Vaccine Series: Pertussis/Whooping Cough

The dilemma with effective vaccines is that we forget the terrible diseases they prevent. The “Vaccine Series” discusses the diseases to help us remember why vaccines are critical to public health.

“Whooping cough” is one of the latest diseases to regain headline notoriety. Technically called pertussis, a highly contagious bacterial disease, whooping cough causes the upper respiratory tract infection known for the violent coughing and the “whooping” sound that is heard when a young patient tries to take a deep breath. This disease typically lasts for 6 weeks, providing for its rapid spread through a population when a patient coughs up the bacteria. Before vaccines, the whooping cough was most common in infants and young children, and families dreaded the permanent disability and even death that could occur in infants.

When the pertussis vaccine was first widely recommended in the 1940s, childhood deaths due to the disease dropped dramatically. Unfortunately, controversy over the connection between autism and routine vaccines have led parents to increasingly resist recommendations to vaccinate their children. (Follow-up studies have shown that autism is not a side effect of routine childhood vaccinations.) The failure to vaccinate children is extremely dangerous for the infants who have not yet received their full series of DTaP vaccinations.

The DTaP vaccine is for kids younger than 7 years of age, and it provides protection against diphtheria, tetanus, and pertussis. Because the first dose of DTaP vaccine is recommended at 2 months of age, babies younger than this are most at risk for preventable infant mortality. Children whose parents declined to have them immunized against pertussis have been found be 23 times more likely to get whooping cough compared to fully immunized children.

Areas experiencing outbreaks of whooping cough, such as in the northwest, have reached a tipping point in the loss of herd immunity. Herd immunity refers to the community-wide protection against disease by large percentage of vaccinated individuals. However, when enough people are not protected by vaccines, sensitive groups such as infants, pregnant women, or immunocompromised individuals are put at greater risk for the disease. Complicating the issue is the fact that pertussis vaccines have a duration of protection between five to ten years. For this reason, Tdap booster shots are recommended for adults and may be requested by parents of small children.

Vaccination against pertussis is critical in preventing the widespread outbreak of the disease. In the context of a community, it is just as important for adults to be protected as it is for children to receive the recommended vaccine series. When more people are protected, the disease is less likely to spread to sensitive groups, and the overall risk of infant mortality is lowered. If you would like to learn more about which vaccine is right for you and when it is recommended, see this summary of pertussis vaccine recommendations provided by the CDC.