Frequently asked questions about whooping cough

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About whooping cough

About whooping cough vaccines

How well the vaccines work

Vaccine safety and monitoring

Where to get the vaccines

How to pay for the vaccines

For pregnant women and new parents

For health care workers and providers

About Whooping Cough

What is whooping cough (also known as pertussis)?

Whooping cough (pertussis) is a highly contagious bacterial infection. Whooping cough spreads easily by coughing and sneezing and mainly affects the respiratory system (the organs that help you breathe, such as your lungs).

How serious is whooping cough?

Whooping cough is very serious, especially for babies and young kids. Whooping cough can cause pneumonia, seizures, brain damage, and death. Babies younger than one year of age who get whooping cough may be hospitalized or even die.

What are the symptoms of whooping cough?

The symptoms of whooping cough are different depending on your age. Babies and young kids can have severe coughing spells that make it hard to eat, drink, breathe, or sleep. Some babies may turn blue because they can't catch their breath. They may not cough at all but have life-threatening pauses in their breathing. Older kids and adults may only have a runny nose and low fever, followed by a persistent cough that can last for several weeks or months and is often worse at night. The name "whooping cough" comes from the sound many babies and kids make when trying to get air after a coughing spell. It is important to know that not everyone with whooping cough makes the "whoop" sound. The best way to know if you have whooping cough is to see your doctor, nurse, or clinician.

How soon do symptoms appear?

Symptoms usually start 5 to 21 days after exposure to whooping cough. The average is 7 to 10 days after exposure.

How is whooping cough treated?

Whooping cough is generally treated with antibiotics. It's important to start treatment as soon as possible to help keep from spreading the disease to others. Early treatment can also make the symptoms end sooner and be less severe.

How is whooping cough prevented?

Getting vaccinated is the best way to lower the risk of getting whooping cough. It's also important to wash your hands, cover your cough, and stay home whenever you're sick.

Are some people at higher risk from whooping cough?

People at greatest risk from whooping cough include:

  • Infants under one year old.
  • Pregnant women (especially in the third trimester).
  • People that have a chronic respiratory illness.

Can I spread whooping cough even if I don't have a bad cough?

Yes. You can have whooping cough without realizing it and infect others. This is especially important to know for people who are going to be around babies or pregnant women. Any time you have a runny nose or cough, you should stay away from high-risk people, and make sure you are vaccinated before seeing them.

How common is whooping cough in Washington?

Whooping cough is always active in our state. In a typical year, Washington has anywhere between 184 and 1026 cases of whooping cough, but in 2012 we had an epidemic with nearly 5000 cases. In the past 20 years, whooping cough has caused as many as two deaths in some years with no deaths in other years. Most outbreaks in Washington are local, with a variation in cases from county to county. Some areas report a high number of cases and others have none. Find the current number of whooping cough cases in Washington (PDF), or the number of whooping cough cases reported in past years.

Is there still a whooping cough epidemic in Washington?

Our statewide case count of 4,918 during the epidemic of 2012 was well above what we expect to see in an average year—the highest level since 1941, when 4,960 cases were reported. The pace of new whooping cough cases slowed after the 2012 epidemic, but some communities are beginning to see higher numbers again. Even when the number of cases decreases, it's important to remember that whooping cough never goes away completely. Getting vaccinated and staying away from others when you are sick are the best ways to slow the spread of whooping cough and protect people at highest risk, like babies and pregnant women. Find the current number of whooping cough cases in Washington (PDF), or the number of whooping cough cases reported in past years.

Are there more cases of whooping cough than what's reported?

There are always more cases of whooping cough than what's reported. Only about one out of every 10 cases gets reported to public health because:

  • Sometimes whooping cough is diagnosed as something else.
  • Some people have whooping cough without knowing it, so they may not see a doctor and it could go undiagnosed and unreported.

What if I was exposed to someone who has whooping cough?

Talk to your doctor, nurse, or clinic as soon as you learn that you have been exposed. You may be given antibiotics to treat your infection and make the infection less serious, especially if you start it early. Try to stay away from other people until you have completed the first 5 days of treatment (or until another diagnosis for the cough is given and you know that you are not contagious).

What should I do if I think someone in my family has whooping cough?

If you think you or one of your family members has whooping cough, call your doctor, nurse, or clinic and ask to be evaluated for whooping cough. Anyone that might have whooping cough should stay away from other people until the illness is treated (or another diagnosis for the cough proves it's not contagious).

How should employers handle employees returning to work who have had whooping cough?

Employers should talk with their Human Resources office to understand their company policies, procedures, and labor agreements, and work with their local health agency if they have questions about when a person with whooping cough can safely return to work. Employers should not share individual employee health information with others.

What's the best cleaning method to prevent spreading whooping cough?

While pertussis bacteria can live on a surface or object for several days, most people don't get whooping cough from contact with surfaces or objects. They get it from close face-to-face contact with people who have whooping cough.

Where can I get more information about whooping cough?

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About Whooping Cough Vaccines

What is the whooping cough vaccine?

There are two vaccines that protect against whooping cough:

  • DTaP is for babies and children younger than age seven years.
  • Tdap is for kids seven years and older, adolescents, and adults (including pregnant women).

Who needs the whooping cough vaccine?

People of all ages should get a whooping cough vaccine. Which vaccine you need depends on your age. Vaccination is the best protection against whooping cough, and helps to reduce the risk to yourself, vulnerable infants, and pregnant women.

Who Which vaccine

Adults 19 years and older

(who did not already get a Tdap
booster)

Especially:

  • Health care workers
  • Anyone who is in contact with babies less than a year old
Tdap; one dose
Pregnant women
(even if you were previously vaccinated)

Tdap; one dose as early as possible during the third trimester (between 27 and 36 weeks of gestation) of each pregnancy

Teens 11 to 18 years old (preferably at 11 or 12 years of age) Tdap; one dose

Kids 7 to 10 years old

(who did not get all 5 doses of DTaP listed below)

Tdap; one dose
Children 2 months to 7 years old DTaP

One dose at each age:
  • 2 months
  • 4 months
  • 6 months
  • 15-18 months
  • 4-6 years

How soon can my new baby get the vaccine?

The first dose of DTaP vaccine is recommended at two months. Talk to your health care provider if you think your baby may be at increased risk of getting whooping cough.

What happens if children and teens haven't gotten all of their scheduled whooping cough vaccines?

Not getting recommended vaccines on time puts children and teens at higher risk for getting and spreading whooping cough. Vaccination is the best protection we have against whooping cough, so it's important that everyone—children and adults—get their scheduled whooping cough vaccines.

  • If your child is younger than seven years and isn't up to date, talk to his or her healthcare provider right away about getting caught up on DTaP vaccines.
  • If your child is seven to ten years old and hasn't followed the recommended immunization schedule, he or she needs a Tdap vaccine.

How often should adults get the whooping cough vaccine?

All adults should get one dose of the Tdap vaccine. Pregnant women need Tdap with each pregnancy. If you had the Tdap vaccine as a teenager (age 11 or older), you don't need another one unless you're pregnant, in which case, you should get the Tdap vaccine again when you are 27 to 36 weeks pregnant, preferably as early as possible within that window. Check with your doctor, nurse, or clinic to make sure you're up to date with all of your immunizations.

If my child had whooping cough, should he or she still get vaccinated?

Yes. When someone gets whooping cough, their body develops a natural immunity. However, it's unknown how long that immunity lasts for each person, so routine vaccination against whooping cough is still recommended for people who have had whooping cough.

Why should I get vaccinated if I don't have close contact with babies?

While you may not have direct contact with babies, you may be around them in public places such as the grocery store or the library. Babies often catch whooping cough from an adult or family member who may not even know they have the disease. Babies who get whooping cough often have to be hospitalized and could die.

How many people are vaccinated in Washington?

According to data from the National Immunization Survey (NIS), here are the vaccination rates in 2016 for children and adolescents in Washington:

Rate

Age

Doses received

85.8% (+ 4.8%)

19-35 month old children

4 doses or more of DTaP

86.8% (+ 4.6%)

13-17 year olds

1 dose or more of Tdap

The Tdap vaccination rate for adults in our state isn't available. The national adult Tdap rate in 2014 was 22 percent, according to the National Health Interview Survey.

Find more whooping cough vaccination rates from the CDC:

How many people need to be immunized to reach community (or herd) immunity?

Typically, more than 90 percent of a population must be vaccinated against a disease to produce general protection for the population. Since whooping cough vaccines don't last a lifetime, and because it spreads so easily, we can't rely on community immunity to protect us from this disease. Making sure you and those around you are up to date on whooping cough vaccine is your best chance to protect yourself and your family from this serious disease.

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How Well the Vaccines Work

Does the whooping cough vaccine really work?

While it is not perfect, the whooping cough vaccine is the best available protection against the disease. It helps protect both the person who gets the vaccine and those around them who are most vulnerable to severe whooping cough or complications (like babies and pregnant women). We know that the protection received from any of the available whooping cough vaccines is fairly good (73 to 98 percent effective) in the first year after receiving the vaccine, but it does wear off over time. In the same way, people that had whooping cough in the past gradually become susceptible to the disease in about five to ten years.

Can people who have been vaccinated still get whooping cough?

Sometimes when vaccinated people are exposed, they get whooping cough anyway, although they usually have milder symptoms, a shorter illness, and may be less likely to spread the disease to others.

How long does the vaccine for younger kids (DTaP) last?

Recent studies show that the whooping cough vaccine for young kids (DTaP) doesn't last as long as expected, and protection wears off over time. Protection is high—about 98 percent—within the first year after getting the fifth DTaP dose. It goes down to about 70 percent by five years later, and may continue to gradually go down after that.

In the 1990s, the United States switched from DTP vaccine to a new whooping cough vaccine for kids. The new vaccine (DTaP) causes fewer side effects than the old one but protection from DTaP doesn't last as long as it did for DTP. This may explain why there are more whooping cough cases in older children. Teens today are the first group of kids to get only the newer DTaP vaccine as babies; they didn't get any doses of the old vaccine.

How long does the vaccine for older kids, teens, and adults (Tdap) last?

A study done here in Washington State during the 2012 pertussis epidemic showed that overall, the Tdap vaccine is 64% effective in protecting against pertussis disease, and within the first year after vaccination it is 73% effective. There are more reported whooping cough cases among teens—a changing trend across the country that indicates that the duration of protection against whooping cough for Tdap vaccine is shorter than expected. By four years after vaccination, protection may drop below 50% effectiveness. This shows why it is so important for pregnant women to be vaccinated toward the end of every pregnancy.

If the vaccine doesn't last very long, why should I get it?

The vaccine works very well for the first couple of years. Even after five years, children still have moderate protection from whooping cough. Infants usually get whooping cough from a family member or caregiver and are at greatest risk for getting very sick and potentially dying from whooping cough. People who are vaccinated and still get whooping cough usually have milder, shorter illnesses, and are less likely to spread the disease to others, like babies and pregnant women.

Should I get vaccinated again if I got a Tdap vaccine a few years ago?

The current recommendation is that everyone 11 years and older should get a one-time dose of Tdap vaccine. Pregnant women should get the Tdap vaccine at each pregnancy.

Will vaccination recommendations change?

Recommendations for pregnant women have changed, and it's possible that other recommendations could change. The Centers for Disease Control and Prevention develop and adjust recommendations based on what they learn by monitoring disease and safety reports.

What is the best prevention for people who are up to date on their whooping cough vaccine?

Unless there are new recommendations for the Tdap vaccine, or a new vaccine, everyone should wash their hands, cover their cough, and stay home when they're sick. It's best to avoid close contact with anyone who has cough or cold symptoms.

Does the flu vaccine affect how well the whooping cough vaccine works?

There's no evidence that the whooping cough vaccine works any differently if you get a flu vaccine. We recommend that everyone six months and older get a flu shot each year. Learn more about the flu vaccine.

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Vaccine Safety and Monitoring

Are the whooping cough vaccines safe?

Research and ongoing surveillance of vaccine safetyhas shown that pertussis vaccines are safe. You can get more information on the safety of whooping cough vaccines from Centers for Disease Control and Prevention (CDC).

How are the vaccines monitored for safety?

Vaccines are tested before they're licensed for use. Once a vaccine is in use, the CDC and the Food and Drug Administration always monitor the vaccine through the national VAERS (Vaccine Adverse Event Reporting System) and other provider-based systems to make sure the vaccine continues to be safe for use.

Are there side effects from the vaccines?

Like any medication, vaccines may cause side effects. Most are mild:

  • Pain, redness, or swelling at the injection site (In children, this is more common after the fourth and fifth doses of DTaP than after the first three doses.)
  • Mild fever
  • Headache
  • Tiredness
  • Nausea, vomiting, diarrhea, or stomach ache
  • Chills, body aches, sore joints, rash, or swollen glands (uncommon)

Moderate reactions to whooping cough vaccine are rare, but could include crying for three hours or more in children. The only known serious reaction to the DTaP (child) vaccine is an allergic reaction to the vaccine and is very rare, less than 1 in 1 million doses. There are no known moderate or serious reactions to the Tdap (teen and adult) vaccine.

I'm unsure if I've had the Tdap vaccine. Is it okay to get it again?

For most people, the benefits of protection against whooping cough outweigh the risk of any side effects that might occur after receiving a second dose. Check with your doctor, nurse, or clinic if you have specific concerns.

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Where To Get Whooping Cough Vaccines

Where can I get whooping cough vaccine?

There are many places that offer whooping cough vaccine:

  • Your health care provider
  • Most pharmacies (some have limits on what ages they serve)
  • Your local health agency

For your child, vaccines are often due on their scheduled well child visits and will be given by their healthcare provider. If you need help finding a health care provider or if you don't have health insurance, call the Family Health Hotline at 1-800-322-2588 or visit the ParentHelp123 website.

Are there vaccination clinics?

There may be vaccination clinics in your community. Contact your local health agency.

Will there be school vaccination clinics?

Some schools may offer vaccination clinics. The local school district or health agency can provide information.

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How To Pay for Whooping Cough Vaccines if You Are an Adult

Does my private health insurance pay for the vaccine?

Children through age 18 receive vaccines at no cost in Washington through the Childhood Vaccine Program. For adults, call the customer service number on the back of your insurance card to find out if Tdap vaccine will be covered for you.

Does Medicare cover the vaccine?

Medicare Part D covers the cost of the adult vaccine (Tdap) for adults aged 65 and older. Since it's a prescription drug benefit, coverage depends on the use of that benefit so far during the year. Call 1-800-633-4227 with questions about Medicare. Health care workers with questions should contact their patients' Part D plan for Part D vaccine information.

Does Washington Apple Health (Medicaid) cover the vaccine?

Washington Apple Health (Medicaid) covers the whooping cough vaccine per the recommended immunization schedule. Click here for more information about what vaccines are covered by Apple Health.

How can I pay for the vaccine if I'm uninsured?

There may be programs that can help you. Call the Family Health Hotline at 1-800-322-2588 or visit parenthelp123 website for more information. You can also contact your local health agency to find out if free vaccination clinics are planned in your community.

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For Pregnant Women and New Parents

What is the vaccine recommendation for pregnant women?

The Centers for Disease Control and Prevention recommends that pregnant women get one Tdap vaccine at each pregnancy as early as possible between 27 and 36 weeks of gestation (the third trimester). Check with a health care provider if you have questions about what's right for you.

Why should pregnant women get vaccinated against whooping cough?

Getting vaccinated while pregnant helps your baby in two ways: (1) the baby gets some short-term protection from your vaccination because you pass it to them before they are born; and (2) you reduce the risk of getting whooping cough yourself and exposing your newborn to to the infection.

Why should pregnant women get vaccinated during each pregnancy?

Women should be vaccinated during each pregnancy because the mother passes some protection to the baby before he or she is born, and because protection from Tdap is most effective within the first year after receiving the vaccine. Whooping cough can be serious for infants, and most get it from parents, siblings, or caregivers. Getting the mother vaccinated at each pregnancy provides the best protection for each baby.

If I recently gave birth, can I get the whooping cough vaccine?

If you just gave birth and have never received Tdap (the adolescent and adult whooping cough vaccine), you should get it right away. Your baby is vulnerable to whooping cough because babies are too young to be vaccinated until about two months of age and aren't fully protected until after the first four doses of the DTaP vaccine (given at 2, 4, 6, and 15-18 months of age). Your child will also need a fifth dose of DTaP vaccine between age four and six years.

Whooping cough is very serious for babies and young children, and the most common way for them to get it is from parents, caregivers, and other family members. The best way to protect your baby is to get the vaccine and make sure your other children are immunized on time.

Should new dads and siblings get vaccinated?

All family members living in your house and anyone who will spend time around your new baby—like grandparents and child care providers—should get the whooping cough vaccine if they have not already done so. Check with your healthcare provider to make sure your family is up to date.

Can I get the pertussis vaccine if I'm breastfeeding?

It is safe to get Tdap while you're breastfeeding. If you're breastfeeding and you haven't received Tdap as an adult, you should get it right away.

Does breastfeeding protect my baby from whooping cough?

Mothers vaccinated with Tdap may pass some whooping cough antibodies to their babies through breast milk, but it does not provide full protection. It is still important to protect a baby who is still too young to be vaccinated by limiting his or her exposure to whooping cough. Ask people who are sick to stay away and make sure you and everyone who is around your baby is vaccinated. Then, as soon as your baby is old enough, get him or her vaccinated by following the recommended immunization schedule (PDF).

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For Healthcare Workers and Providers

Is the whooping cough vaccine required for healthcare workers?

All healthcare workers should get one dose of Tdap vaccine. This helps protect the workers and their patients. This is especially true if the health care worker will be working with babies and pregnant women. There is no state law that requires healthcare workers to get the whooping cough vaccine, but some health care organizations have policies that require staff to be vaccinated. Check with your employer about your workplace vaccination policies.

Were there documented whooping cough cases in healthcare workers during the 2012 epidemic?

Yes, there were several cases of pertussis in healthcare workers during Washington's 2012 whooping cough epidemic. We recommend that all healthcare workers have a Tdap vaccination, stay home when they're sick, and use appropriate personal protective equipment to prevent infection when caring for patients with respiratory infections like whooping cough and flu.

Do healthcare providers in Washington report all people tested for whooping cough?

In Washington, whooping cough is a reportable condition and even a suspected case is supposed to be reported by healthcare professionals to their local health agencies. Some providers are unaware of the requirement to report. Some cases of whooping cough are diagnosed as other conditions and aren't reported. Some people with whooping cough don't go for medical attention and aren't diagnosed. An estimated one in 10 cases of whooping cough is reported to public health.

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