A shot of prevention

St. Louis Post-Dispatch: SARS, that mysterious and deadly upper respiratory illness, captured world headlines recently. So did monkeypox and West Nile virus, two other exotic attention-grabbers. But who's heard lately about pertussis?
This disease is a real killer in very young children. It sends kids into spasms of coughing so severe they've been known to break ribs or develop a hernia. Pertussis infection rates have been slowly increasing since about 1980. Outbreaks of this once uncommon illness have occurred in at least eight states in recent months. Infants have died in Oregon and New Mexico. South Carolina experienced its worst outbreak in state history. Washington state saw the number of pertussis cases more than triple between 2001 and 2002, to 574 from 184. A new generation of doctors has become familiar with the characteristic high-pitched hacking that gives pertussis its common name: whooping cough.
This didn't have to happen. Whooping cough is not only treatable in its early stages, it is entirely preventable. A vaccine has long been available, with shots given at 2, 4, 6, and 12 months of age. But just three-quarters of American kids get their shots on time.
Paradox
One paradox of vaccination is that success in targeting a disease makes the illness appear less threatening. Parents are less likely to have their children vaccinated. Today, many parents are more worried about the shot than the sickness. Contributing to that muddled thinking are theories linking childhood vaccinations with autism or other developmental problems. Those claims have been investigated, and discounted. But that hasn't laid the fears to rest. Catering to them, state legislatures have passed laws making it ever easier for parents to exempt their children from vaccination. One, Colorado, is now experiencing an outbreak of whooping cough.
Programs exist to help low-income families get their children vaccinated. They can -- and should -- be expanded.