A disturbing trend is gaining hold in the United States as parents make the decision not to vaccinate their children according to federal guidelines. With the resulting breakdown of community-wide immunity, vulnerable populations risk exposure to very serious, potentially even life-threatening diseases. Pertussis (also known as whooping cough) is one such vaccine-preventable disease whose rates have been steadily increasing in South Carolina and across the United States.
In 1999, South Carolina had only 26 reported cases, a number that increased to 230 by 2012, with a peak of over 400 cases in 2005. Both Georgia and North Carolina have also shown increased incidence rates of pertussis, a trend common to most states east of the Mississippi.
Newborns and infants too young to be fully vaccinated are particularly vulnerable to pertussis infection and experience severe breathing difficulties that can lead to hospitalization, pneumonia, seizures and even death. The infection rate of infants is up to 80 times greater than that of adults. In 2013 and 2014, there were 26 pertussis-related deaths in the United States — 21 of them were infants less than 12 months old.
The Centers for Disease Control and Prevention (CDC) is the federal organization responsible for promulgating national immunization guidelines. In 2011, the CDC made a recommendation that all adults coming in close contact with infants less than 12 months old receive a one-time tetanus, diphtheria and acellular pertussis (Tdap) vaccination. This CDC recommendation specifically includes child care employees. Unfortunately, not all caregivers in state licensed child care facilities are current with their Tdap vaccinations.
Eleven states address this issue through official regulations. Although South Carolina is not among them, a timely recommendation is currently under review by the South Carolina Governor’s Advisory Committee on the Regulation of Child Care Facilities.
Structures already exist to support this initiative. For example, the Department of Health & Environmental Control (DHEC) has a program in place providing low-cost immunizations to uninsured or under-insured adults. While costs associated with the Tdap vaccination can be a concern, the costs not to vaccinate can be even greater.
Adults infected with pertussis have been found to miss almost 10 days of work for reasons linked directly to their illness. Tdap immunization for child care employees can benefit the individuals receiving the vaccine, the child-care facility in which they work and the community as a whole. However, the greatest benefit rests with helping to prevent pertussis infection in those most at-risk for contracting and being seriously impacted by the disease — infants less than 12 months old.
This issue truly can be one of life or death for these vulnerable children.
Contact your legislators (http://www.scstatehouse.gov/legislatorssearch.php) to help South Carolina take a leadership role in protecting infants.
Jeanette Parker, BSN, R.N.
High Battery Circle