New Republic writer Julia Ioffe has whooping cough (also known as pertussis), and she is placing the blame squarely on anti-vaccine crank Jenny McCarthy.

While we agree that McCarthy is a font of misinformation on vaccines, there are other factors at work here.

Here’s what the Centers for Disease Control website says about the causes of whooping cough outbreaks:

Q: I’ve heard about parents refusing to get their children vaccinated and travelers to the U.S. spreading disease; are they to blame for pertussis outbreaks?

A: Even though children who haven’t received DTaP vaccines are at least 8 times more likely to get pertussis than children who received all 5 recommended doses of DTaP, they are not the driving force behind the large scale outbreaks or epidemics…

Why, then, are whooping cough outbreaks increasing? Here, again, is the CDC’s perspective:

Since the early 1980s, there has been an overall trend of an increase in reported pertussis cases. Pertussis is naturally cyclic in nature, with peaks in disease every 3-5 years. But for the past 20-30 years, we’ve seen the peaks getting higher and overall case counts going up. There are several reasons that help explain why we’re seeing more cases as of late. These include: increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity.

When it comes to waning immunity, it seems that the acellular pertussis vaccine (DTaP) we use now may not protect for as long as the whole cell vaccine (DTP) we used to use. Throughout the 1990s, the US switched from using DTP to using DTaP for infants and children…

The National Foundation for Infectious Diseases recommends that all non-elderly adults receive a booster shot.

The CDC also recommends a booster shot for all non-elderly adults.

For whatever reason, Ioffe didn’t get one.

If outbreaks are caused by declining herd immunity, then aren’t adults who don’t get their booster shots part of the problem?

Ioffe doesn’t like that argument at all:

At the same, she seems to acknowledge that, yes, she should have gotten the booster:

We’ll give journalist Seth Mnookin the last word:

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