Is this their best shot? - Whooping cough outbreak stirs debate over the decision to inoculate

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Nine-week-old triplets Jenna, Ethan and Alexis Bodenberger line up for their first round of immunizations Tuesday. Parents across the county are considering their views on immunizations in light of a current outbreak of whooping cough.

It was three times the tears and three times the trauma Tuesday as Taunee Bodenberger submitted her 9-week-old triplets to their first immunizations against diphtheria, tetanus and pertussis.

The Medford mother winced as first Ethan, then Jenna, then Alexis cried out at the sharp sting of nurse Sharon Keller’s needle.

But Bodenberger, who also has three older children, said the triple ordeal didn’t diminish her commitment to vaccination — especially in the midst of a Jackson County pertussis outbreak.

"Oh, no, I never had any doubts at all," said Bodenberger, 30. "All my kids were immunized."

Parents across Jackson County are considering — or confirming — their views on immunizations as the number of suspected or confirmed pertussis cases climbed to 35 by Tuesday.

Some cited the outbreak as evidence in favor of vaccinations widely endorsed by public health officials, while others said they remain wary of side effects of the childhood shots.

Barbra Usselman-Crofoot of Talent said she remains committed to her decision not to immunize her 20-month-old daughter, Amelia, or the baby she expects next month.

"What it means for us is that we would just be a little more careful. We would make an effort to limit her contact with other children," said Crofoot. "I definitely will be more careful about our new baby."

Paul Cieslak, a doctor who directs the communicable health program for the state Department of Human Services, said limiting contact is no guarantee.

"I don’t think it’s enough. The bugs tend to come to you," he said. "I’d be worried. Sooner or later, you’re going to be exposed to it."

An 11-week-old Klamath Falls baby died this month after contracting pertussis, state health officials said.

In Jackson County, a 12-year-old Medford girl is the latest person whose symptoms suggested the disease more commonly known as whooping cough, said Viki Barbour, a county public health nurse.

The number of reported cases in Jackson County has grown from three to nearly three dozen in the past two weeks. Cities affected include Medford, Central Point, Eagle Point, White City, Jacksonville, Phoenix and Trail. The outbreak appeared to slow over the Memorial Day weekend, however, said Hank Collins, county health director.

Two infants were hospitalized at Rogue Valley Medical Center, one with a confirmed case of pertussis, another with a suspected case of the disease, a hospital spokeswoman said.

All told, local cases of pertussis involve people ranging in age from a few months to 42 years. The disease, which is common, can be deadly to infants under 6 months.

"There were definitely some of the cases who have had absolutely no immunization against pertussis," she said. "There were some who were partially immunized and some who were fully immunized."

Parents routinely are advised to immunize infants through a series of shots at 2, 4, 6 and 15 months and again before entering school.

Since the outbreak began, more parents have been bringing children into county clinics for shots, Barbour said. The clinics dispense between 60 and 300 shots a month, with an average of about 150, she added.

"We have definitely heard that parents have chosen to come in and seek immunizations," she said.

In addition, Barbour said she’s been fielding more calls from concerned parents in Ashland, which consistently logs the highest level in the state of exemptions from immunizations required for school.

More than 10 percent of Ashland students are exempted from required immunizations for religious or medical reasons. No cases of pertussis have been suspected in Ashland during the recent outbreak.

Maureen Mitchell, an Ashland midwife, said parents aren’t changing their minds about avoiding immunizations.

"I haven’t heard any more worry," she said. "I would say there’s a little more caution about taking really small babies out."

Crofoot said before her first child was born, she read widely in mainstream and alternative sources about immunizations. She and her husband, Emory, objected primarily to the impact of immunizations on the immune systems of very young babies.

"We didn’t go into it blind," she said. "We feel like it’s a whole lot on a little person."

In addition, she said she believes pharmaceutical companies promote immunizations for profit, not for health benefits.

But Bodenberger, the mother of the new triplets, doesn’t agree with dissenters.

"I believe it’s their choice," she said. "But I believe it’s safer to get it done."

Pertussis, also known as whooping cough, is a highly contagious respiratory disease. It is caused by a bacteria found in the mouth, nose and throat of an infected person.

Pertussis can occur at any age. Most reported cases occur in children under 5, but half of those are children under age 1. Between 1993 and 2002, an average 85 pertussis cases a year were reported in Oregon.

Pertussis begins as a mild respiratory infection, with symptoms similar to a common cold: sneezing, runny nose, low-grade fever, mild cough. Within two weeks, the cough becomes severe and includes episodes of numerous rapid coughs followed by a high-pitched crow or "whoop."

Those episodes, more frequent at night, might continue for one to two months. Older people and partially immunized children generally have milder symptoms.

The disease can be fatal if pneumonia develops. Seventy percent of all fatalities occur in infants younger than 6 months.

Source: The Oregon Department of Human Services Acute and Communicable Disease program.

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