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Letter: Castlegar's medical health officer speaks to local Pertussis outbreak and immunizations

To the Editor:

Regarding: Whooping Cough Outbreak and Pertussis Vaccine for Children

As a public health specialist physician who is the Medical Health Officer for the Kootenay-Boundary area (including Castlegar), it is my responsibility to ensure all residents of the region get the best health information possible on which to base their decisions for themselves and their families, and do everything possible to improve the overall health of the population I serve.

One of our legal and ethical responsibilities as MHOs under the Public Health Act of BC is to let area residents know when an outbreak of a communicable disease begins occurring, like happened this past week with whooping cough (pertussis) in the West Kootenay. While the majority of area parents have their children fully immunized and protected against whooping cough, the remainder 30 per cent of young children under two years are either behind on their immunizations, or unimmunized and not protected at all. This is a serious concern, because whooping cough is a very severe illness for infants and toddlers to catch. In the pre-vaccine era, it was one of the largest killers of our youngest children. For unimmunized infants, that risk still exists.

I think all parents, both those who have their children immunized and those who have chosen not to have their children immunized so far, want to do their best to protect their families. I also think that there is a lot of misinformation, myths and untruths out there about vaccines and their safety, with a lot of it popping up on web-based Google searches. There is also fortunately a lot of credible information on-line, from the Canadian Pediatric Society, Canadian Public Health Association, and the B.C. Center for Disease Control websites, but it can be hard to sort the credible information from that which isn’t.

My job is to try to ensure all parents get the most accurate information possible, and this is what I know – the pertussis vaccine in use in BC is very safe and very effective, and the only real way to protect our infants and toddlers against the severe effects of whooping cough. The albeit rare but severe “side effects” (brain/neurologic disorders) supposedly related to pertussis vaccine that are cited on the web by anti-vaccinationists, actually relate to the old whole-cell pertussis vaccine, and initially came from large UK studies done in the 1970s and 1980s. Further followup of the small numbers individual cases of neurologic disorders that had occurred in both the immunized group and the unimmunized group under study, showed other disease causes for the neurologic disorders, unrelated to the vaccine. The newer acellular pertussis has been in used in BC and elsewhere worldwide for 10 years now and has an excellent safety record with many millions of doses given, and no evidence or indication of any risk with regard to neurologic conditions. The most common post-vaccine reaction I review as an MHO is the expected one of a mildly sore red shoulder or leg at the immunization site, which is an expected reaction happening in about one- to five-per-cent of kids depending on age, and which lasts usually only a day or two.

I went into medicine to help people, and then into public health to try to help larger groups of people on a population level. I spent eight years of university study to get my undergraduate and then medical degree, and then after several years family practice, a further 5 years getting specialized training in community medicine and public health, with a focus on communicable disease control and prevention. I’ve spent 20 years practicing public health medicine in B.C., reviewing which vaccines to use when, and watching for any side effects which may be occurring, to ensure all vaccines are safe to use. I am not a fan of big multinational corporations or the pharmaceutical industry. I get no money from vaccine manufacturers to promote their products. My only wage is from you the citizens of BC, and my only job as a physician/public servant is to make sure you get the most accurate information possible.

You will see other Letters to the Editors in Kootenay newspapers in response to the outbreak or even my letter here, and things on the Web, with unsubstantiated conjecture, misinformation and statements taken out of context, trying to convince you that vaccines, either individually or as a whole, are unsafe. Be critical of these statements; be a skeptic. What are the individuals’ credentials and their specific training? Who are they citing - supposed experts who exist on websites from the United States, who want to sell you their books and/or natural products instead? Anti-vaccinationists oft cited Dr. Andrew Wakefield from the UK as having shown the supposed link between MMR vaccine and autism, but he is now fully refuted and discredited, both for bad science and for accepting bribes from companies in competition with the MMR manufacturers. Be a skeptic. What ties exist between the litigation lawyer lobby in the US and anti-vaccine pseudo-experts there? Locally, what are the credentials and training of self-proclaimed experts, and what book of their own are they trying to sell?

I think that there is a percentage of parents, perhaps 10-20 per cent, who are understandable confused with all the variety of material out there about vaccines, and hesitate against getting their children immunized, wanting to protect their kids but uncertain which way protects them best.

I would urge these parents to review and arm themselves with the most credible information possible. Go to a credible source, such as which was developed by specialist public health physicians in BC, who are independent and not beholden to any vaccine manufacturer. Talk to your local Public Health Nurse at the IH-Public Health office in your town.

In addition, if any Kootenay parent who has residual questions or concerns, who remains unsure about whether to go ahead and get immunization for their infant or pre-schooler, wants to go over their questions and concerns with me, then I would be more than happy to talk to you directly, and give you the best scientific and medical information I am aware of, on which to make your choice – just leave your name and phone number with the public health nurse and that you would like me to call.

We owe it to our children to protect them as much as possible, and I trust Kootenay parents in the decisions that they make, based on the best information available.

Dr. Rob Parker
Medical Health Officer
Director of Communicable Disease Control
Interior Health Authority