Dr. Paul Nelson, an Omaha family physician, is not someone you'd call shot-happy.
He recommends some immunizations for his patients but discourages others.
Nelson said he is concerned about what will happen if a certain vaccination leads to complications that would cause people to lose faith in immunizations in general.
"Every new vaccine that comes along just gives us shivers: 'OK, what's going to happen with this one?'"
One of the immunizations Nelson does recommend for his adult patients is the one that protects against pertussis, or whooping cough.
"Of the current immunizations for adults, getting immunized against pertussis is important, especially if you are going to have contact with children under 6 months of age," he said.
Since the early 1980s, whooping cough cases have been increasing, with peaks every three to five years, according to the U.S. Centers for Disease Control and Prevention.
In 2009 there were nearly 17,000 reported cases nationally, including 14 deaths, the CDC said. Last year several states reported increases in cases or localized outbreaks of pertussis, including 9,100 cases and nine infant deaths in California.
Nebraska had 216 pertussis cases in 2010, state figures show, up from 140 in 2009 but down from the 276 reported in 2008.
Iowa public health officials reported 705 cases of whooping cough in the state last year, an increase of 229 percent over the 2007-09 average.
The actual number of cases probably was much higher, the officials said, because most adults with whooping cough typically don't seek medical care and therefore aren't diagnosed.
Older people often don't think they can even get whooping cough, said Dr. Archana Chatterjee, chief of the division of pediatric infectious disease at Creighton University School of Medicine.
But they do, she said, noting that older people with pertussis sometimes cough so hard that they fracture ribs.
Adults can spread the germs to children with whom they come in contact, she said.
Said Jeff Dimond, a CDC spokesman: "What we advocate is anyone who is going to be around a newborn infant should be up-to-date on their Tdap (tetanus, diphtheria and acellular pertussis) shots. What we want to create is a cocoon of immunity around the infant."
Whooping cough — so named because of the "whoop" sound babies make when they inhale — is especially hard on little ones. Children 6 months old or younger with pertussis have the highest rate of hospitalization, pneumonia, seizures and death, the CDC said.
Before pertussis immunizations were available, the CDC said, nearly all children developed whooping cough. In the United States prior to pertussis immunizations, between 150,000 and 260,000 cases were reported each year, with up to 9,000 pertussis-related deaths.
The CDC said the Tdap shot can be given regardless of when the last tetanus-diphtheria booster was given. Nelson said you could get one even if you had a booster the previous week.
Chatterjee noted that people should check with their physicians for information on all vaccinations recommended for their age group.
"They should have the information," she said. "If they don't, they call up somebody like myself."
Contact the writer:
402-444-1109, bob.glissmann@owh.com
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