1 00:00:10,490 --> 00:00:14,789 JOANNE FARYON: Hello, Iím Joanne Faryon. Welcome to tonightís special, When Immunity 2 00:00:14,789 --> 00:00:20,200 Fails: The Whooping Cough Epidemic. Weíll explore the worst whooping cough outbreak 3 00:00:20,200 --> 00:00:26,270 in California in more than 60 years. Just why is a disease that was nearly extinct thirty 4 00:00:26,270 --> 00:00:31,519 years ago, finding its way back not just in this state, but in other parts of the country 5 00:00:31,519 --> 00:00:36,980 as well? What we learned may surprise you. There are serious questions about how well 6 00:00:36,980 --> 00:00:41,830 the vaccine to prevent the disease works; questions government health officials have 7 00:00:41,830 --> 00:00:48,580 been slow to even ask. KPBS teamed up with the Watchdog Institute, an investigative journalism 8 00:00:48,580 --> 00:00:54,549 center at San Diego State University, and Radio Netherlands Worldwide to tell this story. 9 00:00:54,549 --> 00:01:01,239 A story that took us across California and overseas to Amsterdam. But first, we begin 10 00:01:01,239 --> 00:01:06,740 in a delivery room in a San Diego hospital, where a mother has just given birth to her 11 00:01:06,740 --> 00:01:07,409 third son. 12 00:01:07,409 --> 00:01:13,070 [ baby crying ] 13 00:01:13,070 --> 00:01:20,070 Matthew Jacob Bryce was born Oct 11, 2010. A healthy baby boy, the third boy for Cindy 14 00:01:21,729 --> 00:01:26,880 and Marlon Bryce. Matthew started showing signs of a cold when he was just two weeks 15 00:01:26,880 --> 00:01:29,939 old. The Bryce family knew something was wrong. 16 00:01:29,939 --> 00:01:36,170 MARLON BRYCE: So it just seemed like this cold it was just affecting his breathing. 17 00:01:36,170 --> 00:01:40,640 FARYON: The family was aware of the whooping cough epidemic in California, from news reports 18 00:01:40,640 --> 00:01:44,130 REPORTER: State health officials say more than 6,400 cases of whooping cough have been 19 00:01:44,130 --> 00:01:45,039 reported this year. 20 00:01:45,039 --> 00:01:46,429 FARYON: And their pediatrician. 21 00:01:46,429 --> 00:01:52,659 BRYCE: There wasnít any whooping or they always say there is a whooping or a cough, 22 00:01:52,659 --> 00:01:55,509 he didnít have a cough or anything it was just that there was a cold. 23 00:01:55,509 --> 00:02:00,869 FARYON: Matthewís doctor suspected it could be whooping cough, also known as pertussis. 24 00:02:00,869 --> 00:02:06,560 She took a nasal swab and sent it to the lab. She also started Matthew on antibiotics. Six 25 00:02:06,560 --> 00:02:12,950 days later, with Matthew just 23 days old, Cindy Bryce got a phone call from the California 26 00:02:12,950 --> 00:02:15,450 Department of Health. The diagnosis was whooping cough. 27 00:02:15,450 --> 00:02:22,450 M. BRYCE: The moment I heard it I just immediately started thinking the worst because you have 28 00:02:25,150 --> 00:02:28,720 heard the news about the babies that have passed away. 29 00:02:28,720 --> 00:02:34,780 FARYON: From January to October this year, 10 newborns in California died from whooping 30 00:02:34,780 --> 00:02:41,170 cough, two in San Diego County. More than 7,000 children and adults got sick from the 31 00:02:41,170 --> 00:02:46,450 disease - the highest number in the state in more than 60 years. Just how did Matthew 32 00:02:46,450 --> 00:02:51,360 and so many others come down with a disease that is supposed to be preventable with a 33 00:02:51,360 --> 00:02:57,760 vaccine? Tonight weíll raise questions about the effectiveness of that vaccine. A four-month 34 00:02:57,760 --> 00:03:03,870 investigation by KPBS and the Watchdog Institute, found many people who have been diagnosed 35 00:03:03,870 --> 00:03:10,010 with whooping cough were immunized. We also show how government data on the number of 36 00:03:10,010 --> 00:03:15,700 people diagnosed with whooping cough lacks timeliness and is often inconsistent, begging 37 00:03:15,700 --> 00:03:19,320 the question: just who is keeping track of this epidemic? 38 00:03:19,320 --> 00:03:25,210 Weíll show you how some of the experts who influence vaccine policy are financially tied 39 00:03:25,210 --> 00:03:30,750 to vaccine companies. And, weíll follow the Bryce family as they struggle with their sonís 40 00:03:30,750 --> 00:03:37,750 diagnosis, and the setbacks in his recovery. Whooping cough, violent cough, the hundred-day 41 00:03:39,790 --> 00:03:41,800 cough; all names for pertussis. 42 00:03:41,800 --> 00:03:47,230 DR. JAMES CHERRY: What causes the cough actually we donít knowÖ thereís no other cough quite 43 00:03:47,230 --> 00:03:48,280 like it. 44 00:03:48,280 --> 00:03:53,340 FARYON: Pertussis is a respiratory illness caused by the bacterium bordetella pertussis. 45 00:03:53,340 --> 00:03:59,670 At first, it can mimic a cold. But later produces a violent and persistent cough, a cough that 46 00:03:59,670 --> 00:04:06,670 leaves children gasping for air ñ creating the distinct whooping sound. For adults, whooping 47 00:04:06,680 --> 00:04:12,570 cough may only be a nuisance. In fact scientists estimate more than 80 percent of adult cases 48 00:04:12,570 --> 00:04:18,690 are never diagnosed because most people assume they just have a bad cold. But to infants 49 00:04:18,690 --> 00:04:22,729 whooping cough can be deadly, especially if not diagnosed early. 50 00:04:22,729 --> 00:04:29,710 DR. JAMES CHERRY: So with infection that you eventually clear the bacteria and you get 51 00:04:29,710 --> 00:04:36,710 better. But it's a prolonged, a good percentage of cases will last one or two months. 52 00:04:39,969 --> 00:04:44,110 DR. FRITS MOOI: After a pertussis infection it has been shown to get super infections, 53 00:04:44,110 --> 00:04:46,960 in fact that is one of the main complications, pneumonia. 54 00:04:46,960 --> 00:04:51,680 FARYON: Young babies arenít able to cough up secretions that collect in their lungs, 55 00:04:51,680 --> 00:04:56,759 leading to pneumonia and making it difficult to breathe. Early antibiotic treatment is 56 00:04:56,759 --> 00:05:03,020 most critical in this age group. Whooping cough was nearly wiped out by the late 1970ís 57 00:05:03,020 --> 00:05:08,129 because of mass immunization, but itís somehow found its way back to California and other 58 00:05:08,129 --> 00:05:13,629 highly vaccinated communities around the world. Just why itís made such a vengeful comeback 59 00:05:13,629 --> 00:05:18,069 has two of the worldís leading whooping cough experts in disagreement. 60 00:05:18,069 --> 00:05:19,949 Dr. James Cherry of UCLA: 61 00:05:19,949 --> 00:05:22,759 CHERRY: The main reason is increased awareness. 62 00:05:22,759 --> 00:05:26,879 FARYON: and Dr. Frits Mooi of the Netherlands Centre for Infectious Diseases Control. 63 00:05:26,879 --> 00:05:33,400 MOOI: We found really a new mutation in the bug. 64 00:05:33,400 --> 00:05:38,710 FARYON: Dr. Mooi and Dr. Cherry both began their research into Whooping Cough about 30 65 00:05:38,710 --> 00:05:44,819 years ago. Cherry in the U.S. and Mooi in The Netherlands. The two scientists know each 66 00:05:44,819 --> 00:05:45,499 other's work. 67 00:05:45,499 --> 00:05:52,499 CHERRY: First of all, his molecular microbiological is, he's right at the top of scholars. There's 68 00:05:55,180 --> 00:06:02,180 no question about that. I think where some of the things he's published is the clinical 69 00:06:02,189 --> 00:06:04,020 data are not very good. 70 00:06:04,020 --> 00:06:09,289 MOOI: I don't communicate too much with him but what he wrote in the press is that I screw 71 00:06:09,289 --> 00:06:13,249 up epidemiology. That doesn't help me too much. 72 00:06:13,249 --> 00:06:18,059 FARYON: To understand why these two experts disagree, you need to know a little about 73 00:06:18,059 --> 00:06:19,849 the history of the pertussis vaccine. 74 00:06:19,849 --> 00:06:25,599 ANNOUNCER: Since most serious cases occur before school age, immunization in school 75 00:06:25,599 --> 00:06:26,469 may be too late. 76 00:06:26,469 --> 00:06:31,979 FARYON: The bacteria that causes whooping cough was first isolated in Belgium in 1906. 77 00:06:31,979 --> 00:06:35,520 At the time, the illness was one of the leading causes of infant death. 78 00:06:35,520 --> 00:06:42,520 ANNOUNCER: In 1921, whooping cough killed 316 Michigan children. Last year, the number 79 00:06:44,490 --> 00:06:48,039 of deaths was reduced to 63. 80 00:06:48,039 --> 00:06:53,080 FARYON: The discovery lead to the first attempts at a vaccine. But it wasnít until the late 81 00:06:53,080 --> 00:06:57,999 1940ís scientists developed a vaccine effective enough to prevent whooping cough. 82 00:06:57,999 --> 00:07:01,749 ANNOUNCER: Unlike the disease however, a vaccine does not endanger life. 83 00:07:01,749 --> 00:07:07,319 FARYON: By 1946, mass immunization programs began in the U.S. and the number of cases 84 00:07:07,319 --> 00:07:14,319 dropped dramatically. Prior to the vaccine the rate of disease was 157 cases per 100,000. 85 00:07:14,710 --> 00:07:21,589 By the 1970ís, with large scale immunizations, fewer than one in one hundred thousand people 86 00:07:21,589 --> 00:07:27,469 got whooping cough. But the vaccine was not without controversy. The early versions were 87 00:07:27,469 --> 00:07:34,469 associated with side effects such as prolonged crying spells and seizures in babies. By 1996, 88 00:07:34,559 --> 00:07:40,629 the FDA approved a new whooping cough vaccine. It was called an acellular version. That means 89 00:07:40,629 --> 00:07:46,629 the vaccine uses only purified components of the disease-causing organism. That vaccine 90 00:07:46,629 --> 00:07:52,529 was considered to be safer and associated with few mild side effects. Today, the U.S. 91 00:07:52,529 --> 00:07:59,529 uses only the acellular pertussis vaccine. But as the United States was changing vaccines 92 00:08:02,279 --> 00:08:09,279 something else was happening ñ health officials across the country were reporting increasing 93 00:08:09,279 --> 00:08:14,900 numbers of positive whooping cough cases. And in a government lab about 30 minutes outside 94 00:08:14,900 --> 00:08:20,689 of Amsterdam, a group of scientists had discovered something else ñ the bacterium that causes 95 00:08:20,689 --> 00:08:23,770 whooping cough started to look a little different. 96 00:08:23,770 --> 00:08:30,129 MOOI: This new mutation had the effect that the bacteria started to produce more pertussis 97 00:08:30,129 --> 00:08:30,580 toxin. 98 00:08:30,580 --> 00:08:35,490 FARYON: Just whether that mutation is to blame, at least in part, for the California epidemic 99 00:08:35,490 --> 00:08:40,800 and outbreaks elsewhere in the world is at the heart of the whooping cough debate. Dr. 100 00:08:40,800 --> 00:08:44,279 Mooi believes this to be the case, but not Dr. Cherry. 101 00:08:44,279 --> 00:08:48,779 CHERRY: Even though these changes have occurred there is no evidence that thatís lead to 102 00:08:48,779 --> 00:08:53,320 increased vaccine failure. 103 00:08:53,320 --> 00:09:00,320 FARYON: Here in San Diego County, more than 85 percent of children are immunized. In fact, 104 00:09:02,009 --> 00:09:08,060 less than three percent of kids entering kindergarten have not been immunized because of their familyís 105 00:09:08,060 --> 00:09:14,459 personal beliefs. But despite the high immunization rate, San Diego has the second largest number 106 00:09:14,459 --> 00:09:20,480 of positive whooping cough cases in California. Dr. Dean Sidelinger is San Diegoís deputy 107 00:09:20,480 --> 00:09:21,509 public health officer. 108 00:09:21,509 --> 00:09:25,399 DR. DEAN SIDELINGER: This is a disease that if someone has it itís very easy to transfer 109 00:09:25,399 --> 00:09:29,380 from one person to another. So if you or I sitting here during this interview, one of 110 00:09:29,380 --> 00:09:33,430 us had pertussis chances are we could transmit that to the other person. 111 00:09:33,430 --> 00:09:38,250 Sidelinger says in the past, the number of whooping cough cases peaked in summer and 112 00:09:38,250 --> 00:09:41,459 slowed by fall, but this year, that didnít happen. 113 00:09:41,459 --> 00:09:46,860 SIDELINGER: So as time goes on weíre seeing more cases. We know that public awareness 114 00:09:46,860 --> 00:09:52,000 plays into that as we talk about pertussis more people are asking their doctors and doctors 115 00:09:52,000 --> 00:09:55,560 are asking their patients weíre going to see more, but that trend continued. 116 00:09:55,560 --> 00:10:01,759 FARYON: By the end of November 2010, nearly 1000 infants, children and adults in San Diego 117 00:10:01,759 --> 00:10:06,930 County tested positive for whooping cough. More than half of them had been immunized. 118 00:10:06,930 --> 00:10:13,250 Our investigation shows that trend continues throughout California. KPBS and The Watchdog 119 00:10:13,250 --> 00:10:18,290 Institute collected data from 9 California counties that report some of the highest infection 120 00:10:18,290 --> 00:10:25,069 rates. Our research shows that where immunization history is known, between 44 and 83 percent 121 00:10:25,069 --> 00:10:30,420 of people diagnosed with whooping cough were vaccinated. We looked at California Department 122 00:10:30,420 --> 00:10:36,350 of Public Health records too. In cases where vaccination history was recorded, more than 123 00:10:36,350 --> 00:10:39,269 80 percent of infected people had been immunized. 124 00:10:39,269 --> 00:10:45,350 DR. MARK HORTON: From the epidemiology experts and the experts in vaccine that this is absolutely 125 00:10:45,350 --> 00:10:46,019 expected. 126 00:10:46,019 --> 00:10:50,690 FARYON: Dr. Mark Horton is the director of the California Department of Public Health. 127 00:10:50,690 --> 00:10:55,319 HORTON: If you've got a percentage of the population vaccinated and a percentage of 128 00:10:55,319 --> 00:11:00,399 those vaccinated that are still susceptible because the vaccine isn't perfectly effective 129 00:11:00,399 --> 00:11:05,100 or effective in all individuals, when you work out the arithmetic you'll see that even 130 00:11:05,100 --> 00:11:10,430 with a very effective vaccine, and even if you have the majority of the population vaccinated, 131 00:11:10,430 --> 00:11:15,440 the pool of susceptibles will include a number of individuals that have never been vaccinated 132 00:11:15,440 --> 00:11:20,959 but will also include quite a few and in some cases greater than 50 percent of the individuals 133 00:11:20,959 --> 00:11:22,339 have been previously vaccinated. 134 00:11:22,339 --> 00:11:27,569 FARYON: In other words, if you do the math, you will always find a certain number of immunized 135 00:11:27,569 --> 00:11:31,620 people getting sick if a vaccine is not 100 percent effective. 136 00:11:31,620 --> 00:11:36,519 HORTON: So thatís no surprise to us nor is it a reflection on the efficacy of the vaccine. 137 00:11:36,519 --> 00:11:39,120 REPORTER KEVIN CROWE: Itís not a reflection on the efficacy of the vaccine? 138 00:11:39,120 --> 00:11:39,870 HORTON: Correct, correct. 139 00:11:39,870 --> 00:11:44,730 FARYON: But 20 years ago, the reverse was true. According to a report by the Centers 140 00:11:44,730 --> 00:11:48,480 for Disease Control, more than half of the children between 3 months and 4 years old 141 00:11:48,480 --> 00:11:54,380 who got whooping cough nationwide between 1990 and 1996 were not immunized. The rate 142 00:11:54,380 --> 00:11:59,519 of whooping cough has also been increasing for the past 20 years. From less than one 143 00:11:59,519 --> 00:12:06,519 in 100,000 to 18 per 100,000 here in California. And in some California counties such as San 144 00:12:07,310 --> 00:12:14,310 Luis Obispo, rates are nearly as high as before vaccines were developed. Two days after our 145 00:12:14,399 --> 00:12:21,399 interview with the Bryce family, Matthew got a fever. He was hospitalized at Radyís Childrenís 146 00:12:21,430 --> 00:12:28,430 Hospital in San Diego. Matthew was not immunized against whooping cough. Heís too young. Babies 147 00:12:28,839 --> 00:12:31,959 canít be immunized until theyíre two months old. 148 00:12:31,959 --> 00:12:36,230 But everyone else in the Bryce family was vaccinated ñ even his parents got booster 149 00:12:36,230 --> 00:12:41,889 shots. The practice of immunizing everyone around a newborn baby is called cocooning. 150 00:12:41,889 --> 00:12:48,199 CINDY BRYCE: When I called the doctor they asked me who has it and I couldnít give them 151 00:12:48,199 --> 00:12:53,660 an answer because I donít know where he got it from because everyoneís been vaccinated. 152 00:12:53,660 --> 00:12:58,589 FARYON: Myron and one of his sons were also tested for whooping cough ñ both were negative. 153 00:12:58,589 --> 00:13:05,589 M. BRYCE: The one thing I would want to know is the vaccine working? Is it as effective 154 00:13:07,709 --> 00:13:14,709 because before this I thought the vaccine was working and I thought that if I did everything 155 00:13:19,199 --> 00:13:26,199 that I was told to do that our sons would be protected. 156 00:13:27,600 --> 00:13:33,100 FARYON: Just how effective is the vaccine? That all depends on who you talk to. Drug 157 00:13:33,100 --> 00:13:38,319 information included with the two most commonly used whooping cough vaccines in the US say 158 00:13:38,319 --> 00:13:40,509 the vaccine is 85 percent effective. 159 00:13:40,509 --> 00:13:46,329 MOOI: This new strain has completely invaded the Netherlands and also other countries and 160 00:13:46,329 --> 00:13:49,569 pushed out all the other strains. Itís quite unique. 161 00:13:49,569 --> 00:13:54,279 FARYON: Dr. Mooi believes thereís no way to determine how effective the vaccines are 162 00:13:54,279 --> 00:13:58,189 because they have not been tested against the new strain of whooping cough. 163 00:13:58,189 --> 00:14:00,040 MOOI: We call it the p3 strain. 164 00:14:00,040 --> 00:14:05,310 FARYON: A strain he believes is more virulent and can make people sicker. This strain emerged 165 00:14:05,310 --> 00:14:08,490 while the new acellular vaccines were being developed. 166 00:14:08,490 --> 00:14:14,660 MOOI: I can tell you one of the reasons the vaccine companies is not too happy with me 167 00:14:14,660 --> 00:14:21,660 is because if what I say is true they selected the wrong strains the in the 1980ís. 168 00:14:23,100 --> 00:14:28,069 FARYON: Mooiís lab was studying the new strain when The Netherlands experienced an unexpected 169 00:14:28,069 --> 00:14:30,829 whooping cough epidemic in 1996. 170 00:14:30,829 --> 00:14:32,129 MOOI: There were more strains in fact when you compare the two there was a very direct 171 00:14:32,129 --> 00:14:38,750 relationship between the emergence of these strains, we call them p3 strains and the increase 172 00:14:38,750 --> 00:14:40,779 in pertussis notifications. 173 00:14:40,779 --> 00:14:47,629 CHERRY: Thereís absolutely no evidence that either of the two vaccines that are most common 174 00:14:47,629 --> 00:14:54,629 today used in the U.S. that there is increased vaccine failure with either of those vaccines. 175 00:14:55,759 --> 00:15:01,870 FARYON: So if you had to explain why weíre seeing this epidemic the highest number of 176 00:15:01,870 --> 00:15:03,920 cases in 60 years, what would you tell people? 177 00:15:03,920 --> 00:15:10,920 CHERRY: The main reason is increased awareness. People, particularly public health people 178 00:15:12,269 --> 00:15:14,959 are much more aware and that trickles down. 179 00:15:14,959 --> 00:15:19,839 FARYON: Cherry says the increase is also due in part because of something called waning 180 00:15:19,839 --> 00:15:24,779 immunity. Immunity to whooping cough does not last a lifetime, whether you are vaccinated 181 00:15:24,779 --> 00:15:30,810 or develop natural immunity from getting the disease. Almost all experts agree waning immunity 182 00:15:30,810 --> 00:15:36,879 is contributing to whooping cough outbreaks worldwide. Where they disagree: when does 183 00:15:36,879 --> 00:15:43,879 immunity fail? Dr. Mooi believes the new strain of pertussis causes immunity to fail sooner 184 00:15:46,560 --> 00:15:51,100 than in the past. And heís published his findings in several peer reviewed journals 185 00:15:51,100 --> 00:15:53,709 including the CDCís Infectious Diseases. 186 00:15:53,709 --> 00:16:00,709 MOOI: When the immunity is sub-optimal what will happen the bacteria will not be recognized 187 00:16:02,660 --> 00:16:09,660 very well by the immune system because of the mismatch and second of all even if immune 188 00:16:09,899 --> 00:16:16,899 response is started in the body the toxin will be able to delay it. You could say these 189 00:16:17,269 --> 00:16:24,269 two changes work together by decreasing the period of which the vaccine is protective 190 00:16:25,230 --> 00:16:25,860 further. 191 00:16:25,860 --> 00:16:31,040 FARYON: The Netherlands learned something else after its 1996 epidemic. At the time, 192 00:16:31,040 --> 00:16:36,670 it had very few samples of the bacteria that was causing people to get sick. So Mooiís 193 00:16:36,670 --> 00:16:42,040 lab began asking doctors and their labs to send him positive pertussis swabs. His lab 194 00:16:42,040 --> 00:16:48,240 now has 3,000 samples. California that has collected just 29 samples from the more than 195 00:16:48,240 --> 00:16:55,120 7,000 whooping cough cases in the state. During the KPBS/Watchdog four month investigation, 196 00:16:55,120 --> 00:17:01,160 we also learned data kept by the state and the CDC was often lagging behind county data 197 00:17:01,160 --> 00:17:06,050 and was inconsistent. While counties like San Diego knew the immunization status of 198 00:17:06,050 --> 00:17:10,490 the vast majority of people with whooping cough, the stateís data listed the information 199 00:17:10,490 --> 00:17:16,799 as unknown. Despite statewide protocols for reporting pertussis, a KPBS/Watchdog survey 200 00:17:16,799 --> 00:17:21,839 found some counties donít follow them or are slow to report the information 201 00:17:21,839 --> 00:17:27,870 HORTON: Thereís a perception that the more numbers the better, but let me be very clear 202 00:17:27,870 --> 00:17:34,870 we in no way need reports on every single case of pertussis for us to make important 203 00:17:35,419 --> 00:17:38,140 judgments and decisions about whatís happening. 204 00:17:38,140 --> 00:17:44,070 FARYON: The CDC in Atlanta declined our requests for an interview. In an email response they 205 00:17:44,070 --> 00:17:49,510 said it is ìdifficult to disentangle all the factorsî contributing to increases in 206 00:17:49,510 --> 00:17:56,500 pertussis, but listed ìincreasing transmission, better recognition, and increased laboratory 207 00:17:56,500 --> 00:18:00,990 confirmation.î We also asked whether a new more virulent strain could be contributing 208 00:18:00,990 --> 00:18:07,990 to the outbreak. The CDCís response: ìAvailable data do not suggest that ptxP3 is more virulent, 209 00:18:08,309 --> 00:18:15,029 or that increasing reports are attributable only to the emergence of ptxP3. We continue 210 00:18:15,029 --> 00:18:21,490 to work on this and other potential explanations for the increase in pertussis that has occurred 211 00:18:21,490 --> 00:18:27,610 since the 1980s.î The CDC sent us this study by their own investigators. The study looked 212 00:18:27,610 --> 00:18:33,080 at children between 6 months and five years old. It found pertussis vaccines to be more 213 00:18:33,080 --> 00:18:40,080 than 90 percent effective. The study looked at data between 1998 and 2001. It did not 214 00:18:40,409 --> 00:18:42,419 collect pertussis strain information. 215 00:18:42,419 --> 00:18:49,419 SINGING: Do you happen to know what a T-dap is? It's a special vaccine but it's not just 216 00:18:50,220 --> 00:18:52,620 for kids. 217 00:18:52,620 --> 00:18:59,190 FARYON: Sanofi Pastuer, one of two companies that make the vaccine widely used in the U.S., 218 00:18:59,190 --> 00:19:02,320 sponsored this singing competition earlier this year. 219 00:19:02,320 --> 00:19:02,750 SINGING: Persussis is the reason why you should call your doctor today. 220 00:19:02,750 --> 00:19:09,640 FARYON: 221 00:19:09,640 --> 00:19:15,100 It was a public relations exercise to get the word out about whooping cough and immunization. 222 00:19:15,100 --> 00:19:20,640 But just where is the line between good PR and trying to influence public health policy? 223 00:19:20,640 --> 00:19:25,190 SINGING: Take a shot and give pertussis a whooping. 224 00:19:25,190 --> 00:19:31,900 FARYON: Especially when public health policy can increase vaccine sales. Since 2007, the 225 00:19:31,900 --> 00:19:37,450 California department of health has spent more than $200 million on pertussis vaccines 226 00:19:37,450 --> 00:19:44,450 for children on medical or who are under-insured. And itís sure to rise. In September, the 227 00:19:44,520 --> 00:19:50,240 California state legislature passed a law requiring all students to receive another 228 00:19:50,240 --> 00:19:56,110 does, a sixth dose of the pertussis vaccine before entering middle school. It may be a 229 00:19:56,110 --> 00:20:01,150 case of whatís good for business is also good for public health. But how much influence 230 00:20:01,150 --> 00:20:07,309 does industry have over public health policy? Sanofi Pasteur also established and funds 231 00:20:07,309 --> 00:20:13,809 The Global Pertussis Initiative. A group made up of medical experts from around the world. 232 00:20:13,809 --> 00:20:19,720 The GPI was established 10 years ago to study why pertussis was making a comeback and find 233 00:20:19,720 --> 00:20:24,309 ways to control the disease. More than half its members are employees of the pharmaceutical 234 00:20:24,309 --> 00:20:30,190 company or receive research money or consulting fees. Public officials from across the country, 235 00:20:30,190 --> 00:20:36,029 including California and the CDC, site the Global Pertussis Initiative when making vaccine 236 00:20:36,029 --> 00:20:40,140 policy. Dr. James Cherry is a member of the initiative. 237 00:20:40,140 --> 00:20:46,010 Heís also received speaking fees and research funds from vaccine manufacturers. At the same 238 00:20:46,010 --> 00:20:50,929 time, he sat on government committees to help determine vaccine policy and efficacy. 239 00:20:50,929 --> 00:20:57,929 FARYON: A cynic might say that if you have a community of experts in pertussis as in 240 00:20:59,330 --> 00:21:04,970 the Global Pertussis Initiative, who primarily their work in terms of this endeavor is being 241 00:21:04,970 --> 00:21:10,250 funded by the drug company that makes the vaccine, there might be less incentive to 242 00:21:10,250 --> 00:21:16,179 say make a new vaccine and more incentive to say just use the old one more often. What 243 00:21:16,179 --> 00:21:17,830 do you say to them? 244 00:21:17,830 --> 00:21:24,830 CHERRY: I donít think thatís true. I think that weíve been talking about new vaccines. 245 00:21:25,270 --> 00:21:32,270 It think the difficulty with the new vaccine lies in the expense that it would cost to 246 00:21:33,480 --> 00:21:40,480 make a new vaccine and the difficulty in testing it and FDA requirements for it and I think 247 00:21:46,110 --> 00:21:52,380 if the climate was right for two of the major manufacturers they would do it. 248 00:21:52,380 --> 00:21:55,429 MOOI: And these are three different pertussis strains. 249 00:21:55,429 --> 00:21:59,010 FARYON: Dr. Mooi is a critic of the Pertussis Initiative. 250 00:21:59,010 --> 00:22:06,010 MOOI: My big disappointment is they have totally and I think willfully ignored pathogen adaptation. 251 00:22:09,250 --> 00:22:16,250 I think a few years ago we had the year that Darwin died 100 year ago, it was not so long 252 00:22:20,760 --> 00:22:27,760 ago, I think it's very strange that evolution and pathogen adaptation is completely ignored 253 00:22:29,210 --> 00:22:34,600 by such a group. I find that bad for science and bad for public health. 254 00:22:34,600 --> 00:22:41,010 FARYON: Sanofi Pastuer released this statement to KPBS and the Watchdog Institute. It says 255 00:22:41,010 --> 00:22:47,480 its grant to the GPI brings the world's authorities on pertussis together and that benefits society 256 00:22:47,480 --> 00:22:53,100 as a whole. The company also says ìat the present time, there is no evidence to suggest 257 00:22:53,100 --> 00:23:00,100 current pertussis vaccines lack effectiveness.î Dr. Dean Sidelinger was one of the first health 258 00:23:00,309 --> 00:23:05,480 officials to learn immunized people were getting sick in his county. He said he was surprised, 259 00:23:05,480 --> 00:23:11,429 but in the end, he says the current vaccine is still the best thing heís got to protect 260 00:23:11,429 --> 00:23:12,029 his community. 261 00:23:12,029 --> 00:23:16,640 SIDELINGER: It does significantly decrease the pertussis we see a significantly lower 262 00:23:16,640 --> 00:23:21,809 number of pertussis cases now then we saw before we started using the vaccine. So we 263 00:23:21,809 --> 00:23:26,799 donít want people to feel complacent to say I donít want that vaccine because Iíve seen 264 00:23:26,799 --> 00:23:29,620 many of the cases that have been reported were fully vaccinated. 265 00:23:29,620 --> 00:23:34,760 FARYON: Sidelinger says there would be many more cases if there was no vaccine at all. 266 00:23:34,760 --> 00:23:40,230 Dr. Mooi agrees. He believes public health officials should be encouraging cocooning, 267 00:23:40,230 --> 00:23:46,070 immunizing all those around newborn babies. But in the long run, he says we need better 268 00:23:46,070 --> 00:23:53,070 vaccines. Baby Matthew spent four days in the hospital and was eventually discharged. 269 00:23:54,320 --> 00:23:57,230 Today, heís getting his two-month routine check-up. 270 00:23:57,230 --> 00:24:01,070 DOCTOR: I think it was just back luck heís had two illnesses in a row and now the cold 271 00:24:01,070 --> 00:24:03,860 he's building up his immunity. 272 00:24:03,860 --> 00:24:08,940 FARYON: Despite a stuffy nose, Matthew is doing well today. 273 00:24:08,940 --> 00:24:13,980 DCOTOR: As you might know the vaccine is not as effective as we want it to be. And that's 274 00:24:13,980 --> 00:24:19,600 one reason why there've been a lot of cases. But with Matthew in particular, his own immunity 275 00:24:19,600 --> 00:24:26,210 has kicked in from having the illness, that is, in effect a sort of a booster that will 276 00:24:26,210 --> 00:24:31,299 protect him going forward. And how long that immunity lasts is still a question. 277 00:24:31,299 --> 00:24:38,299 MARLON: The one thing I would want to say to parents is just watch your kids, just be concerned. Because at first we thought 278 00:24:48,899 --> 00:24:55,899 we were being over protective. But Iím glad we were just a little bit over-concerned. 279 00:24:57,529 --> 00:25:03,350 FARYON: Since KPBS and the Watchdog Institute began its investigation, state health officials, 280 00:25:03,350 --> 00:25:10,350 the CDC and scientists from UCLA, including Dr. James Cherry, began a new study to determine 281 00:25:10,500 --> 00:25:16,169 whether the new strain of pertussis is contributing to the current whooping cough outbreak. For 282 00:25:16,169 --> 00:25:20,490 more on this story, and to see more of the data collected in our investigation, go to 283 00:25:20,490 --> 00:25:27,490 kpbs.org/whoopingcough and watchdoginstitute.org. For KPBS, the Watchdog Institute and Radio 284 00:25:30,919 --> 00:25:34,480 Netherlands Worldwide, Iím Joanne Faryon. Thanks for watching.