Community Health & Wellness

Public health officials monitoring increase in whooping cough — and decrease in vaccination rates

Posted on November 19th, 2024 By: Conor Wilson

Washington could see more cases of whooping cough in 2024 than any year in the last decade. The state has already reported more than 1,300 cases, up from 54 at the same time in 2023.

The surge of the highly contagious bacterial infection, also known as pertussis, has been a stark reminder of how critical vaccinations are for protecting the most vulnerable, particularly infants, Dr. Tao Sheng Kwan-Gett, chief science officer at Washington Department of Health, said in a statement.

“To protect babies from whooping cough, people of all ages should get up to date on pertussis vaccination,” he said.

Small decline in vaccination rates locally

Centers Disease Controls data also shows a decline in vaccinations among school-age children. The CDC reported that about 2% fewer new kindergarteners are up to date on state-required immunization compared to pre-pandemic totals.

The Kitsap Peninsula – including schools in Kitsap County, Gig Harbor and the Key Peninsula – saw a small decline in immunizations post-pandemic levels, according to a review of Washington Department of Health Data.

Although they vary by district and disease, 88.8% of Kitsap County kindergarteners completed all required vaccinations last year. That was down 0.7% compared to the year before the pandemic, but remained historically high.

In the Peninsula School District, vaccination rates were at 91% last year. That was down 1.4% from the 2019-20 school year.

In Washington, 87.6% of kindergarten students completed the required vaccinations last year. That is down 2.4% from pre-pandemic.

Vaccine hesitancy

Dr. Gig Morrow, health officer for the Kitsap Public Health District, said Kitsap families have done a good job of receiving “routine, life-saving,” childhood vaccinations. Most Americans understand the importance of vaccines, he said. But a decrease nationally has led to a resurgence of preventable diseases like measles, mumps and pertussis after the pandemic.

“Skepticism, misinformation, and conspiracy theories have increased post-pandemic,” he said, “fueled by national leaders who ignore scientific evidence.”

Concerns about vaccine hesitancy have been a national topic of concern among public health officials for the past several years. Conspiracy theories and misinformation – occasionally prompted by high-ranking elected-officials – have led to a growing skepticism of routine immunization.

This month, President-elect Donald Trump nominated Robert F. Kennedy Jr., who has a long record espousing vaccine misinformation, to lead the Department of Health and Human Services.

“Donald Trump’s selection of a notorious anti-vaxxer to lead HHS could not be more dangerous – this is a deep concern for every American,” Sen. Patty Murray, D-Wash., said in a statement urging fellow senators to reject his appointment.

Exemptions

That appointment comes as record levels of children are receiving exemptions to routine vaccinations. In 2023, 3.3% of kindergarten students in the U.S. had an exemption to one or more vaccines, according to the CDC, the highest ever reported.

Fourteen states had exemption rates exceeding 5%. In Washington, 4.8% of students received an exemption to at least one vaccine.

Washington law allows parents to exempt their children from required vaccines for four reasons: personal/philosophical; religious belief; religious membership; or medical. Only the measles, mumps and rubella (MMR) vaccine cannot be exempted for a personal or philosophical reason.

Parents are not required to validate or provide their personal religious belief. The only requirement is that they receive a signature from a state-licensed health practitioner, including a physician, naturopath, physician’s assistant or nurse practitioner.

Last year 4.1% of kindergartners in Kitsap County and 6% in the Peninsula School District had an exemption to at least one required vaccine.

District results

Vaccines remain the most effective way to prevent illness, like whooping cough, and vaccination rates remain high in the region, but have declined.

Kitsap County rates for whooping cough declined by 1.9% from pre-pandemic levels. Immunization rates for the MMR vaccine also fell by about 3%. Rates declined in five of the six school districts on the Kitsap Peninsula last year compared to pre-pandemic levels. The largest drops were in Bremerton and Central Kitsap schools.

Still, an overwhelming number of students in most districts are getting vaccinated. Excluding Bremerton, which was at 79.6%, the other five districts had rates of at least 92%.

Fewer students, however, had received a required whooping cough booster, said Wendy Inouye, communicable disease epidemiologist for the Kitsap Public Health District. Adolescents are advised to get a booster shot at 11 or 12 years old, prior to entering seventh grade. One out of six are not up to date. Of those who are not up to date, over 80% are listed as out of compliance, Inouye said.

Whooping cough resurgence

Cases of whooping cough have been low in recent years. Measures from the pandemic, including masking and distancing, may have suppressed its transmission. As those precautions have fallen off, whooping cough is returning to pre-pandemic patterns, the CDC says.

In a typical year, Washington sees anywhere from 100 to 1,000 cases, with spikes every few years, according to the DOH. Washington last saw over 1,300 cases in 2015.

Pierce County had 85 cases. King had 159.

The disease, caused by the bordetella pertussis bacteria, usually begins with cold-like symptoms such as a runny nose, but can cause severe coughing fits.

Teens and adults usually experience mild symptoms. But whooping cough can be potentially deadly for infants, who encounter life-threatening respiratory problems that frequently lead to hospitalization.

“Pertussis can affect people of all ages, and can be very serious, even deadly, for babies less than a year old,” said Lynn Pittsinger, community health director for the Kitsap Public Health District. “Babies younger than three months have the highest risk of severe disease and of dying from pertussis.”

Immunization is available for people of all ages, although it is not effective for newborns who are less than 2 months old, Pittsinger said. As a result, pregnant people should get a booster shot as early as possible between the 27th and 36th weeks of pregnancy to offer protection, Pittsinger said.

“It is also important that all family members and caregivers are up to date with their vaccines,” she said.