Vaccination fever rises

Watching a child with whooping cough struggle for breath isn't something you forget - particularly when you know what the disease is doing to their body.

"They cough and cough and cough and they can't breathe and they have to do a whoop to bring the air in," says child health expert Fiona Stanley.

"As they are coughing the pressure in their brain goes up and the pressure in their lungs goes up so they can bust blood vessels in the brain and in the lungs.

"And that's where the damage occurs."

Whooping cough, more properly called pertussis, is one of the childhood diseases that should no longer be a problem.

The first form of a vaccine for the disease was developed more than 80 years ago and has been refined many times since then.

Immunisation against whooping cough has been on the schedule in Australia since 1942.

Yet there were 29,700 cases nationwide of whooping cough last year - twice the number notified in 2008 - and three deaths of babies within the first three months.

Many cases were in children who had not been fully vaccinated or in adults whose vaccination coverage had waned and who had not received booster shots.

Falling vaccination rates against diseases such as pertussis concern child health professionals.

Professor Stanley believes any drop in the immunised percentage of the population will lead to preventable deaths.

But health professionals are struggling to combat what they call immunisation conspiracy theories, which suggest the adverse impact of vaccination is somehow more serious or widespread than is recorded by doctors.

This adds to genuine concerns of higher-than-normal adverse effects, such as the number of children who developed fever after taking the seasonal flu vaccine, which can make people less inclined to immunise.

"It feeds the anti-vaccine lobby whenever there are reports of adverse events and, while we don't yet know the outcome around the influenza vaccine, it raises the issue that we need to be vigilant and have really good data," Professor Stanley says.

"People can be reassured that in WA we have some of the best researchers and some of the best data and we will always research these things."

Professor Stanley says it is natural for parents to worry about the risks their children face but the investigation of any side effect is comprehensive.

"It is always easier to make a parent stop doing something like have their children vaccinated than get them to start doing something," she says.

"But what parents need to know is that the risks of the vaccine are less than the risks of the disease.

"The risks of the disease are overwhelming, horrendous, but of course we have forgotten because we have the vaccines and we forget what it was like."

Peter Richmond, a paediatrician and immunologist with Princess Margaret Hospital, is also concerned by anti-immunisation pressure.

He says very high coverage for immunisation not only stops disease spreading within vaccinated children but also protects other vulnerable groups whose own immunity might have waned, including those who are not vaccinated.

"It has been shown for a number of diseases now that vaccinating children prevents disease in older people," he says.

"For instance, if you vaccinate against pneumococcal, you prevent 90 per cent of the pneumococcal vaccine serotypes in young children but you actually prevent twice as many cases in older people from the same strains in the vaccine."

He points to controversy over the Measles Mumps Rubella (MMR) vaccine in the UK as showing what can happen when fear trumps public health measures.

A now-discredited study of 12 children by former doctor Andrew Wakefield linked the vaccine to autism, something researchers say has been refuted by multiple studies.

"A good example is the MMR vaccine in the UK where a researcher who has been struck off the medical register suggested there was a relationship between vaccine and autism," says Associate Professor Richmond.

"That's now been disproved but the rates dropped in the community and they started having measles outbreaks and mumps outbreaks and children dying because of that."

Nationally collected figures show that only a small percentage of children receive no immunisation at all: by the age of two, 94 per cent of WA children have been vaccinated against pertussis, having had two or three doses of the same vaccine that contains protection against diphtheria and tetanus.

By the age of six, though, that figure falls: just 85 per cent of WA five-year-olds have had the additional dose of vaccine they need to be fully covered.

Similar percentages of both groups are covered for measles, mumps and rubella, making WA the State with the highest rate of children not fully immunised.

Professor Richmond says the alternative to immunisation is a life fraught with avoidable risks, as children face diseases that can have deadly implications.

"Some people say, 'We should be able to let children develop natural immunity'," he says.

"But what you are really talking about there is survival of the fittest - there will be children who get very sick and die from the diseases we are preventing.

"The concept you are much better off with natural immunity means I'm willing to take a chance with my child's life that they will get through whooping cough or meningitis without any complications."