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Whooping Cough Vaccines Stored In Specialised Carriers, Not 'biohazard' Boxes: Philippine Medic

Health authorities have stressed that vaccines against whooping cough, also known as pertussis, are safe and effective, contrary to social media posts that falsely claimed the jabs were a "biohazard". The posts, which surfaced in the Philippines amid a surge in reported cases of the disease, misrepresented a photo of safety boxes -- where used syringes and vials are discarded -- from a vaccination drive in the Philippine city of Caloocan.

Whooping cough is a vaccine-preventable disease that spreads through droplets produced by coughing or sneezing. Its symptoms include a mild fever, runny nose and coughing spells lasting four to eight weeks (archived link).

The Philippine Department of Health (DOH) recorded 1,112 cases of pertussis (whooping cough) between January 1 and March 30, 2024, a significant jump from only 32 cases in the same period in 2023. At least 54 deaths were reported as of the end of March this year (archived link).

The Southeast Asian country's health department said an immunisation programme was underway in response to the outbreak.

Following the uptick in locally reported cases, a Tagalog-language Facebook post warned on April 2, 2024, "To all parents, do not vaccinate your kids.

"The biohazard symbol is marked on the box carrying the vaccines. This means its contents are dangerous to health."

Screenshot of the false Facebook post, captured on April 17, 2024

One of the photos showed a red circle highlighting a yellow box marked with a "biohazard" symbol; another showed an online definition for "biohazard"; the third showed a child being vaccinated.

The false claim also surfaced in other Facebook posts here, here and here.

As well as the Philippines, whooping cough has been on the rise in Europe and China with global health authorities blaming the Covid pandemic.

The European Centre for Disease Prevention and Control (ECDC) said last month that whooping cough was "an endemic disease worldwide" with peaks every three to five years.

"The current increase is potentially linked to lower circulation during the COVID-19 pandemic, combined with suboptimal vaccination uptake in certain groups during the COVID-19 pandemic," it added.

Safe and effective

Health authorities -- such as the US Centers for Disease Control and Prevention and the Philippines' DOH -- have said vaccines against whooping cough are safe and effective (archived links here and here).

There are at least two types of whooping cough vaccines. These include diphtheria, tetanus and pertussis (DTap) vaccines for babies and children up to seven years old; and tetanus, diphtheria and pertussis (Tdap) vaccines for teenagers and adults.

The CDC said that most side effects of Tdap are mild. Common side effects from DTaP, by contrast, include swelling to vomiting, while  "more serious reactions," such as seizures or high fever  "happen much less often" (archived link). 

Misrepresented safety boxes

A reverse image search on Google found several photos in the false posts were lifted from a Facebook post shared on April 1, 2024 by Filipino Congressman Oscar Malapitan, a lawmaker from Caloocan City in northern Manila (archived link).

Malapitan's post said infants were given pertussis jabs and other vaccines at the Caloocan City North Medical Center.

Karmela Marquez, medical coordinator for the national immunisation programme in Caloocan City, said the whooping cough vaccines were stored in vaccine carriers -- not in yellow boxes carrying the biohazard logo.

The vaccine carriers --  or the blue container in the picture in the false posts -- are typically used by health workers during vaccination campaigns to keep the jabs cold during transportation (archived link).

The yellow boxes with a biohazard logo, meanwhile, contain used syringes and vials, she said.

"I just want to clarify that the box that says 'biohazard' is what we call a safety box," she told AFP on April 16.

"Syringes and vials will be disposed to their respective safety boxes. These boxes are tamper-proof to avoid needle stick injuries."

Below is a screenshot of the original photo, with the vaccine carrier highlighted by AFP:

Screenshot of original photo, with corresponding elements highlighted by AFP

At its 13-minute three-second mark, this live stream of the event on the official Facebook page of Caloocan City Mayor Dale Gonzalo Malapitan showed a health worker retrieving vials and syringes from the vaccine carrier -- not from the yellow safety box  -- before inoculating a child (archived link).

Below are screenshots of the live stream, with corresponding elements highlighted by AFP:

Screenshot of Facebook livestream, with face blurred by AFP for privacy

Before being kept in vaccine carriers, Marquez said whooping cough vaccines were stored between two to eight degrees Celsius (35 to 46 degrees Fahrenheit) in pharmaceutical-grade refrigerators (archived link).

Local newspaper Manila Standard and state-run radio station Radyo Pilipinas also published similar photos of the event (archived links here and here).

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Pregnant Women Urged To Get Whooping Cough Vaccine

Pregnant women in the Black Country are being urged to get vaccinated against whooping cough after a rise in cases.

The bacterial infection of the lungs spreads very easily and can cause serious problems, especially in babies and young children.

The Black Country Integrated Care Board (ICB) is advising pregnant women between 16 and 32 weeks to contact their GP to get the vaccine so their baby has protection from birth.

The UK Health Security Agency warned earlier this year of a steady decline in uptake of the vaccine in pregnant women and children.

Symptoms of the infection, also known as "100-day cough", are similar to a cold, with a runny nose and sore throat.

Sally Roberts, chief nursing officer for the ICB, which covers Wolverhampton, Dudley, Walsall and Sandwell, said anyone could catch it, but it was more serious for young children and babies.

"Getting vaccinated while you're pregnant is highly effective in protecting your baby from developing whooping cough in the first few weeks of their life – ideally from 16 weeks up to 32 weeks of pregnancy," she said.

"If for any reason you miss having the vaccine, you can still have it up until you go into labour."

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News headlines showcasing outbreaks of infectious diseases are all too common these days. During the pandemic, many families missed routine medical appointments. That meant people weren't getting routine vaccines. That, combined with a loud minority of folks working against science and vaccines, means we have many communities of people at risk. It's easy to think the diseases we vaccinate for are a thing of the past. The reality is that they're not. Those diseases still exist and when we don't vaccinate, we create opportunities for them to spread. While measles is among the most feared vaccine-preventable diseases and seems to dominate today's headlines, there are other serious diseases we can't let our guard down against. Today, we highlight whooping cough. We explain what it is, who is most at risk, and who needs to be vaccinated (hint: nearly all of us).

What is whooping cough?

Whooping cough, or pertussis, is a serious highly infectious disease. It is caused by Bordetella pertussis bacteria and is spread when an infected person coughs or sneezes. Outbreaks can occur in school or child care settings and areas with a concentration of unvaccinated people. Whooping cough is common in the U.S.

Symptoms appear 7 to 14 days after infection and can last  6 to 10 weeks. While whooping cough may start as a simple cold, it progresses to cause uncontrollable coughing spells. Whooping cough is marked by the "whoop" sound that is made following coughing when an infected person inhales. Whooping cough can lead to pneumonia, seizures, brain damage, and even death. We're lucky to live in a time when we have a vaccine to protect against whooping cough!

Who is most at risk for severe infection?

While whooping cough can affect people of all ages, it can be deadly for infants and young children. Some infants who get whooping cough will not cough at all. Instead, they will stop breathing and turn blue. One third of babies who get whooping cough will be hospitalized. One in five will contract pneumonia and one in 100 will die. 

Infants cannot be vaccinated until two months of age. This is why the Centers for Disease Control and Prevention recommends pregnant people receive the Tdap (tetanus, diphtheria, pertussis) vaccine during the third trimester of each pregnancy. By getting vaccinated while pregnant, antibodies are passed to the infant who will then be protected for the first few months of life. The CDC also recommends surrounding babies with protection by ensuring those around them are up to date with whooping cough vaccines. This practice is also known as "cocooning."

While complications are worse in infants and very young children, whooping cough can be serious for other populations as well. This includes pregnant people. Coughs from the disease can cause people to vomit, lose control of their bladder, faint, and even fracture ribs. Cases of whooping cough in adolescents and adults are likely under-reported because their symptoms are milder.

Who should be vaccinated for whooping cough?

While whooping cough is treated with antibiotics, there are vaccines to help prevent it. Everyone should be vaccinated for whooping cough. (Those who have had allergic reactions to previous pertussis vaccines or who have certain health conditions may not be able to be vaccinated.) The DTaP and Tdap vaccines protect against diphtheria, tetanus, and pertussis (whooping cough). Infants should get a dose of the DTaP vaccine at 2 months, 4 months, 6 months, 15 to 18 months, and between 4 and 6 years of age. Adolescents need the Tdap vaccine between 11 and 12 years old. In Colorado, the final dose of the DTaP vaccine is required before kindergarten entry, and the Tdap vaccine is required before entry into sixth grade. Adults should get the Tdap vaccine if they've never received it. A booster dose of Tdap should be given every 10 years to maintain protection.

It's important to note that you can still get whooping cough even if you've been vaccinated. No vaccine is 100% effective. However, vaccinated people usually have much milder infections than unvaccinated people.

Vaccination is not something we do solely for ourselves. When we vaccinate, we help stop the spread of dangerous diseases and protect those in our communities who are most vulnerable, like infants too young to get a whooping cough vaccine. When enough of us are vaccinated, we won't see any more headlines with outbreaks of preventable disease.

Immunize Colorado was formed in 1991 in response to alarmingly low vaccination rates across the state. At the time, only about 50% of Colorado's children were adequately vaccinated. Since then, Immunize Colorado has worked to protect Colorado families, schools, and communities from vaccine-preventable diseases. The organization advances its mission through a focus on six core program areas: coalition building, community outreach, provider education, data translation, free and low-cost vaccines, and public policy. Learn more at immunizecolorado.Org/.

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