Pertussis, or whooping cough, is a disease of the bad old days, now largely eradicated through vaccination—except that it’s making a comeback. It starts out resembling an ordinary cold, but "cough" is an understatement. A pertussis patient will cough constantly, sometimes to the point of nausea. It interferes with sleeping, eating, drinking, talking. Sometimes, the coughing leaves patients gasping for air, or they cough hard enough to break ribs. Whooping cough can last for months.
Thanks to vaccination, pertussis almost disappeared entirely. However, thanks to an increasing tendency for parents not to vaccinate their children, more and more children are getting the disease. The disease can be annoying in adults but fatal to babies, but in 1940, a vaccine was introduced, and within a few generations became a standard part of childhood.
In recent years, however, vaccination has begun to be perceived, wrongly, as dangerous, and the diseases such as pertussis that it prevents perceived, also wrongly, as harmless, and the numbers have accordingly gone up—30 percent over last year, according to the Centers for Disease Control and Prevention. In 21 states, whooping cough cases have more than tripled. That’s nearly as many states as require only a doctor’s note, or less, for an exemption from vaccination requirements. Marin County, California, which has among the highest vaccine exemption rates in the country, also has the second highest rate of whooping cough.
Refusal to vaccinate doesn’t affect only the unvaccinated children. When enough people in a community are immune to a disease, it is impossible for the disease to establish a foothold, protecting even babies too young to be vaccinated or the tiny minority in whom the vaccine itself was ineffective. This herd immunity, however, requires that 93 percent of the population receive the vaccine.
That’s why medical professionals are working on ways to ensure that more people are vaccinated. One approach is to give pregnant women the TDaP vaccine, which combines the vaccine for pertussis with those for tetanus and diphtheria, during the third trimester. This has been found to have no adverse effects on the mother or the fetus, and, once born, the baby starts out with temporary immunity during what would otherwise be the most vulnerable period of life.