A forgotten but crucial cause for the pertussis epidemic

Finally, the media seems to be taking note of the terrible pertussis (whooping cough) outbreaks around the country. I’m relieved to see the coverage, because pertussis can kill or cause long-term complications like brain damage, particularly in infants. But I can’t say I’ve been impressed with how the issue has been handled by the press so far.

Many articles, like this one in Forbes, seem to blame the outbreaks entirely on vaccine denialists. But the fact is, vaccinated kids are getting sick too: In Skagit County, Washington, the epicenter of one of the worst outbreaks this year, less than 25 of more than 500 pertussis cases since March 2012 were in unvaccinated kids, according to Communicable Disease Manager Sandi Paciotti.

Then there’s this popular article published on Tuesday in the Washington Post, where Ezra Klein splits the blame between anti-vaxers and vaccine failure (the latter helps explain the fact that vaccinated kids are getting sick). But again, although these two factors are certainly contributing to the epidemic, I would argue that Klein has forgotten a, if not the, major driving factor.

Most adults have not gotten pertussis boosters.

According to the CDC’s latest numbers, only eight percent of American adults have gotten Tdap boosters since they became available in 2006. And even adults who were fully vaccinated against pertussis as children can and do catch pertussis, because immunity from the vaccine does not last. We don’t always see this adult vulnerability reflected in the official pertussis numbers, which suggest that kids are mainly the ones getting sick, but that’s because pertussis only causes a mild illness in adults who have previously been vaccinated. And let’s face it: how many adults who come down with a mild cough think it’s pertussis and see their doctors about it?

I think un-boostered adults are really driving the ongoing epidemic—in a way, they’re reservoirs. They’re catching pertussis, dismissing it as nothing to worry about and going untreated, and then infecting those around them for a month or longer. (A 2007 study found that at least 73 percent of babies catch pertussis from adults.) We talk about how antivaxers’ kids are crumbling herd immunity against pertussis—and yes, they are—but so are 280 million American adults, and they’re probably the far bigger problem. So please: if you haven’t already, make an appointment with your doctor or stop by a local health clinic and get your Tdap shot immediately.


Wendelboe AM, Njamkepo E, Bourillon A, Floret DD, Gaudelus J, Gerber M, Grimprel E, Greenberg D, Halperin S, Liese J, Muñoz-Rivas F, Teyssou R, Guiso N, Van Rie A; Infant Pertussis Study Group. (2007). Transmission of Bordetella pertussis to young infants Pediatric Infectious Disease Journal DOI: 10.1097/01.inf.0000258699.64164.6d

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16 Responses to A forgotten but crucial cause for the pertussis epidemic

  1. Well… The problem is that the vaccine doesn’t induce very long term immunity. True, if adults had boosters often enough, it would be possible to achieve herd immunity. But how often would be often enough? Every 10 years might not be enough.

    What we really need is a better vaccine. Perhaps the use of an adjuvant or conjugation might make this possible.

  2. I agree, Peter, and I have heard that the CDC is considering recommending Tdap boosters more frequently, such as every 5-10 years. I know that there are groups hard at work trying to improve them, too. I wrote a short article about the latter for this month’s issue of Nature Medicine:

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  4. jre says:

    For whatever it may be worth, I did get my Tdap booster last year. What it took was a sad, fraught lunchtime conversation with a dearly loved family member whose husband had become a disciple of Joseph Mercola. They had stopped vaccinating their kids because of the mercury, or because children’s immune systems were overwhelmed by all the shots, or because of, well, whatever. I am still incredibly depressed by the whole thing. What do you do in such a case? I can’t bear to fight with people I love, so I started donating to ECBT, to the CCIC, and, by God, went straightaway and got my Tdap booster. One does what one can.

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  6. Lowell says:

    The real truth is that the vaccine is not effective and has become even more ineffective over time. The vaccine shows to have had an effect in mutating the pathogen to a point that the vaccine is far less effective, and as well the vaccine appears to have played a role caused another similar non vaccine targeted pathogen to become stronger and more common. This is simply the way nature works, and in ways not so much differently than in the use of antibiotics. Even field weeds in crops have developed resistance to Round Up which at one time killed any living plant. Corn bores develop resistance to GMO/Bt corn. In all of biological nature there are examples where nature will attempt or beat anything that is attempting to change, or beat it. Pathogens and in regard to human physiology, are no different.

    So the message here, is to STOP blaming the un-vaccinated; and as well stop blaming them when the truth is that the majority of these outbreaks were in the vaccinated. Where is there any end to the toxic vaccine boosters, needed? Vaccinating a pregnant woman with any toxic vaccine is purely profit insane, reckless, and irresponsible. There are as well no safety studies.

    What’s Really to Blame for California’s Whooping Cough Epidemic?

    Surprise! Whooping Cough Spreads Mainly through Vaccinated Populations

  7. Paul says:

    Personally I think it has to be an individual decision. There seems to be founded data on both sides of the argument. One cannot deny that some of the ingredients in these vaccines are toxic. It simply cannot be denied. If a parent chooses to obtain exemption from vaccination for their children because they believe the vaccines to be dangerous, those rights should be upheld and name-calling, as in calling these parents crackpots because you deny any possibility of dangerous effects, should stop.

  8. pali says:

    I’m human and herds refer to animals. Quite frankly if these vaccines truly prevented the disease they claim to vaccinated people would not have to worry about getting the disease from the unvaccinated.
    Many of the cases I have seen of pertussis are among the fully vaccinated population. I’m a health care professional by the way

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  11. M. K. says:

    My entire family had whooping cough in 2012. Previously vaccinated adults can indeed get VERY severe cases of it, so please do not dismiss if you are an adult. It is very long illness and I am still feeling the effects over a year later.

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