Why diseases prevented by vaccines are coming back with a vengeance in adults

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When Erin Mathieson and her husband came down with a terrible cough earlier this year, she figured it was just a nasty side effect of having had the flu.

Then the Vancouver couple, who have a 10-year-old, learned that there were confirmed cases of whopping cough at their daughter’s school.

Initially, Mathieson thought it was impossible that the two could have contracted the illness, also known as pertussis. After all, both had been vaccinated against it as kids. However, sure enough, when they went to the doctor, they found out that they indeed were suffering from the highly contagious bacterial illness marked by uncontrollable coughing that makes it hard to breathe. It can affect people of all ages, but can be very serious, even deadly, for babies.

“We got this cough, and it was just super violent,” Mathieson says. “I’ve never had anything like it. You can’t breathe because you just can’t get enough power to cough it out. We were up all night. Nathan [her husband] was vomiting he was coughing so hard. I pulled all my stomach muscles. My vocal chords are still damaged from it.”

“We’re adults,” she adds. “I can’t imagine a toddler or a little baby getting it. It lasted weeks.”

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Mathieson was informed that some of the students at her daughter’s school had not been vaccinated, hence the outbreak.

What she didn’t realize was that, although she and her husband were vaccinated themselves as kids, the protection that childhood vaccines provide against whooping cough and other serious, even life-threatening illnesses — such as diphtheria and tetanus — doesn’t last a lifetime. Adults need booster shots, too.  

A new study from C.D. Howe Institute found that vaccination rates for communicable diseases among adults in Canada are currently much lower than recommended targets. 

For example, adults between the age of 18-65 have a vaccination rate of less than eight per cent for whooping cough — basically, because they don’t know they need a top up.

Emergency room physician Dr. John Murray explains that people will typically get a combined booster shot for tetanus, diphtheria and pertussis — known as Td/Tdap — if they happen to end up in hospital because of a deep cut. Another way adults might end up getting a booster is if they visit a travel clinic for protection against illnesses like malaria; commonly, doctors there will recommend the Td/Tdap booster. Otherwise, it’s up to people to keep track of things themselves.

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“Family docs theoretically should be staying up to date on that stuff,” Murray says.

Dr. Michael Curry, an emergency-room physician in B.C., says he usually sees a couple of cases of whopping cough throughout the year in the Fraser Valley, near Vancouver —  “always in adults, because kids have vaccines and are protected,” Curry says. “Your body tends to forget about vaccines over time. These [Tdap] are very effective vaccines, but they don’t give lifelong immunity. It’s not one shot and you’re good for life.

“The problem is we don’t have a good system for it,” Curry adds of adult boosters. “Classically, we rely on people who have a cut or wound that triggers us to give you a tetanus shot — tetanus bacteria live in soil, and tetanus is a horrible illness. But we’re not afraid of it in North America because we haven’t seen it. If you haven’t had immunization in the last 10 years, you should probably have one.”

Meningitis, the inflammation of membranes around the brain and spinal cord, is another one. “Meningitis used to be a disease of kids,” Curry says. “Professionally, I’ve have not ever seen it in a child. I’ve seen in adults a number of times.”

Generally, adults should get a booster shot for tetanus, diphtheria, and pertussis every decade, according to the American Association of Family Physicians. Curry recommends talking to your family doctor or visiting a public-health clinic for more information.

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