Washington state health officials credit new regulations that made it more difficult for parents to obtain an exemption from the requirement that children to be fully immunized before entering school.

Under the old rules, to obtain an exemption parents only had to sign a certificate indicating that they object on medical, religious or philosophical grounds.

Proponents of the new law said the ease with which exemptions could be obtained in Washington is one reason why the state has the highest vaccine exemption rates in the country.

Under the new law, parents seeking an exemption must get information from a health care provider about the benefits and risks of vaccine before the provider signs a Certificate of Exemption form.

Kids with exemptions tend to cluster geographically, often living in the same areas, going to the same schools — creating “pockets of under-vaccinated children at risk of outbreaks,” Washington state health officials say.

Click on map for more information about exemption rates

Schools with higher exemption rates have higher rates of diseases like measles and whooping cough (pertussis).

Currently, Washington state is in the midst of a whooping cough epidemic with more that 1,000 cases reported so far just this year.

At this rate, the state is projected to see more than 3,000 cases in 2012, the highest rate seen in decades.

Important points:

• All recommended vaccines for Washington children under age 19 are provided at no-cost through the state’s Childhood Vaccine Program.

• Health care providers may charge an office visit fee and a fee to give the vaccine, called an administration fee — but people who cannot afford the administration fee can ask their regular health care provider to waive the cost.

• For help finding a health care provider or an immunization clinic, call your local health agency (doh.wa.gov/LHJMap/LHJMap.htm), visit the ParentHelp123 resource finder (https://resources.parenthelp123.org/) or call the Family Health Hotline (www.parenthelp123.org/resources/family-health-hotline) at 1-800-322-2588.

• Information about the exemption law (www.doh.wa.gov/cfh/Immunize/) is available online.

The total of 1,008 reported as of April 21 is more than reported in all of 2011 and is the highest number of cases since 1,026 were reported in all of 2005.

At this rate, the state is on track to reach more than 3,000 cases for the year; levels that haven’t been seen in more than six decades, officials said.

“We’re very concerned about the risk to infants, especially because of how quickly whooping cough is spreading,” said Secretary of Health, Mary Selecky. “Whooping cough can be life threatening for infants, and they’re too young to get enough doses of vaccine to be protected. That’s why we want everyone else to make sure they’re vaccinated against whooping cough.”

Already this year 71 infants under a year old have been reported to have whooping cough. Eighteen of them have been hospitalized. No babies have died in 2012, but two babies died in 2010 and two in 2011.

Whooping Cough (Pertussis)

Pertussis, the whooping cough bacteria -- CDC photo

Whooping cough, also known as pertussis, is a highly contagious respiratory illness spread by coughing and sneezing.

It is caused by a bacteria called Bordetella pertussis. The name, pertussis, comes from Latin, from per-‘away, extremely’ + Latin tussis ‘a cough.’

According to the U.S. Centers for Disease Control and Preventing, in the 20th century,  pertussis was one of the most common childhood diseases and a major cause of child death in the United States.

Initially, an infection may seem like just a cold. However, during this phase of the infection, which can last several weeks, a person can spread the disease to others.

Patients typically then go on to develop a severe, persistent–often wracking–cough that can last for several more weeks.

The coughing fits can be prolonged and are often followed by a long inhalation that causes the “whooping” sound that gives the disease its name.

The bouts of coughing can leave victims breathless and unable to eat, drink or sleep. Complications of the infection include pneumonia, seizures and death.

Whooping cough can affect people of all ages — but is most serious in infants, especially those too young to get vaccinated or who aren’t fully protected.

There is a vaccine that can prevent infection, but it is not effective in newborns or infants and it wears off with time.

Many cases in the current epidemic are being reported in school age children. The vaccine that young children get wears off over time, so all children age 11-12 should get a whooping cough booster shot, called Tdap, health officials said.

The Tdap vaccine is also recommended for pregnant women and women who recently gave birth.

Getting vaccinated before giving birth helps prevent the mother from spreading the illness to her newborn.

The Department of Health has release a public service announcement featuring Chelsey Charles, a mother whose 27-week-old infant  Kaliah died of whooping cough last year.

“It devastated our family,” Chelsey Charles says. “Don’t wait; go get your Tdap shot before it’s too late for somebody else.”

“This is what we’re trying to prevent,” says Dr. Maxine Hayes, State Health Officer. “When adults get sick with whooping cough it can be miserable, but when babies get the disease, they often must be hospitalized because it’s difficult for them to feed, sleep, and breathe.”

Selecky and Hayes urge all teens and adults to check their immunization status. Many health care providers use the state’s immunization registry and can check which vaccines have been given.

Most health insurance carriers cover the whooping cough vaccine; adults should double check with their health plan.

Whooping cough vaccines are available to all Washington children under 19 years old through health care provider offices participating in the state’s Childhood Vaccine Program.

More information on whooping cough disease and who should be vaccinated is available on Department of Health’s website (www.doh.wa.gov).

The number of reported cases is updated every Tuesday afternoon.

Free vaccine available

Since the beginning of the year, 640 cases of whooping cough have been reported and confirmed in 23 of the state’s 39 counties. At this time last year, only 94 cases had been reported, Sec. Selecky said.

Red represents cases so far this year; blue cases from last year;

The actual number of cases may be far higher, Selecky said, because only about 10 percent to 12 percent of cases are reported. “This is the tip of the iceberg,” she said.

Infants are most vulnerable to the disease, and there have been at four infant deaths in the state due to whooping cough over the past years.

“We’re very concerned about the continued rapid increase in reported cases,” said Secretary of Health Mary Selecky. “This disease can be very serious for young babies, who often get whooping cough from adults and other family members. We want all teens and adults who haven’t had Tdap [a pertussis vaccine] to be vaccinated to help protect babies that are too young for the vaccine.”

In the epidemic continues at its current rate, the state is on track to see the most cases it has seen since 1942, Sec. Selecky said.

Pertussis

Pertussis, the whooping cough bacteria -- CDC photo

Whooping cough, also known as pertussis, is a highly contagious respiratory illness spread by coughing and sneezing.

It is caused by a bacteria called Bordetella pertussis. The name, pertussis, comes from Latin, from per-‘away, extremely’ + Latin tussis ‘a cough.’

According to the U.S. Centers for Disease Control and Preventing, in the 20th century,  pertussis was one of the most common childhood diseases and a major cause of child death in the United States.

Initially, an infection may seem like just a cold. However, during this phase of the infection, which can last several weeks, a person can spread the disease to others.

Patients typically then go on to develop a severe, persistent–often wracking–cough that can last for several more weeks.

The coughing fits can be prolonged and are often followed by a long inhalation that causes the “whooping” sound that gives the disease its name.

The bouts of coughing can leave victims breathless and unable to eat, drink or sleep. Complications of the infection include pneumonia, seizures and death.

Whooping cough can affect people of all ages — but is most serious in infants, especially those too young to get vaccinated or who aren’t fully protected.

There is a vaccine that can prevent infection, but it is not effective in newborns or infants and it wears off with time.

Related article: Vaccine Hesitancy

Seattle’s Child’s lead article this month is a piece by Laura Hirshfield on “Vaccine Hesitancy”. She writes:

“While there is a small, but vocal, minority of parents who outright refuse all vaccines, much more common are parents who choose to skip or delay their children’s vaccines. In a recent Seattle Children’s Research Institute survey, 77 percent of Washington pediatricians reported regularly seeing parents who ask to vary the recommended vaccine schedule.

“Health officials call these parents “vaccine hesitant” and link the statewide rise in outbreaks of whooping cough, a highly contagious, airborne disease, to the rising number of under-vaccinated kids.”

Read the full article on the Seattle’s Child website.

Health officials therefore recommend that anyone who has contact with newborns and infants be vaccinated or, if they have been vaccinated, to make sure their vaccination is up-to-date.

Sec. Selecky urged parents to make sure their children are fully vaccinated and up-to-date and that teens and adults to check to see whether they need a booster.

Because newborns cannot be vaccinated, pregnant women should make sure they are vaccinated because they can transfer some of their immunity to their newborn that will confer some protection during the first months of life.

In addition, being vaccinated will reduce the risk that they will contract the infection and spread it to their child.

“Many adults don’t realize they need to be vaccinated, or they assume they have been,” said State Health Officer Dr. Maxine Hayes. “We’re asking everyone to verify with their health care provider that they’re up-to-date on vaccines. We’re also asking everyone to use good health manners — like cover your cough and stay home when you’re sick — that will also help prevent spreading whooping cough.”

For full information about pertussis vaccines and about who should get vaccinated go to the Department of Health’s pertussis information page: http://www.doh.wa.gov/cfh/Immunize/diseases/pertussis/

Free vaccine available

Pertussis, the whooping cough bacteria -- CDC photo

The number of cases of whooping cough in Washington state increased by more than 50 percent between 2010 and 2011, the State Department of Health reported Wednesday.

Last year there were 912 cases in the state — the highest in six years — up from 608 cases reported in 2010.

In recent years, adolescents and adults have accounted for an increasing proportion of cases, health officials said.

“The number of reported cases is just the tip of the iceberg,” State Health Officer and pediatrician Dr. Maxine Hayes said. “Many young people and adults who get pertussis may not know they have it and don’t seek medical attention.

Whooping cough, also known as pertussis, is a highly contagious respiratory illness spread by coughing and sneezing.

Initially, an infection may seem like a cold, but patients then go on to develop a severe, persistent–often wracking–cough that can last for weeks.

The coughing fits can be prolonged and are often followed by a long inhalation that causes the “whooping” sound that gives the disease its name.

The bouts of coughing can leave victims breathless and unable to eat, drink or sleep. Complications of the infection include pneumonia, seizures and death.

Whooping cough can affect people of all ages — but is most serious in infants, especially those too young to get vaccinated or who aren’t fully protected.

Adolescents and adults often get a much milder case of whooping cough, but they can still spread it, the Department of Health warned.

There is a vaccine that can prevent infection, but it is not effective in newborns or infants. Health officials therefore recommend that anyone who has contact with newborns and infants be vaccinated or, if they have been vaccinated, to make sure their vaccination is up-to-date.

Who should get the vaccine?

The U.S. Advisory Committee on Immunization Practices has issued new pertussis vaccination recommendations:

• Pregnant women to get pertussis vaccine (Tdap) later in pregnancy (after 20 weeks’ gestation). Women who get Tdap vaccine before or during pregnancy pass on extra protection against pertussis to their babies.

• Anyone who takes care of or has close contact with babies to get pertussis vaccine, ideally at least two weeks before beginning close contact with the infant. This includes siblings of infants who should be up-to-date on DTaP and other recommended immunizations.

• Tdap vaccine is available for adolescents and adults through age 64. But adults 65 and older who expect to have close contact with babies younger than 12 months should get a dose of Tdap to help protect the baby from pertussis.

• Health care workers of all ages who have contact with infants should get vaccinated too.

Protection wears off so you may need a booster

Most people get a series of pertussis vaccines when they’re kids, but protection wears off over time. The Department of Health recommends people substitute a Tdap vaccine for one routine tetanus (Td) booster, which is needed every 10 years; people should get it sooner if they’re in close contact with young kids or live in an area where there are pertussis cases. There’s no minimum time period between getting Td and Tdap vaccines. Only one Tdap vaccine is recommended in a person’s lifetime.

Vaccines available for free for kids under 19

All recommended vaccines are offered to all kids under 19 at no cost through health care provider offices participating in the state’s Childhood Vaccine Program.

Health care providers may charge an office visit fee and a fee to give the vaccine, called an administration fee.

People who cannot afford the administration fee can ask their regular health care provider to waive the cost.

Adults should talk to their insurance carriers about coverage for pertussis vaccine.

To learn more:

• Visit the PKIDS Online pertussis information page.

• Contact your local health agency  or the Department of Health’s Office of Immunization and Child Profile at 360-236-3595.

Pertussis, the whooping cough bacteria CDC photo

The number of cases of whooping cough in Washington are up sharply this year with 431 cases reported in the state — 53 more than had been reported at this time last year, according to Washingtion State health officials.

The respiratory infection, which is also called pertussis, can cause serious illnesses in all age groups, but babies are particularly vulnerable, health officials said.

Of pertussis cases reported to state officials this month, 58 have been infants under that age of one — 22 of whom required hospitalization and two of whom died.

Pertussis is highly contagious and is easily spread by coughing and sneezing. Infection can cause severe bouts of coughing that are often followed by a long inhalation that causes the “whoop” that gives the disease the name whooping cough.

The coughing fits can leave victims breathless and unable to eat, drink or sleep. Complications include pneumonia, seizures and death.

There is a vaccine that can prevent infection, but it is not effective in newborns or infants. Health officials therefore recommend that anyone who has contact with newborns and infants be vaccinated or, if they have been vaccinated, to make sure their vaccination is up-to-date.

“Older kids and adults can help protect babies by getting the pertussis vaccine,” said State Health Officer and pediatrician Dr. Maxine Hayes. “By being vaccinated, close contacts of infants create a protective ‘cocoon’ for newborns and infants who can’t yet be vaccinated or have not completed their initial vaccine series.”

Most people receive the pertussis vaccine as a child, but the vaccine wears off over time.

The pertussis vaccine (Tdap) is available for adolescents and adults through age 64.

The Department of Health recommends:

• Pregnant women are urged to get vaccinated, as are health care workers of all ages who have contact with infants.

• People of all ages should get immunized if they have close contact with a baby; this is especially important for siblings of infants, who should be up-to-date on DTaP and other recommended immunizations.

To learn more:

• Visit the Department of Health’s whooping cough/pertussis webpage: (www.doh.wa.gov/cfh/Immunize/diseases/pertussis/)
• More information on preventing whooping cough is available by contacting your local health agency (www.doh.wa.gov/LHJMap/LHJMap.htm)

• Or the Department of Health’s Office of Immunization and CHILD Profile (www.doh.wa.gov/cfh/Immunize) at 360-236-3595.