Pertussis (Whooping Cough)
What is it?
Pertussis (whooping cough) is a highly contagious infection that impacts breathing. It is most severe in infants and young children. It may seem like an ordinary cold at first. As it progresses, pertussis causes uncontrollable, sometimes violent coughing spells. It can lead to pneumonia, seizures, brain damage, and death. Pertussis is spread when an infected person coughs or sneezes. Symptoms do not appear until about 7 – 14 days after infection. Symptoms usually last 6 – 10 weeks. Pertussis is marked by the “whoop” sound infected people make when air is inhaled following coughing spells. Thankfully, there’s a vaccine to protect against whooping cough.
Why is the vaccine important?
We saw a surge in pertussis cases in the U.S. from 2012-2014. In 2012, there were 48,277 reported cases of pertussis in the U.S – the highest in 64 years. The epidemic continued into 2013, with 28,639 cases reported. Since then, cases have been dropping to a low of 2,116 cases in 2021. If there was ever a time to make pertussis vaccination a priority, now is it.
Pertussis affects people of all ages, but it is most common and most severe in infants and young children. Infants cannot be vaccinated against pertussis until 2 months old. They do not have substantial protection until at least 6 months old, after they have received three doses of DTaP vaccine. About 30% of babies under 1 year who get whooping cough need care in the hospital. Complications in infants can include apnea (slowed or stopped breathing), pneumonia, or the need for assisted breathing. They can also include convulsions (violent, uncontrolled shaking), encephalopathy (disease of the brain), or death. Approximately 1 – 2% of infants who get the infection will die from it.
Older children, adolescents, pregnant women, and adults need protection from whooping cough, too. Many infants and children who get it are infected by an older sibling, parent, or caregiver. Pertussis cases in adults and adolescents are likely under-reported because symptoms are much milder. Teens and adults can also get complications from pertussis. They are usually less serious. Complications can include prolonged cough, passing out, or rib fractures from severe coughing.
Progress
Before the whooping cough vaccine was introduced in the 1940s, about 200,000 U.S. children came down with the disease every year. After the vaccine became available, the number of cases in the U.S. dropped to a historic low of 1,010 in 1976. However, there has been a spike in the number of cases more recently. Experts say there are several factors that may explain why the U.S. experienced a pertussis epidemic. These include increased awareness (resulting in more testing). They also include changes in bacteria strains and waning immunity.
Although it is effective, the pertussis vaccine is not perfect. No vaccine is 100% effective. Changes in vaccine composition in the 1990s may partly explain the 2012 whooping cough outbreaks in the United States. The current vaccine is effective against severe disease and prevents more serious adverse events. But, the protection wears off faster. Still, getting vaccinated is the best way to prevent whooping cough. Some people do develop whooping cough despite being vaccinated. They experience milder symptoms and are less infectious. Studies have shown that children not vaccinated are 23 times more likely to get pertussis than those who are fully vaccinated.
Vaccine Recommendations
The DTaP and Tdap vaccines prevent three diseases with one shot: diphtheria, tetanus, and pertussis. The vaccines are recommended for different groups based on age and health condition:
Children
- Children should get 5 total doses of DTaP vaccine, 1 dose at each of the following ages: 2 months, 4 months, 6 months, 15 – 18 months, and 4 – 6 years.
Teens
- Teens should receive 1 dose of Tdap vaccine at age 11 or 12 years.
Pregnant People
- Pregnant people should receive 1 dose of Tdap vaccine with each pregnancy at 27 – 36 weeks. This allows the person to pass disease-fighting antibodies on to their baby to protect them after birth.
Adults
- Adults who have never received a dose of Tdap should receive one. Adults then should receive 1 booster dose of Tdap every 10 years.
Make sure those in close contact with your infant are up to date with Tdap vaccination. This helps shield or "cocoon" newborns from whooping cough.
Side Effects
Vaccines, like any medicine, can cause side effects (also known as "adverse reactions"). Most side effects are mild and go away within a few days. Common side effects include fever, headache, or body aches. They can also include redness where a shot was given and tiredness. Side effects are normal. They can even be a good sign that the immune system is working to build antibodies that will fight off future infections!
For the DTaP vaccine, side effects may also include loss of appetite and vomiting. More serious reactions like seizures, high fever (over 105°), and non-stop crying are also possible, but these are uncommon. Swelling of the entire limb in which the vaccine was given is also a rare side effect. If this occurs, it is usually after the 4th or 5th dose.
For the Tdap vaccine, nausea, vomiting, diarrhea, and stomach ache may also occur.
Remember, vaccines are continuously studied. They are also closely monitored for safety. Research continues to show that vaccines are safe, and the benefits outweigh the risks. The risk of a severe allergic reaction to a vaccine is rare (about 1 in 1 million). The choice not to vaccinate is ultimately more risky. Not vaccinating may lead to catching a potentially deadly disease.
Talk to your healthcare provider if you have any questions or concerns about vaccine side effects. In the event of a serious allergic reaction, call 9-1-1.
