Joanne Faryon, KPBS and Investigative Newsource reporter.
Kevin Crowe, KPBS and Investigative Newsource reporter.
Related Story: Whooping Cough Vaccine Failures Increasing
CAVANAUGH: Two years ago, KPBS news source revealed some troubling information about the pertussis vaccine. The community is taking a second look as doctors explore the mystery of recurring pertussis outbreaks. Joanne Faryon and Kevin Crowe. Remind us about the situation in 2010 that prompted your situation in the first place. Were there a lot of whooping cough cases being reported in San Diego?
FARYON: There were, Maureen. I actually remember the first news meeting in the summer of 2010, when I heard about this, it was Kenny Goldberg who said the county says we're on our way to having an epidemic. And we were all surprised to hear that. Whooping cough is a a childhood disease. I thought it had been wiped out by the vaccine. We picked up the story when it seemed like it just wasn't going away. By late summer, there were thousands of cases reported in the state. Hundreds of cases reported in the county. When we look back at 2010, it was 9,000 positive cases of whooping cough in California, 1,400 of those affected infants. So an epidemic for a disease I thought a lot of us thought went away.
CAVANAUGH: One of the major concerns were the number of infants coming down with the disease. You spoke with the family of Matthew Brice. Tell us about that.
FARYON: Absolutely. Whooping cough, it's an upper respiratory illness. Basically you feel like you have a bad cold F. You're an adult or a little older, you think I have a really bad cold, sometimes the cough will last weeks and weeks. If you are a baby, this is when it becomes very serious. It's actually fatal in infants. Babies are too little, too young to be immunized. They don't get their first shot until they're two months old so much it's that under two months of age when you're especially vulnerable. And they can't cough that stuff up in their lungs that collects, and that's what ends up making them very sick, they end up being hospitalized, and in California we actually had ten babies who died in 2010.
CAVANAUGH: And the Brice family that you spoke with at the time were just --
FARYON: That's right.
CAVANAUGH: They were mystified.
FARYON: They were. This is a family who actually heard us on the radio talking about the vaccine and whooping cough. We were contacted by them. We've been asking for people, has that happened to you? They had just gotten their diagnosis that their baby boy he was three weeks old at the time?
FARYON: They had all been immunized. They did what they were supposed to do when you have a pregnant person in the family, everyone around is supposed to get immunized. So he has two younger sons, he was immunized, are the boys were immunized, and the mom was in the hospital after giving birth. So they had no idea how their baby got this disease. And they were in a similar situation with a lot of the other families who did the same thing.
CAVANAUGH: When you have an infant who is too young to be immunized, what is this cocooning effect? Everyone around them is supposed to be immunized for whooping cough?
CROWE: That's exactly right. And that's what the Brice family was doing. Is this a highly contagious disease, and so if people around you aren't immunized, they may just feel like they have a bad cold or something, they could transmit this to an infant, and then it becomes a real problem.
CAVANAUGH: Therefore it all comes back to the vaccine. As you you said, everybody was immunized around this little baby. What did your investigation uncover at that time about the vaccine?
FARYON: Initially what we saw, every time, or about once a week, San Diego County health and human services would issue a press release, six new positive cases, 10-case, and down below they would say this is a 2-year-old or a 5-year-old, and they would say immunization status is up-to-date. So I thought is anyone adding all this up? I added it up and found that the majority of people in San Diego County who got whooping cough were up-to-date with their immunizations. Then KPBS went to investigative newssource, went to Kevin who's a data expert, and said what do we do next?
CROWE: Well, we requested the information from the California department of public health. It's always easy to get tops of information from one source but they get their information from the individual county departments of public health. So we ultimately sent it out to about 15 or 17 -- we requested this information from the most-affected counties, so the counties that had the highest number of case, and we found there were pretty similar rate was people who had been fully immunized against pertussis but were being diagnosed with the disease. One county was as high as 80%, and some other lower, around 40%. But statewide, it was still a majority.
CAVANAUGH: So you found that there seemed to be developing this idea that there were a lot of people who were immunized against this disease who shouldn't have gotten it were getting it. What was the reaction from the medical community at that time?
CROWE: Well, at that time, and this is a good time to note that this is not a vaccine that's 100% effective. So the package inserts on the vaccines that tell you how effective it's supposed to be, the efficacy rating is about 85%. So you would expect to see some people who had been immunized getting sick. And this was a pretty common refrain that we were getting from public healthy officials, and from doctors and experts around the country. But some other people were also -- they've come around since to say, yes, it was far more than we expected. So back then they were saying this is what we expected to see. Now they're saying, well, no, it wasn't exactly what we expected to see. It's happening much more rapidly. Immunity is waning much more rapidly than we expected.
CAVANAUGH: You heard from a doctor --
FARYON: Exactly, this is James Cherry, UCLA, one of the world's leading experts on pertussis. This is him in 2010 when we asked what do you make of this?
NEW SPEAKER: There's absolutely no evidence that either of the two vaccines that are most common today used in the U.S. that there's increased vaccine failure with either of those vaccines.
FARYON: That's him in 2010. That failure, what he's referring to is if you're immunized, and still get the disease. Now, doctor James cherry from two weeks ago. We said what now? And here he is.
NEW SPEAKER: 2010, my first thought, well, continued better observation plus better tests. But then my friends up at the California department of public health started saying, well, vaccine failure is a much bigger part of this. And I agree with them.
CAVANAUGH: Vaccine failure, that's an interesting term. Now I know that you found out there is a change in the vaccine that the U.S. was administering in the 1990s that may have something to do with the fact that it's not working as well?
FARYON: That's a theory. And in front of me, I have some papers that were published in scientific journals, and some of these papers make reference to the change in the vaccine. What happened prior to 1977, the U.S., a lot of countries actually used vaccines called wholesale vaccine, and it has a lot bit of the virus in it. It was associated with some serious side effects. There were never really any scientific studies to back up some of these claims in terms of what it was doing, but there was an association of infants, young kids basically having seizures, some fairly serious side effects. So as a result the U.S. switched vaccines, they started using an A-cellular vaccine. Now there's a theory that suggests these kids who have only had the A-cellular vaccine their whole life, are they the ones most vulnerable to getting pertussis even though they have been immunized? Maybe the protection with the new vaccine is not as great as it was with the old vaccine.
CAVANAUGH: And also isn't there -- aren't doctors perhaps thinking about that the bacteria itself has changed, mutated over the years?
CROWE: Right. There are some people around the world who are saying that there's an epidemic or outbreaks going on in Australia right now, there's a leading global scientific named Fritz moi who contends that this is not only a vaccine problem and that it's not as effective as it should be, but it's not effective as it should be because the virus has changed. And it's producing more toxin and making us sicker.
CAVANAUGH: So what are doctors tell us to do now?
CROWE: Well, get immunized. Just because the vaccine is not as effective as they say it is, just because some of the studies are saying it's not as effective as companies say it is, it is still the single best tool that exists today to combat these epidemics and outbreaks. It is still the best production that you can have. So you should probably get a booster, make sure your kids are up-to-date with their immunizations.
FARYON: And here's the thing. Kevin spoke with the California department of public health who we spoke to two years ago and Kevin interviewed, and the head of California department of health said, no, your findings, what you're seeing is not a reflection of the efficacy of the vaccine. So we went back to them as well two years later and said we now have science that says wait a minute, vaccine failure is greater than we exist thought. What do you think?
CROWE: This is doctor Gill Chavez.
NEW SPEAKER: From a public health perspective, when you are in that position of trying to prevent outbreaks and epidemics, you use the best tool that you have at your disposal. And the vaccine worked to a large degree. Even with issues with efficacy and issues of waning immunity, we have large numbers of people that get vaccinated and are protected for large periods of time.
CAVANAUGH: I want to bring us to the last clip that you brought with us. This is mark Sawyer of Rady Children's Hospital here in San Diego basically saying that perhaps another booster is needed, right?
FARYON: That's right. Kids in California are required to get six doses of pertussis vaccine. The last one is before they enter middle school. Now he's considering recommending because he's on the CDC's committee for immunization recommending a seventh dose. Here he is now.
NEW SPEAKER: We're seeing waning immunity over time. So it would suggest that we may need more boosters in order to keep elevating the immune system before we come up with a vaccine that has longer protection.
CAVANAUGH: What about a new vaccine?
CROWE: That's a great question. I've exchanged some messages with the folks at one of the leading vaccine manufacturers in the world, and the makers of only one of two companies that sell these vaccines in the United States, and they say that yes, around the globe they are working on new pertussis vaccines. They say they're new and improved, but the mechanism that fights the pertussis in there is going to be the same kind of mechanism as it is in the old vaccine. I think it's probably too early to say anything about that, and they were probably very purposefully vague in their statements. But they are working on some, and some of them are going to be studied for use in the United States.
CAVANAUGH: One of the important parts we're talking about this now is not to just did back two years ago and say our statistics were right. But the larger issue really is that the United States again finds itself in the middle of an outbreak.
CROWE: That's right. And these things happen sporadically. In places like Washington, Wisconsin, Minnesota, they're seeing thousands of diagnosis. So it's a continuing problem. Here in California this year has been mum's the word. So there's really not a lot going on. Statewide, there are only about 160-case, and in San Diego County, it's only in the neighborhood of 70.
FARYON: Cyclical, as Kevin mentioned, and also immunization. This 2010 we went through it, a lot of people got immunized. So our story is not about don't get immunized. Our story about officials still say this is the best way to protect yourself. Even if you still get it, you're going to get a more mild case of whooping cough.
CAVANAUGH: Well, you went back to visit little Matthew Brice. What is he like?
FARYON: The dad was a reservist, and he's been deployed to Germany. So we talked to marlin via Skype. The mom Cindy was there, and three boys. Little Matthew is now 22 months old. He's talking, running around, being a regular toddler. They're obviously relieved that their son made it through all of this. And they're very saddened obviously that other babies didn't. They're glad they told their story. I think it had a lot of impact because you saw through the eyes of a family why this matters. This is about somebody's baby.
CAVANAUGH: It wasn't just a statistical mystery.
CAVANAUGH: It had real life consequences.
CAVANAUGH: Where can listeners find out more?
FARYON: They can see the Brice family tonight on evening edition. And also our website, KPBS.org, we linked to all these studies. And Kevin's got some great graphs there.
CAVANAUGH: I want to thank you both.