Pertussis outbreak surges in US, jumps 25-fold since 2023; Is it because of fading immunity or falling vaccination? Who faces the greatest risk and what precautions are needed

Pertussis, commonly known as whooping cough, has seen a dramatic upsurge in the United States, with cases rising nearly 25-fold in the first three months of data since 2023. Among all states, Texas reported the highest pertussis numbers - 1,928 cases in 2024. By October 2025, the state had already surpassed 3,500 cases, KFF Health News reported. National figures are equally alarming with roughly 6,600 pertussis cases recorded in the first three months of 2025 - which is four times the pace seen in 2024 and 25 times the total recorded during the same period in 2023.

State and federal health officials, as interviewed by KFF Health News, warn that the spike is likely driven by reduced vaccination rates, waning immunity, and gaps in public health tracking systems. The highly contagious respiratory infection can be especially dangerous for infants, older adults, and individuals with weakened immune systems.

Pertussis cases are climbing rapidly in Texas, Florida, California, Oregon, and numerous other states across the country. Many states are reporting their highest case numbers in ten years, and outbreaks stretching from Louisiana to South Dakota to Idaho show that this spike isn’t confined to one area - it’s widespread nationwide.

IS IT BECAUSE OF FADING IMMUNITY OR FALLING VACCINATION?

According to experts, these vaccines are highly effective at preventing severe illness, but their ability to block infection diminishes over time - similar to the waning immunity seen with COVID and flu vaccines.

“Pertussis cases increase in a cyclical fashion driven by waning immunity, but the size of the outbreak and the potential for severe outcomes in children who cannot be vaccinated can be mitigated by high coverage and good communication to folks at risk,” said Demetre Daskalakis, as quoted by KFF Health News, a former head of the Centers for Disease Control and Prevention’s immunization program, who resigned in August.

Before the first pertussis vaccine was introduced in the early 1900s, whooping cough was widespread and a leading cause of childhood deaths in the US. Routine immunization later brought the disease under control: infants typically receive a series of DTaP shots beginning at 2 months, while adolescents and adults get a Tdap booster every 10 years.

For years, about 80% of toddlers completed four DTaP doses by age 2, keeping cases in check. However, according to KFF Health News, vaccination rates have slipped since the COVID-19 pandemic, and rising nonmedical exemptions in several states have expanded immunity gaps, making communities more vulnerable to outbreaks.

BABIES ARE AT GREATEST RISK

Whooping cough poses the greatest danger to infants under one year old. Some may briefly stop breathing during severe coughing spells, and many require hospitalization, reported KFF Health News.

About one in five hospitalized infants develop pneumonia, and roughly 1% die from the infection. To protect newborns, the CDC strongly recommends that pregnant women receive a Tdap vaccine during each pregnancy. This helps transfer protective antibodies from mother to baby before birth, offering crucial early immunity.

Obstetricians are advised to review Tdap vaccination during every pregnancy, while pediatricians and family physicians are encouraged to ensure teens and adults are up to date on their boosters.

In response to rising case numbers, multiple states have issued health advisories over the past two years. Texas, in particular, released alerts in both 2024 and 2025, calling on clinicians to remain alert and reinforce vaccination efforts, reported KFF Health News.

PRECAUTIONS FOR PERTUSSIS

With the holiday season nearing, health experts are urging families with newborns to be especially cautious. They recommend making sure infants and children are fully up to date on their routine vaccines, and that all family members receive their influenza, COVID, and RSV vaccinations.

Families should also keep anyone who is sick away from newborns. If a baby develops a cough, shows signs of breathing pauses, or seems unusually unwell, caregivers should seek medical attention right away.