July 1, 2013

Maine hoping against whooping cough repeat

Last year's surge began in midsummer, and the severe outbreak totaled 737 cases.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

(Continued from page 1)

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Susan Huff, a Portland Community Health Center medical assistant, administers a pertussis vaccine to colleague Brianna Gonthier. Adults should get a booster shot every 10 years.

John Patriquin/Staff Photographer

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Another factor is the number of pre-teens who miss their booster shots at age 11 for pertussis, tetanus and diphtheria. Sears said the booster shot is not on the radar for many parents, and without the booster, the vaccine's protection starts wearing off.

Of the 737 cases last year, 463 were in the 7-19 age group, according to the Maine CDC. Sixty-nine percent of Maine students ages 13-17 had received their age 11 booster shot, compared with 78 percent nationwide, according to the federal CDC. Maine had the lowest rate of 11-year-olds getting booster shots of any state in the Northeast.

Sears said he would be in favor of a state law that mandates age 11 booster shots as a requirement to attend school.

"That would be a helpful strategy," he said.

Although vaccines are required in Maine, parents sending their children to school can opt out if they sign a statement citing religious or philosophical beliefs opposing vaccines. Most states have some sort of religious or philosophical exemption, but some states require more rigorous documentation, such as a notarized affidavit or a doctor's note, according to the National Vaccine Information Center.

Maine is one of 17 states that allow a philosophical exemption not tied to religious beliefs, according to the vaccine center.

Sears said the anti-vaccination movement is probably not much of a factor in Maine, although it could be in other states where anti-vaccination sentiment is stronger.

"The percentage of people who don't vaccinate their children in Maine is rather small," Sears said. The anti-vaccination movement became more popular in the late 1990s and early 2000s, when some blamed vaccinations for causing autism. Research linking vaccinations to autism has been debunked, according to the Institute of Medicine.

Nevertheless, the pertussis vaccine itself is perhaps not as effective as it was before it was changed in the 1990s in an effort to reduce side effects, Sears said. Researchers with the federal CDC are examining potential solutions, including perhaps introducing a booster shot at age 8, Sears said. The current vaccination schedule includes six shots from childhood through age 11, including booster shots for adults every 10 years.

Sears said that aside from a state law that would require the booster shots for 11-year-olds to enter school, the state is emphasizing public education.

Although the state Department of Health and Human Services is not spending more money on marketing, it is doing more outreach on pertussis with the media, medical professionals and the public.

The message is getting out to the medical community to emphasize vaccines, not only for pertussis, but for other diseases, said Dr. Amy Barksdale of the Portland Community Health Center.

She said pertussis was not discussed much in medical school years ago, probably because it was so rare. And, at the outset, pertussis can be difficult for primary care physicians to diagnose, since in the first few days it can seem like a typical upper respiratory infection.

After a few days of coughing, the "whoop" sound starts to manifest itself, and coughing can be so violent that sufferers have trouble catching their breath, Barksdale said. Antibiotics are used to treat the disease.

To make sure vaccines are a priority, the clinic is now calling patients to remind them they need to come in for their vaccines. Vaccines for pertussis and other diseases are given when children come in for their sports physicals and when patients come in for other reasons, said Susan Huff, a medical assistant at the clinic who manages the vaccine program.

Sears said the state is also making sure that pregnant women are vaccinated for pertussis so that the mother does not pass on pertussis to her infant child. Infants are the most vulnerable to dying from pertussis.

"We're so concerned about the small children," Sears said. "It's a very serious issue if the baby is less than 6 months old."

Joe Lawlor can be contacted at 791-6376 or at:


Twitter: @joelawlorph


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