HEALTH -- August 22, 2012 at 5:47 PM EDT
To Vaccinate or Not? Whooping Cough Outbreak Stirs Debate
SEATTLE | On a clear day in South Seattle, it's not much of a strain to look across Puget Sound and see Vashon Island. Just a 25-minute ferry ride and a few twisting roads separate Karen Winter's subdivision from Celina Yarkin's island farmhouse.
In the summertime, both homes fill up with bright things like home-grown produce and the laughter of children. Yarkin has three girls; Winter has a boy and a girl. And this year, all of them are more susceptible than usual to something darker: whooping cough. Washington state is currently in the midst of its worst pertussis epidemic in half a century.
That's where these parallel stories divide. Because Winter, who believes it's important to vaccinate her kids for some diseases, decided not to do so for whooping cough. She doesn't think the vaccine is very effective and believes there are better ways for a community to tackle outbreaks.
And Yarkin, who had some initial reservations about vaccination, now strongly supports inoculating her children for whooping cough ... and just about every other disease. In fact, she's spent years writing letters to the local newspaper, speaking at public events and talking to people throughout the community -- encouraging everyone else to do the same. She believes that not vaccinating for pertussis is irresponsible and harmful to community health.
To hear how both women came to such strong and differing conclusions, NewsHour health correspondent Betty Ann Bowser sat down separately with them. Listen to their thoughts in the video above.
Winter: With my two kids, we've done a spaced-out vaccine schedule, in part because I do believe in vaccines. And if they have a negative reaction to a single vaccine, I want to be able to stop that vaccine and not the entire series.
Yarkin: I had always gotten vaccines and had been, you know, pro-vaccine for myself. But when I had a small baby and started to hear troubling things about, you know, the vaccines -- there might be a risk to getting the vaccines -- then I started to question it. And I actually, with my first daughter, did delay the schedule.
Winter: There are a number of different factors that go into a vaccine decision. There is a question of the disease itself. How dangerous is the disease? Is the disease treatable? Pertussis is treatable. Some of the other diseases are not.
Yarkin: As I went along, my husband has a science background, and just at some point, he just put his foot down and said, 'Enough is enough. Vaccines are incredible. They're safe.' ... And he kind of put a stop to that with me.
Winter: Pertussis we opted not to vaccinate against ... I was not impressed by the efficacy. I was seeing failure rates of more than 30 percent. I was concerned by the complication rates ... And they were kind of scary complications. Neurological damage in most cases ... that they got better from. But I don't want my kids to have temporary neurological damage, either.
Yarkin: There are risks just to being alive, and I accept that. I love vaccines and that it cuts back on some of those chances of getting sick.
Winter: My kids are at no risk of dying from this disease. They are at essentially no risk of complications from this disease. It would be a long and uncomfortable disease for them, but they would get better. And I've seen pertussis. I have doctors who are ready to work with me to treat it if they should get pertussis. So no, I'm not particularly concerned about them. My only concern is making sure that we protect the infants in our community by keeping coughs away from them.
Yarkin: But the fact is, it does provide coverage for the community and it provides coverage for babies who are unable to get the vaccine and who are at risk of dying if they get the disease.
Winter: The vaccine is over 90 percent effective at reducing the severity of symptoms. But someone who has a mild case of pertussis is still contagious.
Yarkin: It works. It just means that it doesn't last as long as we hoped that it would and that it doesn't have the high coverage that we would like it to have.
Winter: People think, 'Well I'm vaccinated, I don't need to worry about it.' We have so many vaccinated people running around, saying, 'I don't need to worry about it. I can cough around any newborn because I'm vaccinated.' That's a problem.
Yarkin: I think that they're certainly not trying to be irresponsible. I think they are trying to do the responsible thing by being very educated about, you know, everything that's being said out there about vaccines and understanding the risks and evaluating those risks. But I think without a science background, it's hard to do good risk evaluation.
Winter: OK, the most important thing we can do to protect newborns is keep coughs away from babies. All coughs. And then it's early diagnosis, early treatment and informing your contacts. We need to screen everyone who is around a baby for pertussis any time they have a cough of any description.
Yarkin: I do think that it's arrogant to think that you can outsmart a microbe and a virus ... with pertussis, you know, thinking that you can catch ... with just a cough? I mean, I know that we have a lot of coughs through the winter and to identify it as pertussis right away and quarantine is ... boy, I wouldn't trust myself to be able to catch that with my kids to keep other kids safe. I think that's very risky.
Winter: The most important thing that I always say is: Every vaccine is different. Every disease is different. Every child is different. Every family is different. Every environment is different. And the vaccination choices that might be entirely appropriate for one person would be completely inappropriate for another person.
Yarkin: I certainly, you know, I think that individual rights are really important, but I do think that that's part of the conversation that needs to be had, is: How far do your individual rights go when it could affect the health of others around you? And when is it that your actions are actually going to affect the safety and well-being of somebody else and when do you say you can't, you don't have the freedom to make that choice because it could hurt somebody else? And I don't have the answer to that. You know, that's one of the things that makes this vaccination debate so interesting, is that dynamic.
Do you have questions about the whooping cough outbreak? Ask them in the comments section below or send them to firstname.lastname@example.org or via Twitter at @jasokane. We'll post answers from the Centers for Disease Control and Prevention on Friday.
Video edited by Sarah Clune.