Whooping cough cases near 70-year high in NC. What’s behind the spike?
AI-generated summary reviewed by our newsroom.
- Pertussis surged across North Carolina in 2024–25, reporting the highest cases in 70 years.
- Declining vaccination rates and post‑pandemic immunity gaps drove the rise in cases.
- Health officials urge Tdap vaccination for infants, children, pregnant people and adults.
A harsh, hacking cough is making a comeback across North Carolina — and health experts say it’s reaching levels the state hasn’t seen in 70 years.
Whooping cough, also known as pertussis, is a highly contagious infection spread by contact with respiratory droplets when someone talks, coughs or sneezes, according to the Centers for Disease Control and Prevention (CDC).
It’s known to cause severe, uncontrollable coughing fits that can make it difficult to breathe and sometimes cause a “whooping” sound when inhaling. The illness can affect people of all ages but is most dangerous for infants and young children.
There were nearly 600 cases reported near the end of 2024, a total more than six times higher than the same time in 2023, NC Health News reported — and the highest number of cases reported in the state in 70 years.
There have already been more than 550 cases of whooping cough reported in the state this year, meaning the count will likely surpass last year’s total, Dr. David Weber, an infectious disease specialist at the UNC School of Medicine, told The Observer.
“We are seeing a lot more pertussis,” Weber said. “If you look at UNC [Health], we’ve already seen double the number of cases than we saw last year.”
Here’s what you need to know.
What’s behind the spike in whooping cough cases?
There are several factors driving the recent rise in whooping cough cases across North Carolina, Weber said.
He explained that pertussis tends to spike during the winter months and also follows “three- to seven-year cycles” of increased activity.
The pandemic may have played a role, too, with widespread masking and limited exposure to germs from 2021 to 2023, fewer people built up short-term immunity.
“When you do get pertussis, it doesn’t give you lifelong immunity like measles or mumps,” Weber said, noting that immunity fades over time.
He added that declining vaccination rates are also contributing to the spread, making it “a combination of multiple reasons why we’re seeing more pertussis.”
Data show the whooping cough vaccine coverage among kindergarteners in North Carolina has dropped overall in recent years, from 96.5% before the 2014-15 school year to 93.5% by the 2023-24 year, according to the CDC.
Who should get the whooping cough vaccine?
In North Carolina, all kids are required by law to be vaccinated against several illnesses — including whooping cough.
The DTaP/Tdap vaccine, which protects against diphtheria, tetanus, and pertussis, is a must for children in the state.
According to the Mecklenburg County Health Department, here’s the recommended vaccination schedule for kids:
- Four doses at 2 months, 4 months, 6 months and 15-18 months of age
- A booster dose at 4-6 years of age
- A dose of Tdap at 11-12 years of age
“Adults should also be vaccinated with Tdap,” the health department says. “This helps protect adults and adolescents from pertussis and prevents them from spreading the disease to others, especially infants.”
The CDC recommends that people who are pregnant get the whooping cough vaccine between 27 and 36 weeks of pregnancy. This helps protect the baby after birth and allows the child to start building immunity early.
“There’s nothing worse for a fetus than a sick mom,” said Dr. David Weber. “If you’re pregnant — especially with cases on the rise — talk to your provider about getting the pertussis vaccine at the right time to protect both you and your baby.”
However, there are two types of exemptions for required immunizations, according to the N.C. Department of Health and Human Services:
- The state’s medical exemption says if a licensed doctor determines that a vaccine would be detrimental to a person’s health, they can be exempt from it.
- There is also a religious exemption that allows those with religious beliefs that prevent them from getting immunizations to skip them, The News & Observer previously reported.
Where to get a whooping cough vaccine
You can visit any of the following places for whooping cough vaccines in NC:
▪ Pharmacies: Walk in or schedule appointments at pharmacies like CVS and Walgreens. You can also inquire with local neighborhood pharmacies.
▪ Grocery and big box stores with pharmacies: Walk in or schedule appointments at stores like Walmart, Target, Harris Teeter and Publix.
▪ Your healthcare provider: Of course, you can contact your doctor for an appointment.
How to protect yourself from whooping cough
The Mecklenburg County Health Department says getting vaccinated is the best way to protect yourself from whooping cough.
If you or your child are sick, it’s important to stay home to keep from spreading the illness to others. The health department also recommends simple prevention steps, such as washing your hands often and covering your coughs and sneezes, to help stop whooping cough from spreading.
This story was originally published October 7, 2025 at 10:54 AM with the headline "Whooping cough cases near 70-year high in NC. What’s behind the spike?."
