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Reported whooping cough cases so far this year are 10 times what they were for all of 2023, an uptick state health officials believe is partially attributed to declining childhood vaccination rates.
There have been 1,163 cases of pertussis or whooping cough, named for the “whooping” noise people make after a coughing fit, reported through Nov. 16, according to the Michigan Department of Health. This is a stark increase from 110 reported cases for the entirety of 2023.
“With a declining rate of immunizations, we are unfortunately seeing a rise in pertussis and other vaccine-preventable diseases statewide,” said Dr. Natasha Bagdasarian, Michigan’s chief medical executive.
The steep increase in whooping cough cases this year in Michigan bucks a trend in which no more than 116 whooping cough cases were reported in any one year between 2020 and 2023. A health department spokesperson said rates of many communicable diseases were down over that period thanks in part to increased health precautions stressed during the COVID-19 pandemic.
Washtenaw County Health Department nurse coordinator Maggie Kabore agreed that the past few years have not been representative of typical whooping cough numbers.
“Before the pandemic, we did see some pretty big surges of whooping cough, and there might be a few years where it was a little bit less, and then there’d be another surge,” Kabore said. “It’s not uncommon to have, you know, quite a bit of whooping cough, and have quite a bit every year, and then have some years where it spikes a little bit more.”
This year’s spike still outpaces even pre-pandemic levels. Between 2016 and 2019, the state health department said, there were an average of 596.5 cases per year.
Wayne County is seeing three to four times more cases than last year and a return to pre-pandemic levels, Wayne County Chief Medical Officer Dr. Avani Sheth wrote in an email. So far, in 2024, the county had 54 whooping cough cases, up from an average of 12 between 2020 and 2023, and close to the average of 64 between 2017 and 2019.
Pertussis cases are also on the rise in Macomb County, said Andrew Cox, Director of Macomb County Health and Community Services. There have been 60 reported in 2024, up from three in 2023, two in 2022, and five in 2021.
“Making sure that everyone is up to date with their vaccinations is our best strategy for the prevention against the spread of pertussis,” Cox wrote in an email. “It is also important to practice good hygiene to help prevent the spread of bacteria and viruses that can cause many respiratory illnesses.”
The surge could be the result of several factors, including the relaxation of COVID-19-era precautions such as masking, remote work and school, hand washing, and proper cough etiquette, said Dr. Shalini Sethi, senior pediatrician and site lead at Henry Ford Medical Center in Plymouth. Several families also put off doctor appointments during the pandemic and fell behind on routine vaccinations.
“Because of the declining rate of vaccination, we are seeing these vaccine-preventable diseases come back,” Sethi said.
CDC recommendations
In October, the U.S. Centers for Disease Control and Prevention said that a 2024 survey of U.S. parents found that 8.3% disagreed with the statement that school and child care “vaccination requirements for children are important and necessary.” Another 15.2% of parents said they had no opinion.
“These results could indicate changes in attitudes toward routine vaccination transferring from hesitancy about COVID-19 vaccination, or toward any vaccine requirements arising from objections to COVID-19 vaccine mandates, as well as a potential for larger decreases in coverage or increases in exemptions,” the CDC said in its Oct. 17 Morbidity and Mortality Weekly Report.
The CDC recommends the pertussis vaccine for infants, children, adolescents and people who are pregnant. It also recommends a dose of pertussis vaccine for adults who haven’t received a dose as an adolescent or adult, and a booster once every 10 years.
“Vaccinations continue to be our top line of defense against the spread of pertussis,” Bagdasarian said.
According to the state health department, 82.9% of Michigan children have received their first dose of the DTaP vaccine, which protects against diphtheria, tetanus and pertussis, by the time they are 3 months old. However, only 65.6% of 19-month-olds received all four recommended doses for DTaP.
As of September, 71.1% of 19- to 36-month-old children in Michigan had received the recommended four doses of the DTaP vaccine, down from roughly 75% in September 2019 and 2014, according to the Michigan Care Improvement Registry.
“We talk to families who are hesitant about vaccines every day,” Guzman said. “In general, the government, the CDC, the FDA — we lost the trust of the American public, trust that vaccines are made safely, trust that we’re not hiding ingredients from them or side effects. They’re really worried that vaccines haven’t been tested enough, and that herd immunity isn’t as important as everyone says.”
Misinformation on social media also is an important factor impacting some young parents, Guzman said. Oakland County Health has become more willing to meet people where they’re at, rather than stick to the traditional strict vaccine schedules, she said. If parents want to spread out six shots for their child over the course of a year, rather than all in one day, for example, they can work out a delayed schedule, Guzman explained.
“We’re hoping that this will help build the trust. The public doesn’t want to be told what to do,” Guzman said. “They don’t want the government giving them any more mandates, and vaccine schedules are just another mandate.”
The pertussis vaccine efficacy also wanes after a few years, leaving adults who only get the booster once a decade more vulnerable.
“The vaccine works pretty well, but it’s just that the vaccine itself doesn’t last very long,” Laskowski said. “It’s still kind of the best shot we got for preventing illness, especially young children, and trying to cocoon the babies.”