Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 698 - PERTUSSIS VACCINE PAMPHLET CODE › Appendix A - Important Information About Pertussis (Whooping Cough) and the Pertussis Vaccine in DPT

Current through Register Vol. 48, No. 28, July 12, 2024
Introduction
This informational pamphlet is being made available to you to
				explain the benefits and possible side effects to the immunization for
				pertussis (the DTP shot). As a parent, you need to be aware of the importance
				of immunization, the possible risk associated with immunization and the risks
				faced by unprotected children.
Pertussis or whooping cough can be a serious disease. In some
				persons, especially very young children, it can cause permanent brain damage or
				even death. In order to protect persons from whooping cough, Illinois
				immunization rules "Immunizations" (77 Ill. Adm. Code 695) require children to
				get at least four DTP shots before they go to school. However, not all children
				should receive the DTP vaccine. In some cases, the "P" part (pertussis) of the
				DTP vaccine can cause serious reactions, including permanent brain damage or
				even death (See questions "Who Should Not Receive The DTP Vaccine?", "When
				Should a Child's DTP Shots Be Delayed?" and "Which Children Are More Likely
				Than Others To Have a Serious Reaction To DTP Vaccine?"). So some children
				should not get the "P" part of the DTP vaccine at all. These children should
				instead receive pediatric DT (diphtheria and tetanus) in order to have
				protection against these two diseases. Also, for some children the series of
				DTP vaccine should be delayed.
It is very important for you to read and to understand the
				information about whooping cough and the DTP vaccine contained in this pamphlet
				to protect your child's health. If there is something in this pamphlet you
				don't understand, ask the person who gave you the pamphlet to explain
				it.
What is DTP vaccine?
DTP is the abbreviation for the combined
				diptheria/tetanus/pertussis vaccine generally used to prevent these three
				serious diseases. This 3 in 1 vaccine is made from inactive toxins and killed
				germs and does not cause any of the diseases against which it protects. When
				injected, the vaccine causes the body to create disease-fighting substances
				called antibodies. Pediatricians advise that children receive five injections
				of the DTP vaccine prior to entrance into school.
What is Pertussis (whooping cough)?
Pertussis, also known as whooping cough, is a highly contagious
				disease caused by the bacterium, Bordetella pertussis, which is found in the
				mouth, nose, and throat of a infected person. It is spread to others by
				sneezing and coughing. The disease begins with cold-like symptoms and
				progresses to repeated, violent coughing spells, especially at night, which can
				interfere with eating, drinking, breathing, and sleeping. The coughing spells
				are commonly accompanied at the end by a "whooping" sound while the victim
				struggles to take a breath. This is why this disease is also known as whooping
				cough. A child may have as many as 30 or 40 or more coughing fits per day. The
				disease normally lasts for 4 - 6 weeks.
Why is it important to immunize children with DTP
				vaccine?
Whooping cough used to be an extremely common illness in the
				U.S. with as many as 250,000 cases reported per year during the 1930's.
				Widespread use of pertussis vaccine in this country since the late 1940's has
				contributed to a large reduction in the number of cases and deaths from the
				disease.
If infants and children were no longer immunized, the number of
				cases, the complications of illness, and the deaths due to pertussis could
				again become widespread, as has occurred in countries where usage of the DTP
				vaccine has decreased. When acceptance for the vaccine declined in Great
				Britain and Japan during the 1970's each country experienced serious outbreaks
				of pertussis; thousands of children were hospitalized and many died.
Because whooping cough is highly contagious, protection by
				vaccine is important for both the child who gets the shot and the community at
				large.
Must my child be immunized with DTP vaccine?
Illinois immunization rules "Immunizations" (77 Ill. Adm. Code
				695) require most children to receive several different immunizations before
				they can enter school - DTP vaccine is one of them. In order to enter school,
				at least 4 doses of DTP, at the proper intervals, are required; 5 are
				recommended.
Not all children are required to get DTP shots. A child may be
				exempt from Illinois school entrance immunization requirements if he or she
				meets the appropriate conditions for such an exemption as indicated
				below:
* the child has any medical condition listed in the
				section "Who Should Not Receive the DTP Vaccine?";
* the parent or guardian requests an exemption on
				bonafide religious grounds (in which case the objection must be universal, and
				not for DTP vaccine alone).
What are the risks of getting whooping cough?
In recent years, according to the Centers for Disease Control
				(CDC), over 2,000 cases of whooping cough have been reported each year in the
				U.S. Since many cases go unrecognized or unreported, the actual number of cases
				could be much higher.
At the present time, approximately 30% of reported cases in the
				U.S. occur in infants less than 6 months old. One-half of the reported cases
				occur in children less than 1 year of age, and approximately 70% of the cases
				involve children less than 5 years of age. Whooping cough is 21/2 times more
				common in children less than 1 year of age than in children who are between the
				ages of 1 - 4. Fatal cases are most likely to occur in children less than 1
				year of age. This is why it is important that a child be given the vaccine as
				early in life as possible.
Older children and adults...even those who have been
				vaccinated...can also contract the disease and are believed in many cases to be
				the source of infection in the younger children.
What Are The Possible Dangers Of Whooping Cough?
A severe case of whooping cough can cause grave complications,
				among them convulsions, pneumonia, and brain damage. These effects are most
				likely to occur in the very young, and when they do, they can be fatal. An
				alarming number of whooping cough complications occur in infants younger than 1
				year of age:
* more than half of the children are hospitalized
				(highest in infants less than 6 months of age).
* one out of five children develops pneumonia
* one child out of 40 has convulsions
* one child out of 240 develops diseases of the
				brain or permanent brain damage
* death occurs in one out of 100 infants less than
				six months of age.
In recent years, an average of 9 deaths due to whooping cough
				has been reported each year in the U.S. While fatality is low, almost all
				deaths are among children under 1 year of age, most in those under 6
				months.
While there is no specific treatment for whooping cough, prompt
				medical attention and supportive care can be successful in reducing the
				severity and complications of the disease.
How Do The Possible Risks Of The DTP Vaccine Compare To The
				Benefits?
While the chance of your child being harmed from whooping cough
				is high, the chance of your child being harmed by the DTP vaccine is very low.
				The possible side effects of the vaccine should be balanced against the risks
				related to the disease. Both convulsions and permanent brain damage occur more
				frequently following whooping cough disease than after DTP vaccination.
Most U.S. doctors and public health officials believe that the
				benefits of pertussis vaccine outweigh the risk of reactions to the vaccine for
				most children.
What Are The Possible Side Effects Of The DTP Vaccine?
Vaccines are among our safest and most reliable medicines.
				However, vaccines, like all medicines, can cause side effects. With DTP
				vaccine, most children receive the full series of DTP shots without serious
				problems. The most common side-effects of DTP vaccine are soreness, redness and
				swelling at the site of the injection, a slight fever and fussiness. These
				reactions usually occur within the first 48 hours, are mild, and have a short
				duration. The frequency of these reactions is higher when more doses of DTP
				vaccine are given to the child. Less common, but more severe side-effects can
				occur.
The more serious reactions to the DTP vaccine may include
				convulsions; shock-collapse (turning blue or pale, limp, non-responsive); a
				fever of 103° F. or more; high-pitched screaming, persistent crying for
				three or more hours or unusually long sleeping with great difficulty in waking
				the child. Any of these signs should be reported to your doctor or health care
				provider at once.
Although rare, serious reactions that are possibly related to
				the vaccine include long-term seizure disorders, brain damage, and even
				death.
There is a great deal of disagreement over how often these
				serious reactions happen. The DTP vaccine, and particularly the "P" component,
				is known to cause serious reactions more often than other vaccines. It is not
				known how many children develop serious problems after the DTP shot, yet
				clearly children who receive DTP shots are at somewhat greater risk of serious
				reactions than those who receive DT shots, without the "P".
Because nervous system disorders such as seizures are typically
				first noticed in the first year of life, during the same period when three
				doses of DTP vaccine are given, it has been difficult to determine whether DTP
				vaccine causes these illnesses or whether their onset is coincidental. The DTP
				vaccine, therefore, may not necessarily be the cause of these rare
				problems.
When Should Your Child Receive The DTP Vaccine?
The DTP vaccine is given by injection starting early in
				infancy. The U.S. Public Health Service and the American Academy of Pediatrics
				recommend that children receive five injections of the DTP vaccine.
At least three shots are needed to provide initial protection.
				Young children should get 3 doses in the first year of life, normally at 2, 4,
				and 6 months of age, and a fourth dose at about 15 months of age. A booster
				dose is important for children who are about to enter school, and should be
				given between the ages of 4 and 6 years.
Because pertussis is not very common or severe in older
				children, those 7 years of age or older should receive a vaccine that does not
				contain the pertussis part. The vaccine which contains no pertussis part and a
				lower concentration of the diphtheria part is called Td vaccine.
Who Should Not Receive The DTP Vaccine?
Before you schedule your child to receive the DTP vaccine, plan
				to discuss his or her medical history with your doctor or health care provider.
				Some children should not receive the shot or should have the shot delayed until
				another time. If your child had a serious reaction following a previous dose of
				DTP vaccine, he or she should be fully evaluated to clarify his or her medical
				and neurologic status before a decision is made on continuing the DTP
				shots.
The use of DTP vaccine for your child needs to be closely
				evaluated by your doctor or health care provider if:
* he or she has a known problem of the brain or
				nervous system which is worsening or a seizure disorder which is uncontrolled;
				or
* he or she has already had an earlier DTP shot and
				any of the following reactions developed after the shot:
* a measured fever of 103° F. or greater
				(usually within 48 hours);
* an episode of limpness and paleness;
* a severe allergic reaction to any vaccine
				component;
* collapse or shock-like state within 48
				hours;
* an unusual high-pitched screaming;
* convulsion(s) with or without fever occurring
				within 7 days; or
* other severe problems of the brain occurring
				within 7 days, including prolonged sleeping and inability to wake a child,
				unusual twitching of the body or unusual staring;
* persistent crying for 3 hours or more.
Children who have had a convulsion and children who have a
				brother, sister, or parent who has ever had a convulsion are more likely to
				have a convulsion after receiving DTP vaccine. The Centers for Disease Control
				(CDC) and the American Academy of Pediatrics recommend that because of the
				overall risk of pertussis disease and the fact that the risk of convulsions is
				still very low: (1) children with a personal history of a convulsion and whose
				nervous system is stable may receive DTP vaccine; and
(2) children with a family history of convulsions should
				receive DTP vaccine. However, you should tell the person who is to give the
				immunization about such a history and discuss the possibility of using an
				anti-fever medicine.
Your child should not need further whooping cough vaccination
				if he or she has had laboratory confirmed whooping cough. This also should be
				considered with your doctor or health care provider.
If a child should not receive DTP vaccine, he or she should
				still be protected against diphtheria and tetanus by receiving pediatric DT
				vaccine rather than DTP.
When Should A Child's DTP Shots Be Delayed?
A child's DTP shots should be delayed if he or she:
* has a fever or ear or chest infection or is sick
				with an illness more serious than a cold at the proposed time for vaccination,
				or has not completely recovered from a past illness;
* has had a previous convulsion, seizure, or nervous
				system illness, until it can be determined that no more seizures are happening
				and the condition is stable and under control; or
* is taking a drug or undergoing a treatment that
				lowers the body's resistance to infection, such as cortisone, prednisone,
				certain anticancer drugs (chemotherapy), or radiation treatments.
A child's shots can be continued after he or she is well and
				has had a full medical evaluation.
Which Children Are More Likely Than Others To Have A Serious
				Reaction To DTP Vaccine?
The medical experts do not agree on the reasons why reactions
				occur following vaccination, nor can they predict in which children serious
				reactions will occur. But there are some factors which may make children more
				likely to have serious reactions.
A child may be at higher risk of a serious reaction to the "P"
				part of the DTP vaccine if he or she:
* has had a serious reaction to a previous DTP
				shot;
* has a neurologic illness, including a history of
				seizures or convulsions, the severity of which is changing or uncontrolled;
				or
* has a fever or infection or is sick when the shot
				is given.
How To Reduce The Risk Of A Serious Reaction To DTP
				Vaccine
It is important that a child's medical history be provided to
				the doctor or health care provider before he or she receives the DTP vaccine.
				Such a history should include, but not necessarily be limited to, the following
				information:
* major birth problems;
* your child's history of convulsions (seizures) or
				neurological illness;
* any allergy;
* recent or present illness;
* current medicines or treatment, and
* your child's history of previous vaccine
				reactions.
Besides providing your doctor or health care provider with your
				child's medical history, there are other things which can be done to reduce the
				risk of a serious vaccine reaction. Make sure your child has no obvious signs
				of infection at the time vaccine is given. Many physicians recommend giving
				acetaminophen (Tylenol, Tempra) at the time of vaccination and 4 and 8 hours
				later to reduce fever and reactions at the injection site.
What Signs To Look For In A Serious Reaction To Vaccine
It is important to observe your child carefully at periodic
				intervals during the 30 days after receiving the DTP vaccine, particularly
				during the first 72 hours. If your child has any of the following symptoms
				after receiving the DTP shot, write down the details on this form to help you
				report the correct information to your doctor or health care provider:
Symptom
Date
Time
Duration
Description
Measured fever nearing 103 degrees Fahrenheit
High-pitched unusual screaming
Persistent, inconsolable crying (3 or more
						  hours)
Inability to wake child; unusually prolonged
						  sleeping
Shock or collapse; loss of muscle control; turning
						  white, blue or gray; limpness
Convulsion, seizure; unusual repeated twitching,
						  jerking startling, or staring spells
Loss of sensory or muscle control; paralysis, limping,
						  loss of speech, hearing or sight
Difficulty or stoppage of breathing
Severe local reaction; large red, blue or purple
						  coloring with extended swelling near where the shot was given
If any of these events happen within 30 days after your child
				gets a DTP shot, call your doctor or health care provider at once. Tell them
				about the shot, when it was given, and about your child's reaction. Arrange for
				a prompt examination at the doctor's office, clinic, or emergency room. When
				things settle down, write down in detail exactly what happened.
Who Should I Report To If My Child Has A Reaction To The DTP
				Vaccine?
Parents should report any serious reaction occurring within 30
				days of the DTP vaccine to their doctor or the health care provider who gave
				the vaccine. Your doctor or health care provider will report the serious
				reaction to the Illinois Department of Public Health, through local health
				authorities. The Illinois Department of Public Health upon receiving the report
				of the reaction will notify the manufacturer of the vaccine, through the Food
				& Drug Administration and the Centers for Disease Control (CDC).
Will A More Effective DTP Vaccine Be Available?
Currently, new more purified DTP vaccines are being developed
				and tested in the United States and in other countries. Adequate tests to
				ensure that these vaccines will cause fewer reactions and be at least as
				effective as currently available vaccines require large numbers of test
				subjects. Several years will be necessary to complete development and to prove
				the effectiveness and safety of a new vaccine.
Recordkeeping Following A DTP Shot
Each time your child is given a DTP shot, the following
				information is recorded in a permanent record and is available to you from your
				doctor or health care provider upon request:
* the date and time of day the vaccine was
				administered;
* the DTP dose number;
* the name, address, and title of the person who
				gave the shot;
* the vaccine manufacturer name;
* the vaccine lot number; and
* site of injection
You should keep information concerning the dates of all
				vaccines given to your child in a permanent immunization record plus the
				details of any reactions that may occur until your child enters school. A
				personal immunization card can be provided to you by your local health
				department, or in areas without a local health department, by contacting the
				Illinois Department of Public Health Regional Immunization Program Coordinator
				in your area. The names, addresses and telephone numbers of the above resources
				can be found in the Section: "What If I Have Additional Questions Regarding DTP
				Vaccine?"
Immunization Requirements For Entry Into School
Section 27-8.1 of the School Code (Ill. Rev. Stat. 1987, ch.
				122, par. 8.1) requires that every child, prior to entering any public,
				private/independent or parochial school in Illinois must have received certain
				immunizations. Proof of having received the vaccine must be verified by the
				signature of a health provider such as a physician, school health professional,
				or health official. The written record must show the month, day and year of
				each immunization, if it cannot otherwise be determined that the vaccine was
				given after the minimum interval or age.
The following immunizations are currently required in
				Illinois:
DTP - at least 4 doses, at appropriate intervals,
				for students under 6 years of age.
DT/Td - at least 3 doses, at appropriate intervals,
				for students 6 years of age or over.
Polio - at least 3 doses of live oral polio vaccine,
				at appropriate intervals, for all students.
Measles - 1 dose of live virus vaccine at fifteen
				(15) months of age or older (those students who were enrolled in school prior
				to the 1981-1982 school year and were immunized on or after the first birthday,
				may be considered immune).
Rubella - 1 dose of live virus vaccine on or after
				the first birthday.
Mumps - 1 dose of live virus vaccine on or after the
				first birthday.
Exceptions To The Immunization Requirements
Illinois immunization rules "Immunizations" (77 Ill. Adm. Code
				695) allow for a child to be exempt from school entrance requirements
				if:
* the parent or guardian objects to immunizations,
				in general, because of religious beliefs and practices (the objection must be
				universal and not just for DTP vaccination alone);
* a physician licensed to practice medicine in all
				its branches (M.D. or D.O.) indicates, in writing, the medical reason for the
				child not to get the vaccine;
* the doctor decides that because of your child's
				particular situation, the risks of the vaccine outweigh the benefits to the
				child and the public.
Under the Illinois immunization rules, a philosophical or moral
				reluctance exemption will not be acceptable.
What If I Have Additional Questions Regarding DTP
				Vaccine?
Your family doctor, health care provider, or local health
				department can supply you with more information about DTP vaccine as well as
				about the Illinois school entrance immunization law and the other
				vaccine-preventable diseases.
The names, addresses and telephone numbers of the local health
				departments and Illinois Department of Public Health Regional Immunization
				Program Coordinators are as follows:
Names, Addresses And Phone Numbers Of
Local Health Departments In Illinois
If the city or county in which you live has no local health
				department, you may contact the Illinois Department of Public Health's Regional
				Immunization Program Coordinator in your area who is listed below:
Names, Addresses And Phone Numbers Of
Illinois Department of Public Health
Regional Immunization Program
				Coordinators
Summary
You have the right to receive and understand the information
				contained in this booklet. If you don't understand any part of it, ask to
				discuss it before your child receives DTP vaccine. Discuss any questions you
				may have about the benefits or potential risks of the vaccine with your doctor
				or health provider.
Before your child receives the DTP vaccine, ask your doctor or
				health care provider about the treatment of local reactions and fever.
The success of immunizations makes it easy to forget the
				dangers posed to our children, but whooping cough has not "gone away."