Lisa Jarvis
If you’ve heard the telltale cough and seen an infant gasp for breath, it’s easy to understand why a pertussis outbreak strikes fear in a parent’s heart. Babies can wind up hospitalized or even die from the bacterial infection.
That’s why the recent surge in cases of pertussis, or whooping cough, should serve as a warning that we need to do more to instill confidence in and improve access to routine vaccination against the respiratory illness.
Infants typically receive the vaccine in a three-dose series of DTap shots between two and six months of age, then two more boosters by age 6. Adolescents and adults should get a Tdap booster every 10 years. Pregnant individuals should get a Tdap shot during every pregnancy.
An estimated 35,435 cases of pertussis were reported in the U.S. in 2024 (through Dec. 28), according to the Centers for Disease Control and Prevention. That’s five times the number of infections seen in 2023, and the most since 2012, when the country experienced the worst outbreak in more than 50 years.
Experts attribute the surge to a combination of factors. Some of the increase can be chalked up to a rebound after pandemic restrictions brought infections to a 40-year low. But softening vaccination rates in the U.S. are also a contributor. Vaccine hesitancy — even against the most routine childhood immunizations — is on the rise and could snowball under the incoming administration. President-elect Donald Trump’s picks to lead the country’s top public health agencies have actively worked to foment distrust in vaccines.
It also means doing more to ensure the health care system is set up to make it as simple as possible for Americans to get the shot. That means doing more to educate the public, and in particular pregnant women, about the value of the Tdap vaccine and improving access to shots.
One reason the latest outbreak is so concerning is that pertussis is extremely contagious. "If you’re in a household and someone has pertussis, the attack rate — meaning the percentage of other people who get exposed, are not immune to pertussis and get sick — is 80%,” says Ericka Hayes, senior medical director of infection prevention at Children’s Hospital of Philadelphia. That puts whooping cough in the same neighborhood of infectiousness as measles, she says.
And while the symptoms are typically mild in adults, they still risk exposing those more vulnerable to a severe infection, such as infants and people who are immunocompromised or have severe asthma. Additionally, pertussis can look a lot like a common cold for the first week or so, which means someone could unknowingly spread the bacteria for days before the telltale cough kicks in.
That makes it even more important to stay up to date on the vaccine. The shot isn’t foolproof, but it lowers your chances of infection if exposed. Your symptoms are also likely to be less severe — in turn making you less likely to infect others, says Felicia Scaggs Huang, medical director of infection prevention and control at Cincinnati Children’s Hospital.
The surest way to protect vulnerable infants is to ensure women are vaccinated toward the end of every pregnancy and that the people around newborns, whether family or caregivers, are also up to date on their shot.
And while the most recent CDC data suggests vaccination rates among pregnant women have rebounded after a significant pandemic-era drop off, there’s still room for improvement. Just 60% of pregnant women surveyed had opted for the shot, the data shows.
More needs to be done to improve awareness and access.
"We have an education problem,” Hayes says. "Our moms don’t know about it.” For example, in the CDC survey, nearly 20% of women said they didn’t get vaccinated because they had received the shot during a prior pregnancy.
Health care providers should make convincing women of the vaccine’s importance a priority. Obstetricians should offer the shots in their office as part of routine prenatal care rather that leaving it to already overwhelmed patients to seek it out. The same is true for pediatricians, who should offer the vaccine to parents bringing in their newborns.
While pregnant women and children are the highest priority, the rest of us ought to be up to date on our vaccine, too. That’s especially true for those of us who might encounter an infant. The whole family — parents, siblings, aunts, uncles, grandparents — can help cocoon babies too young to be fully protected themselves.
That means staying on top of when you’re due for another booster. Most primary care charting systems and many state health departments allow you to check your vaccination records. But if you’re still unsure and it’s likely been a few years, "there’s really little downside to going ahead and getting it,” Hayes says.
Lastly, it’s important for anyone with a lingering cough, particularly those working in health care or child care settings, to get tested. That can guide behavior (isolating is recommended while contagious) and a doctor can prescribe antibiotics. Other members of the household or at high-risk who have been exposed also might be eligible for "post-exposure prophylaxis,” antibiotic treatment that can ease a brewing infection.
With so many common sense ways to bring down the rate of pertussis infections, there’s no excuse for any parent to have to hear that heartbreaking cough.
(Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry.)