When Chelsey Charles learned whooping cough cases were surging in Washington, like many other parents, she worried for her family’s health.
But this 31-year-old mother has had a longer, more complicated history with whooping cough than most.
Fourteen years ago, Charles’ daughter Kaliah Jeffery died from whooping cough, or pertussis, at 27 days old. Too young to be vaccinated against the bacterial disease, Kaliah quickly developed an unceasing cough that later turned into vomiting, a lack of oxygen and seizures. Her condition worsened, and the baby girl was put on life support.
“I kept thinking to myself, this is a bad dream, I’m going to wake up,” Charles said, remembering that somber period. “There’s no way that she’s going to die.”
After about two days on life support, Kaliah passed away.
Now, more than a decade later, with whooping cough cases on the rise, Charles, health officials, the medical community and other parents are all encouraging the public to vaccinate and protect themselves against the disease. They do so against a backdrop of growing hostility toward a variety of vaccines, and new messaging from the nation's top health official that undermines years of science and public health guidance.
As of June 28 in Washington, 1,434 pertussis cases – 101 of those were infants – have been reported this year, according to the state Department of Health. By this time last year, there were 420.
That doesn’t mean whooping cough rates let up in 2024. By the end of that year, the state had seen almost 26 times as many cases as the year before, and a child in Spokane County died from the disease.
Concurrently, vaccination rates have dropped for young children. While 72.7% of 19- to 35-month-old children were vaccinated statewide in 2016, by 2024, that percentage dropped to 65.4%, according to the state's immunization dashboard.
In King County, the same age group’s vaccination rate dropped from 79.2% to 71.8%, according to the dashboard. Snohomish County rates dropped from 77.5% to 67.6%, and Pierce County from 68.2% to 60%.
To help combat vaccine hesitancy, Dr. Mary Fairchok, a pediatric infectious disease physician and medical director of pediatric infectious diseases at MultiCare Mary Bridge Children’s Hospital, said addressing parents' concerns, directing them to credible resources and sharing stories about the efficacy of vaccines are useful strategies — for those willing to listen.
She encouraged medical professionals to use their voice to promote fact-based information about how vaccines work, how they save lives and how they're safe and effective.
Nationwide, the percentage of kindergartners vaccinated against measles and whooping cough in recent years has also fallen. Internationally, millions of children are at risk for lethal diseases due to a decline in vaccination rates. Amid this drop , last month Health and Human Services Secretary Robert F. Kennedy Jr. announced the end of U.S. funding to global vaccine alliance Gavi.
Fairchok said Mary Bridge Children's Hospital has seen “record numbers” of whooping cough cases over the past few months.
Noting that infants are particularly vulnerable, she said pertussis can create such forceful coughing that patients pop blood vessels in the whites of their eyes, break ribs and encounter other serious symptoms.
“It’s pretty awful to witness,” she said.
For pertussis and other vaccine-preventable diseases, Fairchok estimates more than half of parents who choose not to vaccinate their children “double down” on their decision after seeing their child be sick.
“There’s a bit of defensiveness there,” she said. That being said, she added the experience does lead some parents to consider vaccination.
While vaccines are safe and effective, immunity can wane over time leaving even vaccinated people susceptible.
That’s the period Spokane-resident Terry MacMullan said his son was in when he came down with whooping cough.
It started in April when the teenager’s high school called to notify the family that MacMullan’s son — up to date on vaccines but nearing the time to get a booster – was exposed to the disease. He fell ill soon after and was diagnosed with pertussis, experiencing “whole-body racking coughing fits,” gastrointestinal issues, and lasting fatigue, MacMullan said.
“I was totally unprepared for how unrelenting this is,” he said.
While a doctor had initially expected MacMullan’s son’s illness to last a few days, after about a month in, MacMullan realized “this is not resolving, this is brutal.” Some nine weeks in, he said his son's condition was improving, but he was still dealing with fatigue.
“It was really concerning, and I just felt so helpless that there wasn’t more we could do for him,” he said.
Chelsea Charles remembered being “in such denial” that her daughter might not survive pertussis. After Kaliah's passing, Charles, who lives in Granite Falls, said she coped through doing media interviews.
“I just wanted other people to realize it was a lot more serious than the commercials were making it seem,” Charles said.
Dr. Robert C. Hauck, a retired pediatrician who worked with Group Health Cooperative from 1969 to 1996, said he didn’t see many whooping cough cases during his practice years. He attributed the low case number to high immunization rates and less vaccine hesitancy at the time.
Still, the cases he did see remain etched in his memory.
“In all my years of practice the most miserable patients I ever cared for were infants with whooping cough,” Hauck said.
He added that “the single most important action for me as a pediatrician was ensuring that the children under my care were fully immunized.”
Fast forward a few decades, and for doctors like Fairchok, at Mary Bridge Children's Hospital, the immunization status of young patients is no longer as uniform.
“It’s much, much, more common for parents to say, ‘no we’re not vaccinating,’ than it ever has been,” Fairchok said.
The state’s school immunization data dashboard provides another glimpse into this trend.
From the 2016-2017 school year to the school year just completed, exemptions citing religion as a reason not to be vaccinated, increased sharply in Washington. In King County, during the 2019-2020 school year, 94.5% of kindergartners were vaccinated for pertussis. By the 2024-2025 school year, that percentage dropped to 91%. During the same period, Snohomish County rates dropped from 92.7% to 91.4%, and in Pierce County, from 93.1% to 88.4%
While less coverage is likely behind the recent pertussis spike in Washington, there’s more to the story than just vaccination, said DOH spokesperson Mark Johnson. More awareness about the disease, better testing, and genetic changes to bacteria could also be contributing to more cases, according to the CDC.
And as Meagan Kay — a medical epidemiologist for the county's public health department — pointed out, there is “some kind of cyclical nature” to pertussis cases increasing as immunity from vaccines wane over time. Washington previously faced a pertussis epidemic in 2012.
“It’s an opportunity and a really important reminder as to why everyone does need to get vaccinated,” Kay said.
Vaccines remain the best way to protect against whooping cough, according to the CDC.
Charles, who now has three children including a baby, said now that pregnancy pertussis vaccines are readily available – the CDC started recommending them the year after Kaliah's death – she made sure to get her shot while expecting. Amidthe surge in whooping cough cases, Charles said she took added precautions to protect her family.
“I was just constantly making sure that we were as healthy as we could possibly be to try to avoid it, until the baby could get vaccinated for it,” she said. “Because I didn’t really want to go through that again, you know?”
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