Pertussis (Whooping Cough) | Global Trends, Vaccination, and 2025 Prevention Strategies
Pertussis, commonly known as whooping cough, remains a significant global public health challenge in 2025. Fueled by waning immunity, declining vaccination coverage, and pandemic-related disruptions, outbreaks are surging worldwide.
1. Global Epidemiology: Pertussis in 2025
Pertussis cases surged dramatically in early 2025. In the U.S., over 8,000 cases have been reported, more than double from the previous year, with projections exceeding 70,000 cases by year-end.
Japan also recorded a record-breaking 22,351 cases by week 21 of 2025 over five times the number from the same period in 2024.
In Latin America, countries like Peru, Mexico, Paraguay, and Ecuador reported their highest pertussis incidence since 2018, largely affecting infants under age one.
2. Why Is Pertussis Resurging?
- Routine childhood immunization disruptions during COVID-19 reduced coverage by tens of millions worldwide.
- Vaccine-induced immunity wanes over time adolescents and adults now serve as key reservoirs transmitting to vulnerable infants.
3. Clinical Features and Risk Groups
Pertussis begins with mild cold-like symptoms but progresses to severe coughing fits, sometimes leading to apnea, seizures, or pneumonia in infants, and rib fractures in adults.
Infants under one year are at highest risk, but immunocompromised individuals and those with asthma are also vulnerable.
4. Vaccination Guidelines and Recommendations
1) Childhood Vaccination (DTaP)
The CDC recommends a 5-dose DTaP series at 2, 4, 6 months; 15 ~ 18 months; and 4 ~ 6 years of age.
Catch-up schedules are available for missed doses.
2) Adolescent and Adult Boosters (Tdap)
Adolescents should receive a single dose of Tdap at 11 ~ 12 years of age.
Adults need booster doses approximately every 10 years due to waning immunity.
CDC’s adult immunization schedule updates reflect this.
3) Maternal Immunization
All pregnant individuals should receive Tdap during each pregnancy between weeks 27 ~ 36 to provide early passive immunity to newborns.
4) Cocooning Strategy
Household contacts and caregivers are encouraged to receive Tdap at least 2 weeks before close contact with infants to create a protective “cocoon”.
5. Strengthening Prevention: A Call to Action
- Restore and expand routine vaccination coverage globally to close immunity gaps post-pandemic.
- Boost awareness of booster dose requirements and reinforce adult vaccination.
- Encourage maternal immunization programs to safeguard newborns.
- Implement cocooning and community-level protection strategies.
Pertussis is making an alarming comeback in 2025, often driven by weakened immunity and lack of vaccine coverage. Vaccination especially timely infant doses, maternal boosters during pregnancy, and adult/adolescent boosters is the cornerstone of pertussis prevention. With global coordination, policy reinforcement, and public health advocacy, we can protect the most vulnerable and curb the spread of this highly contagious disease.
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