The age-old struggle against the antivaccinationists. N Engl J Med 2011; 364(2): 97-99.
26 NVIC. National Vaccine Information Center Cites “Betrayal” of Consumers by U.S. Supreme Court Giving Total Liability Shield to Big Pharma. BusinessWire Feb. 23, 2011.
29 World Health Organization/UNICEF. A record 123 million children were immunized globally in 2017 but millions of children are still not reached by potential life saving vaccines. 2017.
30 Yeung KHT, Ducios P et al. An update of the global burden of pertussis in children younger than 5 years: a modeling study. Lancet Infect Dis 2017; 9: 974-980.
33 Long SS, Wellson CJ, Clark JL. Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomology. J Infect Dis 1990; 161(3): 480-486.
35 Trollfors B. Bordetella pertussis whole cell vaccines – efficacy and toxicity. Acta paediatrica Scandinavia 1984; 73(4): 417-425.
36 Wendelboe AM, Van Rie A et al. Duration of immunity against pertussis after natural infection or vaccination. Pediatr Infect Dis J 2005; 24(Suppl 5): S58-S61.
37 Matthias J, Pritchard S, Martin SW et al. Sustained Transmission of Pertussis in Vaccinated, 1–5-Year-Old Children in a Preschool, Florida, USA. Emerging Infectious Diseases Jan. 15, 2016.
38 Nelson JD. The changing epidemiology of pertussis in young infants. The role of adults as reservoirs of infection. Am J Dis Child 1978 132(4): 371-373.
39 Fine PEM, Clarkson JA. The Recurrence of Whooping Cough: Possible Implications for Assessment of Vaccine Efficacy. The Lancet 1982; 1(8273): 666-669.
40 Marchant CD, Loughlin AM, Lett SM et al. Pertussis in Massachusetts, 1981-1991: incidence, serologic diagnosis, and vaccine effectiveness. J Infect Dis 1994; 169(6): 1297-1305.
41 Van Boven M, de Melker HE et al. Waning immunity and sub-clinical infection in an epidemic model: implications for pertussis in The Netherlands. Math Biosci 2000; 164(2): 161-182.
42 Yih WK, Lett SM, desVignes FN et al. The increasing incidence of pertussis in Massachusetts adolescents and adults 1989-1998. J Infect Dis 2000; 182(5): 1409-1416.
43 Tanaka M, Vitek CR, Pascual B et al. Trends in Pertussis Among Infants in the United States, 1980-1999. JAMA 2003; 290)22): 2968-2975.
44 Jenkinson D. Duration of effectiveness of pertussis vaccine: evidence form a 10 year community study. Brit Med J 1988; 296: 612-614.
46 DeSerres G, Boulianne N et al. Pertussis in Quebec: ongoing epidemic since the late 1980’s. Can Commun Dis Rep 1995; 21(5): 45-48.
48 Conley JM, Johnston BL. The role of the acellular pertussis vaccine and the demise of ‘Pertussis Pete.’ Can J Infect Dis 2001; 12(1).
49 Bouchez B, Guiso N. Bordetella pertussis, B. parapertussis, vaccines and cycles of whooping cough. FEMS Pathogens and Disease Aug. 4, 2015 (online).
51 Hinman A, Orenstein WA, Schuchat A. Vaccine Preventable Diseases, Immunization and MMWR 1961-2011. MMWR Oct. 7, 2011; 60(04): 49-57. https://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a9.htm
52 Bernstein DI, Smith VE et al. Comparison of acellular pertussis vaccine with whole cell vaccine as a booster in children 15 to 18 months and 4 to 6 years of age. Pediatr Infect Dis J 1993; 12(2): 131-135.
53 Edwards KM, Meade BD et al. Comparison of 13 Acellular Pertussis Vaccines: Overview and Serologic Response. Pediatrics 1995; 96(3).
54 Greco D, Salmao S et al. A Controlled Trial of Two Acellular Vaccines and One Whole Cell Vaccine against Pertussis. N Eng J Med 1996; 334: 341-349.
55 Gustafasson L, Hallander HO et al. A Controlled Trial of a Two-Component Acellular, a Five-Component Acellular, and a Whole Cell Pertussis Vaccine. N Eng J Med 1996; 334: 349-356.
56 Van Boven M, de Melker HE et al. Waning immunity and sub-clinical infection in an epidemic model: implications for pertussis in The Netherlands. Math Biosci 2000; 164(2): 161-182.
57 Srugo I, Nenilevi D et al. Pertussis Infection in Fully Vaccinated Children in Day Care Centers, Israel. Clin Infect Dis 2000; 6(5): 526-529.
58 Brooks DA, Clover R. Pertussis infection in the United States: Role of Vaccination of Adolescents and Adults. J Am Board Fam Med 2006; 19(6): 603-611.
59 Vickers D, Ross AG et al. Whole-cell and acellular pertussis vaccination programs and rates of pertussis among infants and children. CMAJ 2006; 175(10): 1213-1217.
60 Dashti AS, Karimi A et al. Serologic Evidence of Pertussis Infection in Vaccinated Iranian Children. Iran J Med Sci 2012; 37(4):
61 Centers for Disease Control (CDC). Prevention and Control of Influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR July 28, 2006; 55(RR10): 1-42.
62 Wei SC, Tetti K, Cushing K et al. Effectiveness of Adolescent and Adult Tetanus Reduced-Dose Diphtheria and Acellular Pertussis Vaccine against Pertussis. Clin Infect Dis 2010; 51(3): 315-321.
64 Salzberg S. Whooping Cough Epidemics: Blame the Anti-Vaccine Movement. Forbes Oct. 11, 2016.
65 Jaslow R. 2010 California whooping cough outbreak linked to vaccine adverse parents. CBS News Sept. 20, 2013.
67 Witt MA, Arias L et al. Reduced Risk of Pertussis Among Persons Ever Vaccinated With Whole Cell Pertussis Vaccine Compared to Recipients of Acellular Pertussis Vaccines in a Large US Cohort. Clin Infect Dis 2013; 56(9): 1246-1254.
68 Tartof SY, Lewis M et al. Waning Immunity to Pertussis Following 5 Doses of DTaP. Pediatrics 2013; 131(4).
71 Warfel JM, Zimmerman LI, Merkel TJ. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model. Proc Nat Acad Sci 2014; 111(2): 787-792.
72 Althouse MB, Scarpino SV. Asymptomatic transmission and resurgence of Bordetella pertussis. BMC Med 2015; 13(146).
73 DeAngelis H, Scarpino SV et al. Epidemiological and Economic Effects of Priming With Whole Cell Bordetella pertussis Vaccine. JAMA Pediatr 2016; 170(5): 459-465.
74 Schwartz KL, Kwong JC et al. Effectiveness of pertussis vaccination and duration of immunity. CMAJ Sept. 26, 2016.
75 Locht C. Pertussis: acellular, whole-cell, new vaccines, what to choose? Exp Rev Vaccines 2016; 6.
76 Kovitwanichkanont T. Public health measures for pertussis prevention and control. Aus NZ J Pub Health 2017; 41(6): 557-560.
77 Da Silva Antunes R, Babor M et al. Th1/Th17 polarization persists following whole-cell pertussis vaccination despite repeated acellular boosters. J Clin Invest June 19, 2018.
78 Long SS, Lischner HW et al. Serologic evidence of subclinical pertussis in immunized children. Pediatr Infect Dis 1990; 9(10): 700-705.
80 Zhang Q, Yin Z, Shao LH et al. Prevalence of asymptomatic Bordetella pertussis and Bordetella parapertussis infections among school children in China as determined by pooled real-time PCR: a cross-sectional study. Scand J Infect Dis 2014; 46(4): 280-287.
81 Fine PEM, Clarkson JA. The Recurrence of Whooping Cough: Possible Implications for Assessment of Vaccine Efficacy. The Lancet 1982; 1(8273): 666-669.
82 He Q, Viljanen MK, Nikkari S et al. Outcomes of Bordetella pertussis Infection in Different Age Groups in an Immunized Population. J Infect Dis 1994; 170: 873-877.
83 Aquas R, Goncalves G, Gomes MG. Pertussis: Increasing disease as a consequence of reducing transmission. Lancet Infect Dis 2006; 6(2): 112-117.
84 Lavine JS, King AA, Bjernstad ON. Natural immune boosting in pertussis dynamics and the potential for long term vaccine failure. Proc Natl Acad Sci 2011; 108(17): 7259-7264.
85 Althouse MB, Scarpino SV. Asymptomatic transmission and resurgence of Bordetella pertussis. BMC Med 2015; 13(146).
86 Fisher BL. Pertussis Microbes Outsmarts the Vaccines As Experts Argue About Why. National Vaccine Information Center Mar. 27, 2016.
87 Bart MJ, Harris SR et al. Global Population Structure and Evolution of Bordetella pertussis and Their Relationship with Vaccination. MBio 2014; 5(2).
89 Sealey KL, Harris SR et al. Genomic Analysis of Isolates From the United Kingdom 2012 Pertussis Outbreak Reveals That Vaccine Antigen Genes Are Unusually Fast Evolving. J Infect Dis 2015; 2(15): 244-301.
90 Weber C, Coursaux-Eude C et al. Polymorphism of Bordetella pertussis Isolates Circulating for the Last 10 Years in France, Where a Single Effective Whole-Cell Vaccine Has Been Used for More than 30 Years. J Clin Microbiol 2011; 39(12): 4396-4403.
91 Van Boven M, Mooi FR et al. Pathogen adaptation under imperfect vaccination: implications for pertussis. Proc R Soc B 2005; 272: 1617-1624.
92 van der Ark AAJ, Hozbor DF et al. Resurgence of pertussis calls for re-evaluation of pertussis animal models. (p. 1124). Exp Rev Vaccines 2012; 11(9): 1121-1137.
94 Thakur A, Pedersen LE, Jungersen G. Immune markers and correlates of protection for vaccine induced immune responses. Vaccine 2012; 30(33): 4907-4920.
95 Flaxman A, Ewer KJ. Methods for Measuring T-Cell Memory to Vaccination: From Mouse to Man. Vaccines 2018; 6(43).
96 Institute of Medicine Committee to Review Adverse Effects of Vaccines. Evaluating Biological Mechanisms of Adverse Events: Increased Susceptibility. Chapter 3 (p. 82). Adverse Effects of Vaccines: Evidence and Causality; Washington, DC: The National Academies Press 2012.
97 Institute of Medicine Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule. Summary: Health Outcomes (p. 5-6) and Conclusions About Scientific Findings (p. 11) and Review of Scientific Findings (p. 75-98). The Childhood Immunization Schedule and Safety Stakeholder Concerns, Scientific Evidence and Future Studies; Washington, D.C. The National Academies Press 2013.
98 Casanova JL. Human genetic basis of interindividual variability in the course of infection. Proc Nat Acad Sci 2015; 112(51).
99 Perrie Y, Mohammed AR et al. Vaccine adjuvant systems: enhancing the efficacy of subunit protein antigens. Int J Pharm 2008; 364(2): 272-280.
100 Koenig HC, Sutherland A et al. Application of the immunological disease continuum to study autoimmunity and other inflammatory events after vaccination. Vaccine 2011; 29(5): 913-919.
101 Iwasa Y, Michor F, Nowak MA. Evolutionary dynamics of escape from biomedical intervention. Proc. R. Soc. Lond. B 2003; 270: 2573-2578.
102 Gouma S, Same J et al. Two major mumps genotype G variants dominated recent mumps outbreaks in Netherlands (2009-2012). J Gen Virol 2014; 95: 1074-1082.
103 Kamng’ona AW, Hinds H et al. High carriage and emergence of Streptococcus pneumonia vaccine serotype variants in Malawian children. BMC Infect Dis 2015; 15(234).
104 Munoz-Alia MA, Muller CP, Russell ST. Antigentic Drift Defines a New D4 Subgenotype of Measles Virus. J Virol 2017; 9(11).
105 Ochiai M, Katoako M et al. Evaluation of endotoxin content of diphtheria-tetanus-acellular pertussis combined (DTaP) vaccines that interfere with the bacterial endotoxin content test. Vaccine 2003; 21: 1862-1866.
106 Corbel JJ, Xing DKL. Toxicity and potency evaluation of pertussis vaccines. Expert Rev. Vaccines 2004; 3(1): 89-101.
107 Madsen, T. Vaccination against whooping-cough. JAMA 1933; 101(187).
108 Berg JM. Neurologic Complications of Pertussis Immunization. Brit Med J 1958; 2(5087): 24-27.
109 Strom J. Is Universal Vaccination Against Pertussis Always Justified? Brit Med J 1960; 2(5207): 1184-1186.
110 Kulenkampff, M., Schwartzmann JS, Wilson J. Neurological complications of pertussis inoculation. Archives of Disease in Childhood 1974; 49 46-49.
111 Cody CL, Baraff LJ, Cherry JD et al. Nature and Rates of Adverse Reactions Associated with DTP and DT Immunizations in Infants and Children. Pediatrics 1981; 68(5).
112 Miller DL, Ross EM et al. Pertussis immunization and serious acute neurological illness in children. British Medical Journal 1981; 282:1595-9
114 Barkin RM, Pichichero ME. Diphtheria-pertussis-tetanus vaccine: reactogenicity of commercial products. Pediatrics 1979; 63(2): 256-260.
115 Neuroimmunolgy Clinic, KK Women’s and Children’s Hospital. Encephalitis in Children: Symptoms, Complications and Treatment. Health Xchange 2016.
116 DuVernoy TS, Braun MM, the VAERS Study Group. Hypotonic-Hyporesponsive Episodes Reported to the Vaccine Adverse Event Reporting System (VAERS), 1996-1998. Pediatrics 2000; 106(4).
118 Duffy J, Weintraub E et al. Febrile Seizure Risk After Vaccination in Children 6 to 23 Months. Pediatrics 2016; 138(1).
119 Menkes JH, Kinsbourne M. Workshop on Neurologic Complications of Pertussis and Pertussis Vaccination. Neuropediatrics 1990; 21(4): 171-176.
120 HRSA. Encephalopathy, Encephalitis, Acute Dissemination Encephalomyelitis. Vaccine Injury Compensation Program Vaccine Injury Table. Mar. 21, 2017.
121 Pellegrino P, Carnovale C, Perrone V et al. Acute Disseminated Encephalomyelitis Onset: Evaluation Based on Vaccine Adverse Events Reporting System. PLOS One Oct. 18, 2013.
122 Wolf SM, Forsythe A. Epilepsy and mental retardation following febrile seizures in childhood. Acta Pediatr Scand 1989; 78(2): 291-295.
123 MacDonald BK, Johnson AL et al. Febrile convulsions in 220 children – neurological sequelae at 12 years follow-up. Eur Neurol 1999; 41(4): 179-186.
125 Rao S, Elkon B et al. Long-Term Outcomes and Risk Factors Associated with Acute Encephalitis in Children. J Ped Infect Dis Soc 2015; 1(1): 20-27.
126 Burton KLO, Williams TA et al. Long-Term Neuropsychological Outcomes of Childhood Onset Acute Disseminated Encephalomyelitis (ADEM): A Meta-Analysis. Neuropsychology Rev 2017; 27(2): 124-133.
127 Cody CL, Baraff LJ, Cherry JD et al. Nature and Rates of Adverse Reactions Associated with DTP and DT Immunizations in Infants and Children. Pediatrics 1981; 68(5).
128 Miller DL, Ross EM et al. Pertussis immunization and serious acute neurological illness in children. British Medical Journal 1981; 282:1595-9.
129 Institute of Medicine Committee to Study New Research on Vaccines. DPT Vaccine and Chronic Nervous System Dysfunction: A New Analysis. Executive Summary (pp.1-2) Washington, D.C. The National Academies Press 1994.
130 Stetler HC, Orenstein WA et al. History of convulsions and use of pertussis vaccine. J Pediatr 1985; 107(2): 175-179.
132 Institute of Medicine Committee to Study New Research on Vaccines. DPT Vaccine and Chronic Nervous System Dysfunction: A New Analysis. Executive Summary (pp.1-2) Washington, D.C. The National Academies Press 1994.
133 Lopes SRC, Perin JLR et al. Adverse Events Following Immunization in Brazil: Age of Child and Vaccine-Associated Risk Analysis Using Logistic Regression. Int J Environ Res Pub Health 2018; 15(1149).
134 HRSA. Vaccine Injury Compensation Program (VICP) Data & Statistics. Aug. 31, 2018.
135 Kataoka M, Ochiai M et al. A need for careful evaluation of endotoxin content in acellular pertussis-based combination vaccines. Biologicals 2012; 40 (1): 49-54.
136 Moro PL, Perez-Vilar S et al. Safety Surveillance of Diphtheria and Tetanus Toxoids and Acellular Pertussis (DTaP) Vaccines. Pediatrics 2018; 142(1).
137 Sato Y, Kimura M, Fukumi H. Development of a Pertussis Component Vaccine in Japan. The Lancet 1984; 323 (8369):122-126.
139 Rosenthal S, Chen R, Hadler S. The safety of acellular pertussis vaccine vs. whole-cell pertussis vaccine: A postmarketing assessment. Arch Pediatr Adolesc Med 1996; 159(5): 457-460.
140 Donnelly SA, Loscher CE at al. Whole-Cell but Not Acellular Pertussis Vaccines Induce Convulsive Activity in Mice: Evidence of a Role for Toxin-Induced Interleukin-1 in a New Murine Model for Analysis of Neuronal Side Effects of Vaccination. Infection and Immunity 2001; 69(7): 4217-4223.
141 Shah RC, Shah AR. Pertussis vaccine controversies and acellular pertussis vaccine. Indian Journal of Pediatrics 2003; 70(6): 485-488.
142 Atwell JE, Salmon DA. Pertussis Resurgence and Vaccine Uptake: Implications for Reducing Vaccine Hesitancy. Pediatrics 2014; 134(3).
143 Newsmax. Poll: Most Parents Believe Vaccines are Unnecessary. Sept. 12, 2016.
145 World Health Organization (WHO).Top 20 contributors to the WHO Progamme budget 2016-2017 (US$ millions).
146 Cooley T. New PhRMA Report: Nearly 300 Vaccines Currently in Development. BioTechNow Sept. 11, 2013.
149 Weithorn LA, Reiss DR. Legal approaches to promoting parental compliance with childhood immunization recommendations. Human Vaccines & Immunotherapeutics 2018.
150 Fisher BL. The Moral Right to Conscientious, Philosophical and Personal Belief Exemption to Vaccination. National Vaccine Advisory Committee May 2, 1997 and Debate with Neal Halsey, MD on informed consent to vaccination. Today Show March 1997.
151 Fisher BL. From Nuremberg to California: Why Informed Consent Matters in the 21st Century. National Vaccine Information Center Oct. 24, 2018.
152 Skoff TH, Hadler S, Hariri S. The Epidemiology of Nationally Reported Pertussis in the United States, 200-2016. Clin Infect Dis Aug. 30, 2018.