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Missed opportunity to curb record whooping cough epidemic

Immunisation Foundation of Australia

Key Facts:

• Hospitals ignore Government recommendations to protect against whooping cough with combined tetanus-diphtheria-whooping cough vaccine when treating wounds
• Australians being short-changed, with more than a million older adults protected from tetanus, but not whooping cough
• A whooping cough booster is recommended for adults at least every 10 years, yet fewer than three per cent of adults are up to date
  
  
• With five deaths in 2024 and spring/summer being peak season for cases, immediate action on whooping cough is urged

Missed opportunity to curb
record whooping cough epidemic

Hospitals defy key vaccination recommendations amid cost pressures

While Australia battles a record-breaking whooping cough epidemic, hospitals facing cost pressures are turning away from national guidelines designed to bolster defences against the highly infectious and potentially deadly illness.¹

New analysis by the Immunisation Foundation of Australia (IFA) reveals that many Australians admitted to hospital emergency departments with a tetanus-prone wound do not receive a combined diphtheria-tetanus and pertussis (whooping cough) (dTpa) vaccine, despite the Australian Immunisation Handbook stating “Adults who need a tetanus-containing vaccine are recommended to receive dTpa vaccine rather than diphtheria and tetanus (dT) vaccine”.^1,2    

The analysis of 469 hospitals found that 401 of these continue to stock the older diphtheria and tetanus (dT) vaccine, which costs just a few dollars less per dose than a whooping cough-containing booster.¹ These findings support a recent study which found that more than one million Australians aged over 50 years who were up to date with tetanus protection had received dT instead of the three-in-one dTpa vaccine.³

“It’s unacceptable that so many vaccines used for tetanus in Australian hospitals do not include added protection against whooping cough, despite established national recommendations.^1-3 This is a missed opportunity to boost immunisation rates and reduce the impact of an extremely dangerous and highly infectious disease,”¹ said IFA Founder Catherine Hughes AM, whose 32-day old son Riley died from whooping cough 10 years ago.

The benefits of dTpa for routine wound management in emergency departments have been quantified in the US, where a study showed that vaccination with dTpa instead of dT could prevent around 42,000 cases of whooping cough in the following three years.⁴

Whooping cough is a highly infectious bacterial infection that attacks the airways, causing uncontrollable coughing and difficulty breathing.⁵ Often referred to as the ‘100 day cough’, whooping cough is more contagious than influenza or COVID-19.^6,7 Once infected, an unprotected person can pass the illness to as many as 17 others and remain contagious for three weeks.^6-8

While whooping cough is well known to be fatal in infants, it can also cause serious illness in older children and adults, including death in older people.⁸ In Australia, whooping cough was responsible for five fatalities last year, including two infants under the age of 12 months, and three adults aged over 65 years.⁹

Whooping cough cases in Australia are at an all-time high, with nearly 80,000 confirmed notifications in the past 24 months – the highest ever recorded epidemic in Australia.¹⁰

The IFA analysis comes as new research published in Vaccines reveals concerningly low levels of whooping cough vaccination in the Australian community, despite boosters being recommended for adults at least every 10 years.^5,11 It shows that, of 730,000 Australian adults seen by a primary care doctor, as low as three per cent were up to date with whooping cough booster vaccination.¹¹

“Adults are a large component of the massive pertussis epidemic we’ve seen unfold in Australia, so vaccination of adults is part of the solution,” said Professor Raina MacIntyre, Head of Global Biosecurity at the Kirby Institute at University of New South and senior author of the study.

“Whooping cough is deadly for infants but has also caused serious complications in adults. Our research found that Australian adults with the lowest levels of vaccination, 45-to-64-year-olds, are most likely to suffer complications associated with whooping cough, including pneumonia,”¹¹ she said.

“Whooping cough risk includes soon-to-be grandparents in the context of protecting their newborn grandchild. There are other major risk groups such as people with asthma or chronic lung disease, which causes a much higher risk of complications of whooping cough.”¹¹

The IFA is joining medical experts in urging immediate action to strengthen whooping cough protection in Australia. This includes making whooping cough vaccines affordable and accessible to adults at higher risk of severe illness, as well as ensuring all hospital emergency departments and urgent care clinics replace the older dT vaccine with the combined dTpa vaccine, eliminating inconsistency in vaccine availability. Experts note that while historically there has been a significant cost difference between dT and dTPa, the gap is now far less.

In addition, the Foundation is also advocating for maternal immunisation targets, helping ensure the youngest and most vulnerable Australians are protected from birth.

“We have the vaccines to prevent whooping cough so it makes sense that we take every opportunity to use them,” said Ms Hughes.

 

The Immunisation Foundation of Australia will mark Whooping Cough Day on 8 November with a call for all Australians to remain up to date with whooping cough boosters. With most cases notified during spring and summer, now is the time to act.¹²

 

On the day the Foundation will operate a pop-up immunisation clinic at the Canberra Pregnancy Babies & Children's Expo – Saturday 8 and Sunday 9 November – providing whooping cough and RSV vaccines to expectant parents.

 

More information on whooping cough is available at: www.ifa.org.au/whoopingcoughday

 

References

1. Immunisation Foundation of Australia. Data on file. 2025.
2. Australian Government. Department of Health, Disability and Ageing. Adults who need a tetanus-containing vaccine are recommended to receive dTpa vaccine rather than dT vaccine. June 2018. Available here.
3. Hendry AJ at al. Tetanus, pertussis, and diphtheria vaccination coverage in older adults, Australia, 2023: analysis of Australian Immunisation Register data. MJA 221 (14) August 2024. Available here.
4. Talbird, S.E. et al. Impact of Tetanus, Diphtheria, and Acellular Pertussis (Tdap) Vaccine Use in Wound Management on Health Care Costs and Pertussis Cases. Journal of Managed Care & Specialty Pharmacy. Vol. 21, No. 1, January 2015. Available here.
5. Immunisation Foundation of Australia. November 8. Stay Up-To-Date. Vaccinate! 2025. Available here.
6. Shaw CL. and Kennedy DA. What the reproductive number ℛ0 can and cannot tell us about COVID-19 dynamics.  Theoretical Population Biology. Vol. 137, February 2021. Available here.
7. European Centre for Disease Prevention and Control. Expert Consultation on Pertussis. Available here.
8. Jenkins VA et al. Pertussis in high-risk groups: an overview of the past quarter-century. Human Vaccines & Immunotherapeutics. Vol. 16, 2020. Available here.
9. Australian Government. Department of Health, Disability and Ageing. ATAGI 2025 Annual Statement on Immunisation. October 2025. Available here.
10. Immunisation Foundation of Australia. Whooping Cough Report Card. 2025. Available here.
11. Moa AM, et al. The burden of pertussis disease and vaccination coverage in Australian adults attending primary health care. Vaccines. 2025;13(10):1029. Available here. 
    
12. Victoria Department of Health. Pertussis (whooping cough) [Internet]. Available here.

About us:

About the Immunisation Foundation of Australia

The Immunisation Foundation of Australia (IFA) is a leading not-for-profit organisation and patient advocacy group. It was founded by Catherine Hughes AM and Greg Hughes, who were driven to transform their personal tragedy – the death of their son from whooping cough – into powerful immunisation advocacy.

 

IFA is driven by the vision of a world where every child and adult is protected from vaccine-preventable diseases. Its mission is to advance public health through community-driven immunisation advocacy.

The Foundation’s unique approach combines personal narratives with scientific evidence to create compelling campaigns that foster understanding and build trust in immunisation. IFA champions the importance of immunisation, working tirelessly to ensure every Australian has the opportunity to live a life free from vaccine-preventable diseases.

Contact details:

Candice Hitchcock on 0466 586 758, [email protected]

Catherine Hughes on 0421 483 391