1038: Kentucky’s Pertussis Surge: Preventable Tragedies and a Path Forward

JOHN SHEEHAN: 

This is Public Health Review Morning Edition from Monday, December 8, 2025. I'm John Sheehan, with news from the Association of State and Territorial Health Officials.

Today, we discuss rising whooping cough, or pertussis, rates in Kentucky and the public health response with Dr. Steven Stack, secretary of Kentucky's Cabinet for Health and Family Services. As we'll hear, Kentucky is seeing its highest rate of pertussis since 2012, despite the availability of an effective vaccine.

STEVEN STACK: 

Right, so the rise in our whooping cough cases that we're having, or Bordetella pertussis, which is the name of the bacteria, happens in a cyclical pattern. So, every three to five years, we see an uptick. So, that's pretty typical. The pandemic disrupted this, probably because people were social distancing and wearing masks, and so, we saw a suppression. So, we were due, probably, for an increase. But that being said, this is a vaccine that does work well to reduce the severity of illness, but its immune protection wears off over time. And so, if people don't get boosters when they're children, and if they don't get an occasional booster when they're an adult, their protection wanes. And so, they can still get infected, though the immunization still reduces their severity. So, what seems to be happening now is, as immunization rates are declining, that surge, or that little spike we would expect every few years, is actually becoming a much bigger spike. So, we currently have the largest number of cases so far this year in 2025 that we've had in 13 years. So, it's the highest that we've had since 2012, and so, we're concerned about that because vaccination rates continue to decline, which means more people are at risk, which means that the vulnerable among us face a greater danger from the disease.

SHEEHAN: 

Yeah, and how should state agencies respond to that?

STACK: 

Well, I think we need to stay the course, and we need to, at least my approach is, I think we need to try to continue to be steady, fact-based, supportive. We need to be very careful not to, you know, pillory or impugn people for not doing what we say they need to do. It's confusing out there. There's all sorts of mis- and disinformation on social media. There's- there's people in positions of authority sharing things that are scientifically wrong, long-proven to be false, and it's creating confusion, and that's going to cause problems for a population of over 330 million Americans, and certainly for four and a half million Kentuckians, who start to wonder, well, what is true and what is accurate? So, my goal is to try to treat people like mature adults, give fact-based information, do my very best to stay dispassionate about advocating for these things that are important and rely upon the fact that all of us want to be healthy and well, generally, and every parent wants their child to be healthy and well. People don't choose to not do things because they want to harm their child, with regard to vaccines. But people may think that they're helping their child [by] avoiding vaccines. And unfortunately, science has proven that that is a bad choice to make; that over the long haul, vaccines have saved hundreds of millions, if not more, lives across all of humanity that would have otherwise been lost to these diseases.

SHEEHAN: 

And to your point, three infants have have died from this. Both the infants and their mothers were unvaccinated. How- how can public health officials reach out and try and strengthen that message to mothers, to expectant mothers, that it's- it's really good to get vaccinated.

STACK: 

Yeah, it breaks my heart when I hear these things, because, not always, but almost always, those deaths are preventable and- and there's two ways. There- the vaccine: all pregnant women should receive a booster for pertussis during their pregnancy to protect their unborn child, because their antibodies pass on to the child. And all children should receive six doses of the vaccine between the ages of zero to six years of age to get themselves up to a good level of immunity. And so, we're going to continue to encourage people to do that. And what I've said consistently is I strongly encourage people to go to licensed healthcare providers to get the best possible advice if you can't be sure who to trust because you don't know if your social media platform has given you good stuff or bad stuff. Unfortunately, now, you can't really have the same confidence in the federal government websites and maybe even some of the other sources of information. Your licensed health care provider is someone who has trained for many, many years to provide quality- quality medical guidance to you and is overseen by a board of medical licensure, and so would be accountable for providing high-quality and good information to you. So, I'd encourage people to talk to doctors and nurses and pharmacists and physician assistants and hope that you can get good information from your medical professional.

SHEEHAN: 

Another challenge is that whooping cough, pertussis, starts off with very mild symptoms, right? What can- what can clinicians do to sort of help out that early detection?

STACK: 

Right, so I think clinicians are going to have to do more asking about immunization status now than maybe we had in the past. It used to be, you could rely that the vast majority of people were immunized, and so that was, you know, some diseases were unlikely to occur. Thankfully, we still have 85-90% or more of the population immunized. So, let's be very clear about this. This is not even close. It's a slam dunk when you know 90% of the population or more is immunized. Overwhelmingly, the population has understood that the vaccines are important. The problem is some of these diseases are so contagious that when you fall, and you lose 10%, it's enough people to spread disease and cause problems. So, I think we're going to have to continue to focus on encouraging people to be immunized. But then the clinicians, the doctors, the nurses, the PAs, are going to have to ask more often, have you received all of your immunizations? And perhaps verify that to the extent they can through an immunization record, because normally a child who comes in who's got a runny nose, cough and a fever, just has a viral illness, and you don't give them antibiotics, because it's not a good idea to do that. But if they're unimmunized, then you may ask other questions, and then you may find through your questioning that they were exposed to someone with whooping cough, and that therefore they are in a different bucket or a different category. So, it's going to require clinicians to continue to evolve based on the choices the population makes, and ferret out when are things not just a common cold, but maybe something different that requires a different approach.

SHEEHAN: 

That's really good advice. Finally, how is Kentucky working with federal partners in response to the- to the rise?

STACK: 

Yeah, so we have our own laboratory reporting requirements, and pertussis, or whooping cough, is a reportable disease in Kentucky. So, the hospitals, the doctors, have to inform us if they find a patient with pertussis. So, we rely on a robust set of statewide information streams to try to keep on top of this. We certainly partner with our fellow states, and historically, we have partnered really robustly with the CDC. We certainly work very hard in Kentucky to make sure that the advice we give from our Kentucky Department for Public Health and- and to our people, is the best fact-based, scientifically-based guidance we can provide that improves their chances of health and wellness.

SHEEHAN: 

Well, Dr. Steven Stack, thanks so much for joining us.

STACK: 

Thanks. It's been a pleasure to be here.

SHEEHAN: 

Dr. Steven Stack, secretary of Kentucky's Cabinet for Health and Family Services.

An ASTHO blog highlights how the Vermont Department of Health leveraged the Public Health Infrastructure Grant, or PHIG, to create a Data Modernization Advisory Committee and how they will continue to make strategic improvements to modernize infrastructure over the next two years. Read more by clicking the link in the show notes.

And an ASTHO webinar, Don't Panic: A Panel on How to be an Effective Crisis Communicator, explored strategies for strengthening jurisdictional capacity for public health risk communication. The session showcased best practices for communicating about trending public health threats, innovative resources for applying the latest risk communications research, and an overview of practical tools to help public health communicators effectively address crises and emergencies across diverse jurisdictions. You can watch the webinar recording by clicking the link in the show notes.

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.