Revising State Policy to Help Reduce High Rates of Pertussis

Pertussis is a highly contagious respiratory disease that can have very serious effects on babies and young children. Over the past five years, Maine children have been exposed to higher rates of pertussis (also known as whooping cough) compared to their peers across the country. In 2012, there were 737 cases across the state¹, and in 2016, there were 243 cases.²

Even though the number of cases went down between 2012 and 2016, Maine had the fourth highest rate of pertussis in the country in 2016.³ Within the state, rates of pertussis vary across counties. Cumberland and Waldo Counties had rates of 53 and 46 out of 100,000, respectively, while eight counties had rates less than 14 out of 100,000.⁴

In 2017, Maine took action to combat Pertussis by requiring a Tdap booster vaccination for all students entering 7th grade. Tdap is the vaccine that prevents Pertussis (as well as tetanus and diphtheria). The Maine Immunization Coalition, of which MaineHealth is a member, monitored and provided public comment in support of the rulemaking process to add these requirements through joint Department of Health and Human Services and Department of Education rules. According to public health experts, improving vaccination coverage helps to reduce the number of cases because adolescents are common transmitters of the infection to babies and young children.⁵

This policy was enacted in time for the start of the 2017-2018 school year; public health officials and clinical leaders will be closely following the number of cases of pertussis and vaccination rates over the course of the next several years to estimate the impact of this rule change. Maine was the 48th state in the nation to require the booster shot for middle school entry.

¹ U.S. Centers for Disease Control and Prevention. "2012 Final Pertussis Surveillance Report." https://www.cdc.gov/pertussis/surv-reporting.html  (December 2017)

^2,3 U.S. Centers for Disease Control and Prevention. "2016 Provisional Pertussis Surveillance Report." https://www.cdc.gov/pertussis/surv-reporting.html  (December 2017)

⁴ Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention. "Maine Monthly Pertussis Surveillance Report October 2017." http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vaccine/pertussis.shtml  (December 2017)    

⁵ Adolescents are common transmitters of the infection to infants and other young children. The protection from whooping cough vaccination wears off by the teen years so it is so important for adolescents to receive this vaccine as they are at risk for infection and then transmission. http://www.nfid.org/pertussis/