ATAGI warns of pertussis risk for older adults

The Australian Technical Advisory Group on Immunisation (ATAGI) has flagged the risks of whooping cough in older adults, as pertussis cases continue to rise.
 
In its latest bulletin, which is aimed at immunisation providers including GPs, ATAGI warns that ‘pertussis is NOT only a disease of childhood’ and that ‘older adults and people with chronic illnesses have higher morbidity and mortality compared to healthy adults’.
 
It said vaccine coverage for adults aged 50–64 and 65 and over was ‘suboptimal’ for both tetanus and diphtheria vaccination, at less than 37% for both cohorts, and below 25% for pertussis.
 
The advisory group also stressed its recommendation that healthcare workers and adults aged 65 years and over have a dose of dTpa, the combined tetanus/diphtheria/pertussis vaccine, every 10 years, while noting the vaccine is not available on the National Immunisation Program (NIP) for those cohorts.
 
At present, eligibility for free pertussis vaccinations under the NIP is limited to children aged two months, four months, six months, 18 months and four years, adolescents aged 12–13 years through school-based vaccination programs, and pregnant women.
 
GP and Immunisation Coalition Chair Dr Rodney Pearce told newsGP he strongly supports expanding the vaccine’s eligibility on the NIP to older cohorts, and recommends GPs discuss pertussis vaccination with patients from the age of 50.
 
‘Think of 50 as the time when everyone should have a conversation about whooping cough,’ he said.
 
Dr Pearce also recommends GPs suggest a dose to patients aged 50 and over every five years.
 
‘If it’s five years since you’ve had one, you’re probably not getting much protection from the last injection,’ he said.
 
‘But if it’s more than 10 years, then you’ve got none, essentially.’
 
A 2020 study showed that nearly three-quarters of adults proceeded with a pertussis vaccination when GPs proactively raised the topic.
 
During 2024–25, Australia recorded 82,530 pertussis cases – the highest number since monitoring began in 1991.
 
However, that number could be much higher, with Dr Pearce citing research he led looking into case numbers in 2018–19, which he believes could have been seven times more common than reported.
 
That work, which was published in 2024 in the Emerging Infectious Diseases journal, also suggested that people aged 50 years or more with COPD or asthma had a higher incidence of and risk for pertussis diagnosis, with women more at risk.
 
In February 2026, the surge in cases was described by Federal Health and Ageing Minister Mark Butler as ‘a very big concern’.
 
When asked if pertussis vaccinations should be made free to older Australians, Minister Butler said if the Pharmaceutical Benefits Advisory Council (PBAC) were to provide such advice, ‘of course we would follow it’.
 
In response to a newsGP inquiry on Tuesday, a Department of Health, Disability and Ageing spokesperson said that under Australian law, a vaccine can only be listed on the NIP for a specific cohort if it is recommended by the PBAC.
 
‘When recommending a vaccine be a designated vaccine, the PBAC is legally required to consider the medical conditions for which the vaccine is registered for use in Australia,’ they said.
 
‘The PBAC must also consider how effective the vaccine is, the benefits, and cost compared to other available vaccines.
 
‘To date, the PBAC has not received a submission from pharmaceutical companies for listing a pertussis containing vaccine on the NIP for older adults.’
 
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