Pertussis Outbreaks And Vaccine Effectiveness: a screed by "Orac"

If it is not corporate medicine and Big Pharma, Orac is ranting against it. However, in this particular instance he has some legitimate observations.
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Pertussis Outbreaks And Vaccine Effectiveness
Posted by Orac
https://www.waccobb.net/forums/wacco...-10_1537-1.png

Respectful Insolence
September 5, 2012
https://scienceblogs.com/insolence/2...effectiveness/

[moderator: to view the informative graphics which
accompany this article please use the link above]

About a month ago, I deconstructed a typically dishonest
and deceitful attempt by that Overlord of Quackery on
the Internet (in my opinion, of course), Joe Mercola, to
claim that the acellular pertussis vaccine doesn't work.
It was a typical Mercola bit of prestidigitation that,
as so much antivaccine propaganda does, took a grain of
truth (that there have been outbreaks among vaccinated
populations) and ran with it to construct a fantasy
world in which pertussis outbreaks are somehow an
indictment of all vaccines, which, of course, don't work
at all, ever, under any circumstances, anywhere at least
in the minds of antivaccinationists.

Perhaps the biggest difference between science-based
doctors and quacks is a very simple one. When a
treatment or preventative measure isn't working as well
as it should, we science-based physicians ask why. We
try to find out what is not working optimally. We try to
figure out how to make things better. So it is with the
acellular pertussis vaccine. It's no secret that recent
outbreaks have been notable for a large contingent of
vaccinated children being involved. Indeed, I cited two
studies that both basically agreed that there appears to
be a hole in the vaccination schedule that leaves
children in the 10-12 year age range inadequately
protected, such that the attack rate is nearly equal in
vaccinated and unvaccinated or undervaccinated children
during the outbreaks was nearly the same.
Antivaccinationists love to cite these studies, but what
they always leave out is the finding that the acellular
pertussis vaccine is effective in protecting younger
children and also in protecting teens who have received
the recommended booster at age 11 or 12.

In other words, antivaccinationists willfully invoke the
fallacy of the perfect solution (also known as the
Nirvana fallacy), which I like to liken to an old sketch
Mike Myers back when he was on Saturday Night Live in
which he played a Scotsman who would loudly say, "If
it's not Scottish it's crap." Basically, under this
fallacy, if a vaccine doesn't work perfectly 100% of the
time, it's crap. If it isn't absolutely, positively,
100% safe, it's crap. If it fails, even just once, to
protect against the disease it's designed to protect
against, it's crap. Never mind that nothing in medicine
is 100% effective and safe and the only certainty in
medicine (and life) is that all of us will one day die.

None of this is to say that we shouldn't strive to
improve the acellular pertussis vaccine or improve the
vaccine schedule, and that was the topic of a recent
paper in the New England Journal of Medicine by Dr.
James D. Cherry, a pediatrician at the David Geffen
School of Medicine, University of California at Los
Angeles, Los Angeles entitled Epidemic Pertussis in 2012
- The Resurgence of a Vaccine-Preventable Disease. He
begins by noting that we are currently experiencing what
may turn out to be the largest outbreak of pertussis in
50 years, asking the question: Why has this
theoretically vaccine-preventable disease been on the
upswing? Several answers are forthcoming, but here's a
graph of pertussis versus time:

continues at https://scienceblogs.com/insolence/20...effectiveness/