0:00:10.490,0:00:14.789 JOANNE FARYON: Hello, Iím Joanne Faryon.[br]Welcome to tonightís special, When Immunity 0:00:14.789,0:00:20.200 Fails: The Whooping Cough Epidemic. Weíll[br]explore the worst whooping cough outbreak 0:00:20.200,0:00:26.270 in California in more than 60 years. Just[br]why is a disease that was nearly extinct thirty 0:00:26.270,0:00:31.519 years ago, finding its way back not just in[br]this state, but in other parts of the country 0:00:31.519,0:00:36.980 as well? What we learned may surprise you.[br]There are serious questions about how well 0:00:36.980,0:00:41.830 the vaccine to prevent the disease works;[br]questions government health officials have 0:00:41.830,0:00:48.580 been slow to even ask. KPBS teamed up with[br]the Watchdog Institute, an investigative journalism 0:00:48.580,0:00:54.549 center at San Diego State University, and[br]Radio Netherlands Worldwide to tell this story. 0:00:54.549,0:01:01.239 A story that took us across California and[br]overseas to Amsterdam. But first, we begin 0:01:01.239,0:01:06.740 in a delivery room in a San Diego hospital,[br]where a mother has just given birth to her 0:01:06.740,0:01:07.409 third son. 0:01:07.409,0:01:13.070 [ baby crying ] 0:01:13.070,0:01:20.070 Matthew Jacob Bryce was born Oct 11, 2010.[br]A healthy baby boy, the third boy for Cindy 0:01:21.729,0:01:26.880 and Marlon Bryce. Matthew started showing[br]signs of a cold when he was just two weeks 0:01:26.880,0:01:29.939 old. The Bryce family knew something was wrong. 0:01:29.939,0:01:36.170 MARLON BRYCE: So it just seemed like this[br]cold it was just affecting his breathing. 0:01:36.170,0:01:40.640 FARYON: The family was aware of the whooping[br]cough epidemic in California, from news reports 0:01:40.640,0:01:44.130 REPORTER: State health officials say more[br]than 6,400 cases of whooping cough have been 0:01:44.130,0:01:45.039 reported this year. 0:01:45.039,0:01:46.429 FARYON: And their pediatrician. 0:01:46.429,0:01:52.659 BRYCE: There wasnít any whooping or they[br]always say there is a whooping or a cough, 0:01:52.659,0:01:55.509 he didnít have a cough or anything it was[br]just that there was a cold. 0:01:55.509,0:02:00.869 FARYON: Matthewís doctor suspected it could[br]be whooping cough, also known as pertussis. 0:02:00.869,0:02:06.560 She took a nasal swab and sent it to the lab.[br]She also started Matthew on antibiotics. Six 0:02:06.560,0:02:12.950 days later, with Matthew just 23 days old,[br]Cindy Bryce got a phone call from the California 0:02:12.950,0:02:15.450 Department of Health. The diagnosis was whooping[br]cough. 0:02:15.450,0:02:22.450 M. BRYCE: The moment I heard it I just immediately[br]started thinking the worst because you have 0:02:25.150,0:02:28.720 heard the news about the babies that have[br]passed away. 0:02:28.720,0:02:34.780 FARYON: From January to October this year,[br]10 newborns in California died from whooping 0:02:34.780,0:02:41.170 cough, two in San Diego County. More than[br]7,000 children and adults got sick from the 0:02:41.170,0:02:46.450 disease - the highest number in the state[br]in more than 60 years. Just how did Matthew 0:02:46.450,0:02:51.360 and so many others come down with a disease[br]that is supposed to be preventable with a 0:02:51.360,0:02:57.760 vaccine? Tonight weíll raise questions about[br]the effectiveness of that vaccine. A four-month 0:02:57.760,0:03:03.870 investigation by KPBS and the Watchdog Institute,[br]found many people who have been diagnosed 0:03:03.870,0:03:10.010 with whooping cough were immunized. We also[br]show how government data on the number of 0:03:10.010,0:03:15.700 people diagnosed with whooping cough lacks[br]timeliness and is often inconsistent, begging 0:03:15.700,0:03:19.320 the question: just who is keeping track of[br]this epidemic? 0:03:19.320,0:03:25.210 Weíll show you how some of the experts who[br]influence vaccine policy are financially tied 0:03:25.210,0:03:30.750 to vaccine companies. And, weíll follow the[br]Bryce family as they struggle with their sonís 0:03:30.750,0:03:37.750 diagnosis, and the setbacks in his recovery.[br]Whooping cough, violent cough, the hundred-day 0:03:39.790,0:03:41.800 cough; all names for pertussis. 0:03:41.800,0:03:47.230 DR. JAMES CHERRY: What causes the cough actually[br]we donít knowÖ thereís no other cough quite 0:03:47.230,0:03:48.280 like it. 0:03:48.280,0:03:53.340 FARYON: Pertussis is a respiratory illness[br]caused by the bacterium bordetella pertussis. 0:03:53.340,0:03:59.670 At first, it can mimic a cold. But later produces[br]a violent and persistent cough, a cough that 0:03:59.670,0:04:06.670 leaves children gasping for air ñ creating[br]the distinct whooping sound. For adults, whooping 0:04:06.680,0:04:12.570 cough may only be a nuisance. In fact scientists[br]estimate more than 80 percent of adult cases 0:04:12.570,0:04:18.690 are never diagnosed because most people assume[br]they just have a bad cold. But to infants 0:04:18.690,0:04:22.729 whooping cough can be deadly, especially if[br]not diagnosed early. 0:04:22.729,0:04:29.710 DR. JAMES CHERRY: So with infection that you[br]eventually clear the bacteria and you get 0:04:29.710,0:04:36.710 better. But it's a prolonged, a good percentage[br]of cases will last one or two months. 0:04:39.969,0:04:44.110 DR. FRITS MOOI: After a pertussis infection[br]it has been shown to get super infections, 0:04:44.110,0:04:46.960 in fact that is one of the main complications,[br]pneumonia. 0:04:46.960,0:04:51.680 FARYON: Young babies arenít able to cough[br]up secretions that collect in their lungs, 0:04:51.680,0:04:56.759 leading to pneumonia and making it difficult[br]to breathe. Early antibiotic treatment is 0:04:56.759,0:05:03.020 most critical in this age group. Whooping[br]cough was nearly wiped out by the late 1970ís 0:05:03.020,0:05:08.129 because of mass immunization, but itís somehow[br]found its way back to California and other 0:05:08.129,0:05:13.629 highly vaccinated communities around the world.[br]Just why itís made such a vengeful comeback 0:05:13.629,0:05:18.069 has two of the worldís leading whooping cough[br]experts in disagreement. 0:05:18.069,0:05:19.949 Dr. James Cherry of UCLA: 0:05:19.949,0:05:22.759 CHERRY: The main reason is increased awareness. 0:05:22.759,0:05:26.879 FARYON: and Dr. Frits Mooi of the Netherlands[br]Centre for Infectious Diseases Control. 0:05:26.879,0:05:33.400 MOOI: We found really a new mutation in the[br]bug. 0:05:33.400,0:05:38.710 FARYON: Dr. Mooi and Dr. Cherry both began[br]their research into Whooping Cough about 30 0:05:38.710,0:05:44.819 years ago. Cherry in the U.S. and Mooi in[br]The Netherlands. The two scientists know each 0:05:44.819,0:05:45.499 other's work. 0:05:45.499,0:05:52.499 CHERRY: First of all, his molecular microbiological[br]is, he's right at the top of scholars. There's 0:05:55.180,0:06:02.180 no question about that. I think where some[br]of the things he's published is the clinical 0:06:02.189,0:06:04.020 data are not very good. 0:06:04.020,0:06:09.289 MOOI: I don't communicate too much with him[br]but what he wrote in the press is that I screw 0:06:09.289,0:06:13.249 up epidemiology. That doesn't help me too[br]much. 0:06:13.249,0:06:18.059 FARYON: To understand why these two experts[br]disagree, you need to know a little about 0:06:18.059,0:06:19.849 the history of the pertussis vaccine. 0:06:19.849,0:06:25.599 ANNOUNCER: Since most serious cases occur[br]before school age, immunization in school 0:06:25.599,0:06:26.469 may be too late. 0:06:26.469,0:06:31.979 FARYON: The bacteria that causes whooping[br]cough was first isolated in Belgium in 1906. 0:06:31.979,0:06:35.520 At the time, the illness was one of the leading[br]causes of infant death. 0:06:35.520,0:06:42.520 ANNOUNCER: In 1921, whooping cough killed[br]316 Michigan children. Last year, the number 0:06:44.490,0:06:48.039 of deaths was reduced to 63. 0:06:48.039,0:06:53.080 FARYON: The discovery lead to the first attempts[br]at a vaccine. But it wasnít until the late 0:06:53.080,0:06:57.999 1940ís scientists developed a vaccine effective[br]enough to prevent whooping cough. 0:06:57.999,0:07:01.749 ANNOUNCER: Unlike the disease however, a vaccine[br]does not endanger life. 0:07:01.749,0:07:07.319 FARYON: By 1946, mass immunization programs[br]began in the U.S. and the number of cases 0:07:07.319,0:07:14.319 dropped dramatically. Prior to the vaccine[br]the rate of disease was 157 cases per 100,000. 0:07:14.710,0:07:21.589 By the 1970ís, with large scale immunizations,[br]fewer than one in one hundred thousand people 0:07:21.589,0:07:27.469 got whooping cough. But the vaccine was not[br]without controversy. The early versions were 0:07:27.469,0:07:34.469 associated with side effects such as prolonged[br]crying spells and seizures in babies. By 1996, 0:07:34.559,0:07:40.629 the FDA approved a new whooping cough vaccine.[br]It was called an acellular version. That means 0:07:40.629,0:07:46.629 the vaccine uses only purified components[br]of the disease-causing organism. That vaccine 0:07:46.629,0:07:52.529 was considered to be safer and associated[br]with few mild side effects. Today, the U.S. 0:07:52.529,0:07:59.529 uses only the acellular pertussis vaccine.[br]But as the United States was changing vaccines 0:08:02.279,0:08:09.279 something else was happening ñ health officials[br]across the country were reporting increasing 0:08:09.279,0:08:14.900 numbers of positive whooping cough cases.[br]And in a government lab about 30 minutes outside 0:08:14.900,0:08:20.689 of Amsterdam, a group of scientists had discovered[br]something else ñ the bacterium that causes 0:08:20.689,0:08:23.770 whooping cough started to look a little different. 0:08:23.770,0:08:30.129 MOOI: This new mutation had the effect that[br]the bacteria started to produce more pertussis 0:08:30.129,0:08:30.580 toxin. 0:08:30.580,0:08:35.490 FARYON: Just whether that mutation is to blame,[br]at least in part, for the California epidemic 0:08:35.490,0:08:40.800 and outbreaks elsewhere in the world is at[br]the heart of the whooping cough debate. Dr. 0:08:40.800,0:08:44.279 Mooi believes this to be the case, but not[br]Dr. Cherry. 0:08:44.279,0:08:48.779 CHERRY: Even though these changes have occurred[br]there is no evidence that thatís lead to 0:08:48.779,0:08:53.320 increased vaccine failure. 0:08:53.320,0:09:00.320 FARYON: Here in San Diego County, more than[br]85 percent of children are immunized. In fact, 0:09:02.009,0:09:08.060 less than three percent of kids entering kindergarten[br]have not been immunized because of their familyís 0:09:08.060,0:09:14.459 personal beliefs. But despite the high immunization[br]rate, San Diego has the second largest number 0:09:14.459,0:09:20.480 of positive whooping cough cases in California.[br]Dr. Dean Sidelinger is San Diegoís deputy 0:09:20.480,0:09:21.509 public health officer. 0:09:21.509,0:09:25.399 DR. DEAN SIDELINGER: This is a disease that[br]if someone has it itís very easy to transfer 0:09:25.399,0:09:29.380 from one person to another. So if you or I[br]sitting here during this interview, one of 0:09:29.380,0:09:33.430 us had pertussis chances are we could transmit[br]that to the other person. 0:09:33.430,0:09:38.250 Sidelinger says in the past, the number of[br]whooping cough cases peaked in summer and 0:09:38.250,0:09:41.459 slowed by fall, but this year, that didnít[br]happen. 0:09:41.459,0:09:46.860 SIDELINGER: So as time goes on weíre seeing[br]more cases. We know that public awareness 0:09:46.860,0:09:52.000 plays into that as we talk about pertussis[br]more people are asking their doctors and doctors 0:09:52.000,0:09:55.560 are asking their patients weíre going to[br]see more, but that trend continued. 0:09:55.560,0:10:01.759 FARYON: By the end of November 2010, nearly[br]1000 infants, children and adults in San Diego 0:10:01.759,0:10:06.930 County tested positive for whooping cough.[br]More than half of them had been immunized. 0:10:06.930,0:10:13.250 Our investigation shows that trend continues[br]throughout California. KPBS and The Watchdog 0:10:13.250,0:10:18.290 Institute collected data from 9 California[br]counties that report some of the highest infection 0:10:18.290,0:10:25.069 rates. Our research shows that where immunization[br]history is known, between 44 and 83 percent 0:10:25.069,0:10:30.420 of people diagnosed with whooping cough were[br]vaccinated. We looked at California Department 0:10:30.420,0:10:36.350 of Public Health records too. In cases where[br]vaccination history was recorded, more than 0:10:36.350,0:10:39.269 80 percent of infected people had been immunized. 0:10:39.269,0:10:45.350 DR. MARK HORTON: From the epidemiology experts[br]and the experts in vaccine that this is absolutely 0:10:45.350,0:10:46.019 expected. 0:10:46.019,0:10:50.690 FARYON: Dr. Mark Horton is the director of[br]the California Department of Public Health. 0:10:50.690,0:10:55.319 HORTON: If you've got a percentage of the[br]population vaccinated and a percentage of 0:10:55.319,0:11:00.399 those vaccinated that are still susceptible[br]because the vaccine isn't perfectly effective 0:11:00.399,0:11:05.100 or effective in all individuals, when you[br]work out the arithmetic you'll see that even 0:11:05.100,0:11:10.430 with a very effective vaccine, and even if[br]you have the majority of the population vaccinated, 0:11:10.430,0:11:15.440 the pool of susceptibles will include a number[br]of individuals that have never been vaccinated 0:11:15.440,0:11:20.959 but will also include quite a few and in some[br]cases greater than 50 percent of the individuals 0:11:20.959,0:11:22.339 have been previously vaccinated. 0:11:22.339,0:11:27.569 FARYON: In other words, if you do the math,[br]you will always find a certain number of immunized 0:11:27.569,0:11:31.620 people getting sick if a vaccine is not 100[br]percent effective. 0:11:31.620,0:11:36.519 HORTON: So thatís no surprise to us nor is[br]it a reflection on the efficacy of the vaccine. 0:11:36.519,0:11:39.120 REPORTER KEVIN CROWE: Itís not a reflection[br]on the efficacy of the vaccine? 0:11:39.120,0:11:39.870 HORTON: Correct, correct. 0:11:39.870,0:11:44.730 FARYON: But 20 years ago, the reverse was[br]true. According to a report by the Centers 0:11:44.730,0:11:48.480 for Disease Control, more than half of the[br]children between 3 months and 4 years old 0:11:48.480,0:11:54.380 who got whooping cough nationwide between[br]1990 and 1996 were not immunized. The rate 0:11:54.380,0:11:59.519 of whooping cough has also been increasing[br]for the past 20 years. From less than one 0:11:59.519,0:12:06.519 in 100,000 to 18 per 100,000 here in California.[br]And in some California counties such as San 0:12:07.310,0:12:14.310 Luis Obispo, rates are nearly as high as before[br]vaccines were developed. Two days after our 0:12:14.399,0:12:21.399 interview with the Bryce family, Matthew got[br]a fever. He was hospitalized at Radyís Childrenís 0:12:21.430,0:12:28.430 Hospital in San Diego. Matthew was not immunized[br]against whooping cough. Heís too young. Babies 0:12:28.839,0:12:31.959 canít be immunized until theyíre two months[br]old. 0:12:31.959,0:12:36.230 But everyone else in the Bryce family was[br]vaccinated ñ even his parents got booster 0:12:36.230,0:12:41.889 shots. The practice of immunizing everyone[br]around a newborn baby is called cocooning. 0:12:41.889,0:12:48.199 CINDY BRYCE: When I called the doctor they[br]asked me who has it and I couldnít give them 0:12:48.199,0:12:53.660 an answer because I donít know where he got[br]it from because everyoneís been vaccinated. 0:12:53.660,0:12:58.589 FARYON: Myron and one of his sons were also[br]tested for whooping cough ñ both were negative. 0:12:58.589,0:13:05.589 M. BRYCE: The one thing I would want to know[br]is the vaccine working? Is it as effective 0:13:07.709,0:13:14.709 because before this I thought the vaccine[br]was working and I thought that if I did everything 0:13:19.199,0:13:26.199 that I was told to do that our sons would[br]be protected. 0:13:27.600,0:13:33.100 FARYON: Just how effective is the vaccine?[br]That all depends on who you talk to. Drug 0:13:33.100,0:13:38.319 information included with the two most commonly[br]used whooping cough vaccines in the US say 0:13:38.319,0:13:40.509 the vaccine is 85 percent effective. 0:13:40.509,0:13:46.329 MOOI: This new strain has completely invaded[br]the Netherlands and also other countries and 0:13:46.329,0:13:49.569 pushed out all the other strains. Itís quite[br]unique. 0:13:49.569,0:13:54.279 FARYON: Dr. Mooi believes thereís no way[br]to determine how effective the vaccines are 0:13:54.279,0:13:58.189 because they have not been tested against[br]the new strain of whooping cough. 0:13:58.189,0:14:00.040 MOOI: We call it the p3 strain. 0:14:00.040,0:14:05.310 FARYON: A strain he believes is more virulent[br]and can make people sicker. This strain emerged 0:14:05.310,0:14:08.490 while the new acellular vaccines were being[br]developed. 0:14:08.490,0:14:14.660 MOOI: I can tell you one of the reasons the[br]vaccine companies is not too happy with me 0:14:14.660,0:14:21.660 is because if what I say is true they selected[br]the wrong strains the in the 1980ís. 0:14:23.100,0:14:28.069 FARYON: Mooiís lab was studying the new strain[br]when The Netherlands experienced an unexpected 0:14:28.069,0:14:30.829 whooping cough epidemic in 1996. 0:14:30.829,0:14:32.129 MOOI: There were more strains in fact when[br]you compare the two there was a very direct 0:14:32.129,0:14:38.750 relationship between the emergence of these[br]strains, we call them p3 strains and the increase 0:14:38.750,0:14:40.779 in pertussis notifications. 0:14:40.779,0:14:47.629 CHERRY: Thereís absolutely no evidence that[br]either of the two vaccines that are most common 0:14:47.629,0:14:54.629 today used in the U.S. that there is increased[br]vaccine failure with either of those vaccines. 0:14:55.759,0:15:01.870 FARYON: So if you had to explain why weíre[br]seeing this epidemic the highest number of 0:15:01.870,0:15:03.920 cases in 60 years, what would you tell people? 0:15:03.920,0:15:10.920 CHERRY: The main reason is increased awareness.[br]People, particularly public health people 0:15:12.269,0:15:14.959 are much more aware and that trickles down. 0:15:14.959,0:15:19.839 FARYON: Cherry says the increase is also due[br]in part because of something called waning 0:15:19.839,0:15:24.779 immunity. Immunity to whooping cough does[br]not last a lifetime, whether you are vaccinated 0:15:24.779,0:15:30.810 or develop natural immunity from getting the[br]disease. Almost all experts agree waning immunity 0:15:30.810,0:15:36.879 is contributing to whooping cough outbreaks[br]worldwide. Where they disagree: when does 0:15:36.879,0:15:43.879 immunity fail? Dr. Mooi believes the new strain[br]of pertussis causes immunity to fail sooner 0:15:46.560,0:15:51.100 than in the past. And heís published his[br]findings in several peer reviewed journals 0:15:51.100,0:15:53.709 including the CDCís Infectious Diseases. 0:15:53.709,0:16:00.709 MOOI: When the immunity is sub-optimal what[br]will happen the bacteria will not be recognized 0:16:02.660,0:16:09.660 very well by the immune system because of[br]the mismatch and second of all even if immune 0:16:09.899,0:16:16.899 response is started in the body the toxin[br]will be able to delay it. You could say these 0:16:17.269,0:16:24.269 two changes work together by decreasing the[br]period of which the vaccine is protective 0:16:25.230,0:16:25.860 further. 0:16:25.860,0:16:31.040 FARYON: The Netherlands learned something[br]else after its 1996 epidemic. At the time, 0:16:31.040,0:16:36.670 it had very few samples of the bacteria that[br]was causing people to get sick. So Mooiís 0:16:36.670,0:16:42.040 lab began asking doctors and their labs to[br]send him positive pertussis swabs. His lab 0:16:42.040,0:16:48.240 now has 3,000 samples. California that has[br]collected just 29 samples from the more than 0:16:48.240,0:16:55.120 7,000 whooping cough cases in the state.[br]During the KPBS/Watchdog four month investigation, 0:16:55.120,0:17:01.160 we also learned data kept by the state and[br]the CDC was often lagging behind county data 0:17:01.160,0:17:06.050 and was inconsistent. While counties like[br]San Diego knew the immunization status of 0:17:06.050,0:17:10.490 the vast majority of people with whooping[br]cough, the stateís data listed the information 0:17:10.490,0:17:16.799 as unknown. Despite statewide protocols for[br]reporting pertussis, a KPBS/Watchdog survey 0:17:16.799,0:17:21.839 found some counties donít follow them or[br]are slow to report the information 0:17:21.839,0:17:27.870 HORTON: Thereís a perception that the more[br]numbers the better, but let me be very clear 0:17:27.870,0:17:34.870 we in no way need reports on every single[br]case of pertussis for us to make important 0:17:35.419,0:17:38.140 judgments and decisions about whatís happening. 0:17:38.140,0:17:44.070 FARYON: The CDC in Atlanta declined our requests[br]for an interview. In an email response they 0:17:44.070,0:17:49.510 said it is ìdifficult to disentangle all[br]the factorsî contributing to increases in 0:17:49.510,0:17:56.500 pertussis, but listed ìincreasing transmission,[br]better recognition, and increased laboratory 0:17:56.500,0:18:00.990 confirmation.î We also asked whether a new[br]more virulent strain could be contributing 0:18:00.990,0:18:07.990 to the outbreak. The CDCís response: ìAvailable[br]data do not suggest that ptxP3 is more virulent, 0:18:08.309,0:18:15.029 or that increasing reports are attributable[br]only to the emergence of ptxP3. We continue 0:18:15.029,0:18:21.490 to work on this and other potential explanations[br]for the increase in pertussis that has occurred 0:18:21.490,0:18:27.610 since the 1980s.î The CDC sent us this study[br]by their own investigators. The study looked 0:18:27.610,0:18:33.080 at children between 6 months and five years[br]old. It found pertussis vaccines to be more 0:18:33.080,0:18:40.080 than 90 percent effective. The study looked[br]at data between 1998 and 2001. It did not 0:18:40.409,0:18:42.419 collect pertussis strain information. 0:18:42.419,0:18:49.419 SINGING: Do you happen to know what a T-dap[br]is? It's a special vaccine but it's not just 0:18:50.220,0:18:52.620 for kids. 0:18:52.620,0:18:59.190 FARYON: Sanofi Pastuer, one of two companies[br]that make the vaccine widely used in the U.S., 0:18:59.190,0:19:02.320 sponsored this singing competition earlier[br]this year. 0:19:02.320,0:19:02.750 SINGING: Persussis is the reason why you should[br]call your doctor today. 0:19:02.750,0:19:09.640 FARYON: 0:19:09.640,0:19:15.100 It was a public relations exercise to get[br]the word out about whooping cough and immunization. 0:19:15.100,0:19:20.640 But just where is the line between good PR[br]and trying to influence public health policy? 0:19:20.640,0:19:25.190 SINGING: Take a shot and give pertussis a[br]whooping. 0:19:25.190,0:19:31.900 FARYON: Especially when public health policy[br]can increase vaccine sales. Since 2007, the 0:19:31.900,0:19:37.450 California department of health has spent[br]more than $200 million on pertussis vaccines 0:19:37.450,0:19:44.450 for children on medical or who are under-insured.[br]And itís sure to rise. In September, the 0:19:44.520,0:19:50.240 California state legislature passed a law[br]requiring all students to receive another 0:19:50.240,0:19:56.110 does, a sixth dose of the pertussis vaccine[br]before entering middle school. It may be a 0:19:56.110,0:20:01.150 case of whatís good for business is also[br]good for public health. But how much influence 0:20:01.150,0:20:07.309 does industry have over public health policy?[br]Sanofi Pasteur also established and funds 0:20:07.309,0:20:13.809 The Global Pertussis Initiative. A group made[br]up of medical experts from around the world. 0:20:13.809,0:20:19.720 The GPI was established 10 years ago to study[br]why pertussis was making a comeback and find 0:20:19.720,0:20:24.309 ways to control the disease. More than half[br]its members are employees of the pharmaceutical 0:20:24.309,0:20:30.190 company or receive research money or consulting[br]fees. Public officials from across the country, 0:20:30.190,0:20:36.029 including California and the CDC, site the[br]Global Pertussis Initiative when making vaccine 0:20:36.029,0:20:40.140 policy. Dr. James Cherry is a member of the[br]initiative. 0:20:40.140,0:20:46.010 Heís also received speaking fees and research[br]funds from vaccine manufacturers. At the same 0:20:46.010,0:20:50.929 time, he sat on government committees to help[br]determine vaccine policy and efficacy. 0:20:50.929,0:20:57.929 FARYON: A cynic might say that if you have[br]a community of experts in pertussis as in 0:20:59.330,0:21:04.970 the Global Pertussis Initiative, who primarily[br]their work in terms of this endeavor is being 0:21:04.970,0:21:10.250 funded by the drug company that makes the[br]vaccine, there might be less incentive to 0:21:10.250,0:21:16.179 say make a new vaccine and more incentive[br]to say just use the old one more often. What 0:21:16.179,0:21:17.830 do you say to them? 0:21:17.830,0:21:24.830 CHERRY: I donít think thatís true. I think[br]that weíve been talking about new vaccines. 0:21:25.270,0:21:32.270 It think the difficulty with the new vaccine[br]lies in the expense that it would cost to 0:21:33.480,0:21:40.480 make a new vaccine and the difficulty in testing[br]it and FDA requirements for it and I think 0:21:46.110,0:21:52.380 if the climate was right for two of the major[br]manufacturers they would do it. 0:21:52.380,0:21:55.429 MOOI: And these are three different pertussis[br]strains. 0:21:55.429,0:21:59.010 FARYON: Dr. Mooi is a critic of the Pertussis[br]Initiative. 0:21:59.010,0:22:06.010 MOOI: My big disappointment is they have totally[br]and I think willfully ignored pathogen adaptation. 0:22:09.250,0:22:16.250 I think a few years ago we had the year that[br]Darwin died 100 year ago, it was not so long 0:22:20.760,0:22:27.760 ago, I think it's very strange that evolution[br]and pathogen adaptation is completely ignored 0:22:29.210,0:22:34.600 by such a group. I find that bad for science[br]and bad for public health. 0:22:34.600,0:22:41.010 FARYON: Sanofi Pastuer released this statement[br]to KPBS and the Watchdog Institute. It says 0:22:41.010,0:22:47.480 its grant to the GPI brings the world's authorities[br]on pertussis together and that benefits society 0:22:47.480,0:22:53.100 as a whole. The company also says ìat the[br]present time, there is no evidence to suggest 0:22:53.100,0:23:00.100 current pertussis vaccines lack effectiveness.î[br]Dr. Dean Sidelinger was one of the first health 0:23:00.309,0:23:05.480 officials to learn immunized people were getting[br]sick in his county. He said he was surprised, 0:23:05.480,0:23:11.429 but in the end, he says the current vaccine[br]is still the best thing heís got to protect 0:23:11.429,0:23:12.029 his community. 0:23:12.029,0:23:16.640 SIDELINGER: It does significantly decrease[br]the pertussis we see a significantly lower 0:23:16.640,0:23:21.809 number of pertussis cases now then we saw[br]before we started using the vaccine. So we 0:23:21.809,0:23:26.799 donít want people to feel complacent to say[br]I donít want that vaccine because Iíve seen 0:23:26.799,0:23:29.620 many of the cases that have been reported[br]were fully vaccinated. 0:23:29.620,0:23:34.760 FARYON: Sidelinger says there would be many[br]more cases if there was no vaccine at all. 0:23:34.760,0:23:40.230 Dr. Mooi agrees. He believes public health[br]officials should be encouraging cocooning, 0:23:40.230,0:23:46.070 immunizing all those around newborn babies.[br]But in the long run, he says we need better 0:23:46.070,0:23:53.070 vaccines. Baby Matthew spent four days in[br]the hospital and was eventually discharged. 0:23:54.320,0:23:57.230 Today, heís getting his two-month routine[br]check-up. 0:23:57.230,0:24:01.070 DOCTOR: I think it was just back luck heís[br]had two illnesses in a row and now the cold 0:24:01.070,0:24:03.860 he's building up his immunity. 0:24:03.860,0:24:08.940 FARYON: Despite a stuffy nose, Matthew is[br]doing well today. 0:24:08.940,0:24:13.980 DCOTOR: As you might know the vaccine is not[br]as effective as we want it to be. And that's 0:24:13.980,0:24:19.600 one reason why there've been a lot of cases.[br]But with Matthew in particular, his own immunity 0:24:19.600,0:24:26.210 has kicked in from having the illness, that[br]is, in effect a sort of a booster that will 0:24:26.210,0:24:31.299 protect him going forward. And how long that[br]immunity lasts is still a question. 0:24:31.299,0:24:38.299 MARLON: The one thing I would want to say[br]to parents is just watch your kids,[br]just be concerned. Because at first we thought 0:24:48.899,0:24:55.899 we were being over protective. But Iím glad[br]we were just a little bit over-concerned. 0:24:57.529,0:25:03.350 FARYON: Since KPBS and the Watchdog Institute[br]began its investigation, state health officials, 0:25:03.350,0:25:10.350 the CDC and scientists from UCLA, including[br]Dr. James Cherry, began a new study to determine 0:25:10.500,0:25:16.169 whether the new strain of pertussis is contributing[br]to the current whooping cough outbreak. For 0:25:16.169,0:25:20.490 more on this story, and to see more of the[br]data collected in our investigation, go to 0:25:20.490,0:25:27.490 kpbs.org/whoopingcough and watchdoginstitute.org.[br]For KPBS, the Watchdog Institute and Radio 0:25:30.919,0:25:34.480 Netherlands Worldwide, Iím Joanne Faryon.[br]Thanks for watching.