Iowa to require mandatory whooping cough vaccines for children


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As the number of cases of pertussis — known as whooping cough — increases across Iowa, state health officials are making vaccinations throughout school systems mandatory.

Local nurses said the move helps students stay healthy and keeps them in the classroom.

"The rationale behind this is, of course, [because] we see cases of pertussis that are occurring in schools," said Don Callaghan, the bureau chief of immunizations with the Iowa Department of Public Health. "Immunity does wane over time, and we want to make sure children are protected to prevent outbreaks."

According to 2010 statistics from the Iowa Department of Public Health, there was a 229 percent increase in whooping-cough activity over the previous three years' average, a trend consistent with Iowa's highest reported outbreak in 2004-2005.

Currently, Iowa is one of 10 states that doesn't require a tetanus, diphtheria, and pertussis booster vaccine at the secondary-school level.

Callaghan said Iowa is trying to follow the national recommendations by requiring 13- and 14 year-olds to get vaccinated, but negotiations with health-care providers has delayed the requirement.

"This isn't the first time [Iowa school districts] have been hearing about this," Callaghan said.

Susie Poulton, the director of the Iowa City School District health and student services, said the schools see anywhere from five to 10 cases of pertussis every year.

"We've been fortunate we haven't had a true outbreak for years, but there have been some in Iowa City where we have 100-plus kids who end up with pertussis," she said.

Whooping-cough symptoms are similar to the common cold, said Miles Weinberger, a University of Iowa professor of pediatrics. Infected people often do not realize they have the infection, allowing for easy transmission.

Studies have shown 20 to 30 percent of young adults and college students who have a cough for more than two to three weeks tend to have pertussis, Weinberger said.

"Hopefully, physicians are becoming more aware that someone with a persistent cough may have pertussis," he said. "I think they're thinking more about it now."

Weinberger said the continued spread of this infection is not only harmful to adolescents but can be fatal for infants.

"Coughing could be so bad it could be difficult to sit in classes for students," he said. "It's a very troublesome cough, older children and teens aren't at risk of fatalities, but they can lose a lot of sleep and it can interfere with functioning."

Iowa Public Health officials aim to have the vaccination regulation enacted by 2013. The vaccine has an open-market price around $38, but the cost is covered by all insurance programs and the Vaccines for Children's Program allows access for underprivileged individuals.

"It will take eight to nine months to look at the rule-making process and educate school districts regarding the changes in the law, specifically targeting the changes in school nurse's workloads," Callaghan said.

Kathy Campbell, a school nurse for Clear Creek Elementary in Oxford, said she, among many school nurses, believe it will be worth the time and effort.

"I think it's definitely a good thing if it helps keep students in school," she said. "It's a serious illness that makes them absent for a long period of time — if we can stop that, that's great, that's a good thing."

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