EDITORIAL: Anchorage’s whooping cough outbreak reveals some uncomfortable facts

With only two-thirds of the year tallied so far, Alaska is having its worst outbreak of whooping cough in more than a decade — and with Anchorage classrooms recording new cases almost daily, that number will only rise as the school year continues. Through the end of August, the state had seen 215 cases of a disease for which there has been a safe and extremely effective vaccine since before World War II. What gives?

The 100-day cough

What makes whooping cough so dangerous are its severity, longevity and the high risks it poses for children — particularly infants. Children hospitalized with severe pertussis (the scientific name for whooping cough) suffered a mortality rate of 34%, according to a 2021 study — with the vast majority of those deaths occurring in infants younger than 6 months. With fragile bodies and little resilience to infections, infants suffer worst when they contract the disease.

Even for older children for whom the disease is unlikely to be fatal, its symptoms are horrible. The disease gets its name from the deep coughing fits that develop about two weeks after infection. These coughing fits are often so severe they cause vomiting and even loss of consciousness — and are followed by a struggle to take in a new breath, making a “whooping” sound. Worse, the disease’s heavy coughing fits don’t pass within a week or so, as we’ve come to expect from COVID-19 and other common respiratory infections. It can persist for as long as three months, which gave pertussis its original colloquial name, “the 100-day cough.” And the coughing can return the next time a victim contracts a respiratory infection — even something as mild as a chest cold.

Why is it back?

The question of why whooping cough is making a comeback when effective vaccines for it have been widely distributed for nearly 70 years isn’t one that has a one-size-fits-all answer, but here in Alaska, relatively low vaccine rates are a sure contributor. In Anchorage, only 62% of kindergarten-age kids are up to date on their whooping cough shots, compared to roughly 80% nationwide. The picture is even worse elsewhere in the state — that figure for kindergartners is 57% in the Mat-Su and 50% in the Interior, leaving those areas even more susceptible to fast-spreading outbreaks.

There are a variety of reasons why Alaska’s vaccination rate is markedly lower than the national one. Recent disinformation trends certainly haven’t been helping: Debunked claims about a relationship between vaccines and autism have been promulgated online since the 1990s. And, as the saying goes, a lie can travel halfway around the world by the time the truth puts on its boots, frustrating efforts to stamp out the claims. Interestingly, vaccine skepticism and outright denial are popular on the fringes of both ends of the political spectrum, among woo-woo “all-natural” leftists and COVID-denying right-wingers alike.

Also contributing to Alaska’s anemic vaccination rate, ironically, is the fact that vaccines in general — and the whooping cough vaccine specifically — have been so successful at preventing outbreaks of serious disease. There were more than a million cases of pertussis in the U.S. during World War II, when it was a leading cause of death for infants and children. The advent of the vaccine in the postwar years brought that number down to about 3,000 cases nationwide per year by 1970. And although numbers have slowly climbed since that low point, most people still have not seen a whooping cough case firsthand. We humans have short memories, and it’s easy to forget about the importance of vaccinations (or assume that everyone else will vaccinate so that you don’t have to) when you haven’t experienced the consequences.

It’s not all bad news

Fortunately, not every trend or news item in Alaska related to whooping cough is bad. The state’s adult vaccination rate for pertussis, though it lags behind the U.S. average, has been improving continually in recent years — climbing from less than 50% in 2018 to 65% by 2024. If that trend line continues, it will help keep outbreaks isolated and, crucially, keep adults from infecting the infants they contact who might suffer far worse from the disease. Now we need to make similar progress with the child vaccination rate, which has been dropping among Anchorage’s school-age children.

And the further good news is that there’s an easy, free option in Anchorage for vaccination against pertussis and other serious diseases. Through a contract with the state Department of Health, vaccines are offered free to everyone at the Fairweather clinic at Tikahtnu Commons (1130 N. Muldoon Road, Suite 110) from 9 a.m. to 6 p.m., seven days a week. Appointments are available, but drop-ins are welcome.

When it comes to serious, long-lasting health impacts, whooping cough is no joke. Do your part and make sure your kids (and you, too) are protected, and we’ll all benefit from greater immunity.