By Céline Gounder, KFF Health News

Rates of pertussis, also known as whooping cough, are surging in Texas, Florida, California, Oregon, and other states and localities across the country.

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The outbreaks are fueled by falling vaccination rates, fading immunity, and delays in public health tracking systems, according to interviews with state and federal health officials. Babies too young to be fully vaccinated are most at risk.

“Pertussis cases increase in a cyclical fashion driven by waning immunity, but the size of the outbreak and the potential for severe outcomes in children who cannot be vaccinated can be mitigated by high coverage and good communication to folks at risk,” said Demetre Daskalakis, a former head of the Centers for Disease Control and Prevention’s immunization program, who resigned in August.

Before the first pertussis vaccine became available in the early 1900s, whooping cough was one of the most common childhood diseases and a major cause of childhood death in the United States. Today, children get a series of DTaP shots (full-dose version) starting at 2 months old, and teens and adults receive a Tdap booster (lower-dose version) every 10 years. (Both vaccines target diphtheria and tetanus in addition to pertussis.)

Until recently, 8 in 10 toddlers had received four doses of the DTaP vaccine by age 2, and case rates were controlled. But vaccine coverage has declined since the covid pandemic and increases in state nonmedical exemptions have widened immunity gaps, which is when the proportion of individuals who are immune falls below the level needed to contain spread.

Texas logged 1,928 pertussis cases in 2024. By October 2025, the state had exceeded 3,500. National numbers are just as stark: In the first three months of 2025, the U.S. tallied 6,600 cases — four times last year’s pace and 25 times 2023’s. Several states are posting their highest case totals in a decade, and outbreaks from Louisiana to South Dakota to Idaho make clear this surge isn’t regional. It’s everywhere.

Key factors behind these numbers

Texas lawmakers recently passed a law that made it easier for parents to claim nonmedical exemptions from school vaccine requirements by allowing them to download exemption forms online. These forms now go straight to schools, not health departments, making the exemptions harder to track.

Dallas County Health and Human Services Director Phil Huang said the full impact of the new exemption rule is not yet known because it began this school year, but he expects it will make school-level vaccination rates fall even more.

He’s already noted a dramatic drop in vaccinations. Normally, during back-to-school season, “our whole front downstairs area is packed,” he said. “We did not see that this year.”

Huang believes fear of immigration enforcement may be keeping at least some families, especially Hispanic families, from getting vaccinated. Dallas County is about 40% Hispanic. “We think that a lot of them are deterred by the ICE activity,” he said, referring to Immigration and Customs Enforcement.

More complications: These vaccines protect against severe disease, but protection against infection fades over time, as is the case with the covid and influenza vaccines.

The U.S. switched in the 1990s from whole-cell pertussis vaccines to “acellular” ones, which cause fewer side effects but do not last as long. Because more adults today than in the past received the acellular vaccine as children, many have lost immunity over time and may unknowingly pass the infection to babies.

Babies face the greatest risk

Whooping cough is especially dangerous for infants under a year old. Some stop breathing during coughing fits. Many need hospital care, about 1 in 5 of whom develop pneumonia, and about 1% of whom die.

Because of this high risk, the CDC urges pregnant women to get a Tdap vaccine during every pregnancy. This allows the mother’s antibodies to pass to the baby before birth.

Health officials once promoted “cocooning,” vaccinating all family members and caregivers around the baby, but that strategy was hard to carry out in real life and is no longer widely recommended. Vaccination of pregnant women and babies at 2 months of age remains the strongest protection.

Better testing finds more cases

Modern PCR testing is also uncovering more pertussis cases than in the past. Many clinics now routinely use this lab-based technology to test for several respiratory infections at once, including pertussis. Ten years ago, these panels were uncommon.

CDC experts say this explains part of the rise in case counts. But the large number of infant hospitalizations and the size of state outbreaks show that true transmission has also increased.

A growing worry: antibiotic resistance

Doctors normally treat pertussis with macrolide antibiotics, such as erythromycin, azithromycin, and clarithromycin. These drugs work best early in the illness and help stop spread. Another drug, trimethoprim-sulfamethoxazole, is an option for some older infants and adults.

But macrolide-resistant pertussis has become common abroad, especially in China, and recent reports show resistance rising in Peru. In the U.S., resistant cases have been rare.

CDC officials warn that resistant strains could spread more easily through international travel. Because treatment options are limited, especially for very young infants, health workers are watching this closely.

Huang said macrolide resistance has not been seen yet in Dallas County. But he is aware of the national concern.

What happens now

The resurgence of whooping cough has no single cause. Instead, several problems are occurring at once: falling vaccine coverage, only about 60% of pregnant women receiving Tdap, waning immunity, improved testing, and early signs of antibiotic resistance.

Health experts say solutions must match the problem’s complexity.

Across the nation, clinicians are being told to have a higher suspicion for pertussis when they see patients, especially children or caregivers of newborns with a persistent cough or coughing fits followed by vomiting. Babies who stop breathing or turn blue need immediate care.

Obstetricians are encouraged to discuss Tdap during every pregnancy. Pediatricians and family doctors are urged to check booster status for teens and adults.

Several states have issued health advisories over the past two years, including Texas, which has issued alerts in both 2024 and 2025 urging clinicians to stay vigilant.

Huang said Dallas County is trying to rebuild public health outreach programs that were cut when covid funding ended. But staffing is still limited. “There’s just a lot of different things that are making it more difficult,” he said.

He also noted that Dallas County now receives immunization registry data only once a month, rather than daily, making it harder to track vaccine coverage. “We don’t have that yet. … It’s not real time,” he said.

Protecting the youngest

As the holiday season approaches, experts urge families with newborns to take extra care:

Ensure infants and children are up to date with their childhood vaccines and that everyone in the family is up to date with their vaccines for influenza, covid, and RSV, or respiratory syncytial virus.
Keep sick visitors away.
Seek care quickly if an infant has a cough or pauses breathing.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

Once the haze clears from Thanksgiving sales, you might feel like a triumphant bargain hunter — or maybe you’ll be panicking over your receipts. Either way, you’re not alone.

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“Retailers have been pushing people to shop earlier and harder for years,” says Melissa Caro, a certified financial planner based in New York City and founder of digital platform My Retirement Network. “It’s incredibly normal to overshoot a bit on Black Friday or Cyber Monday.”

In fact, holiday shoppers plan to spend $1,107, on average, for gifts this year, according to a NerdWallet study, which is $182 more than last year’s average.

Overspending happens for people at all income levels, says Tom Geoghegan, a CFP with Beacon Hill Private Wealth in Summit, New Jersey. “It doesn’t really matter if you’re making five figures, high six figures or even seven figures,” he says. “People just tend to get out over their skis and then that guilt comes in.”

But your November guilt doesn’t have to ruin the rest of your holidays. Here’s how to recover from any overspending and set yourself up for smoother holidays ahead.

Do a shopping reality check

In the wake of your Thanksgiving shopping spree, look at all of your purchases (or make a list) and evaluate: Did you buy holiday gifts, and are you happy with them? Did you overspend? Did you make any impulse buys?

“Most people don’t do an honest inventory, and that’s where the trouble starts,” Caro says.

When you look at the whole haul, Caro says, a few things usually will be clear: “What was an actual gift you’re happy about, and what was impulse noise driven by limited-time deals and ‘act now’ messaging?” she asks.

It might be that you got stellar gifts for some people in your life and you’re done with that shopping. If that’s the case, check them off your list and don’t do any more browsing for them in December.

Make use of return policies

If you end up with regrets, remember that you can return things. Retailer return policies around the holidays are typically fairly generous, in order to allow giftees time to return unwanted presents.

“If you truly overspent, it’s not defeat to take things back,” Caro says. “On the flip side, if you look at everything and think, ‘Actually these are the gifts I wanted to give,’ then call it done.”

Returning purchases can help you rescue a budget in distress, particularly if your shopping is jeopardizing your ability to pay for basic expenses in December.

You don’t want to put yourself in a position where your holiday spending creates a credit card bill that takes three to six months to pay off next year, Geoghegan says. Not only will you pay interest on that balance, but it could throw off some of the financial goals you’ve already set.

“We don’t want people to be in a situation where they’re having to cut back on the 529,” Geoghegan says.

Set a spending cap

After you’ve dipped your toes in the holiday shopping waters, put some limits on the rest of your spending. How much more can you reasonably lay out on the holidays? That number may be smaller than previous years if you spend a big chunk during Thanksgiving weekend sales.

“The goal isn’t a perfect budget,” Geoghegan says. “It’s stopping a spiral. A single number for gifts, travel and gatherings tends to work better than tracking every line item.”

If that number is looking slim, now’s the time to consider trade-offs to keep overall costs down. You might decide you’ll eat fewer dinners out in December, for instance, or stop ordering takeout.

“It’s those kinds of swaps, rather than ‘Nobody can use their credit card for the rest of the month,’” Geoghegan says. “We still have time to — maybe not right the ship, but we have time to at least make it not the Titanic.”

Pump the brakes on impulse buys

If Thanksgiving weekend shopping turns into a free-for-all, it pays to put some guardrails around the rest of your holiday spending.

At a basic level, tracking your purchases, whether that’s in a Google Doc or a spreadsheet, can help you prevent gift creep — the phenomenon of picking up “just one more” stocking stuffer for your giftees.

To slow yourself down, consider giving yourself a 24-hour waiting period before buying. “Just see how you feel about it the next day,” Caro says. “A lot of times that will eliminate the overspending, and that kind of helps you be a little more thoughtful around gift giving.”

Plan for next year

If you’re veering toward spending more than you planned this holiday season, bookmark a month or two in 2026 to buckle down and pay off those bills.

“A month is not terribly difficult to handle,” says John Bell, a CFP and owner of Free State Financial Planning in Highland, Maryland. “It’s easier than saying, ‘I’m not going to do anything for the next six months.’”

And ideally, you’ll be motivated to create a savings bucket for next year’s holidays. You could, for example, budget $1,000 for holiday spending next year.

That would mean setting aside about $91 dollars a month for the first 11 months of the year. This is far less painful than paying off a $1,000 credit card bill after the fact.

“The biggest issue I see is that people have not saved throughout the year and don’t have a defined amount they are going to spend on each person,” Bell says. “It’s just being more intentional and aware of it, rather than just going with the flow.”

Kate Ashford, WMS writes for NerdWallet. Email: kashford@nerdwallet.com. Twitter: @kateashford.

The article Thanksgiving Debt Regrets: How to Recover If You Overspend originally appeared on NerdWallet.

By PATRICK WHITTLE and ADAM SCHRECK

PORTLAND, Maine (AP) — Black ice, snow showers and fog pestered post-holiday travelers in the Midwest on Monday while the Northeast geared up for its first major snowstorm of the season.

More than 8 inches of snow fell at Chicago O’Hare International Airport this weekend, setting a record for the highest single calendar day snowfall in November at the airport, according to the National Weather Service. The previous record was set in 1951.

About 300 flights into and out of O’Hare had been canceled by early Sunday evening, while about 1,600 had been delayed, according to the tracking site FlightAware. Dozens remained canceled or delayed there into Monday, and commuting conditions on roads were expected to remain dangerous in some areas well into Monday night.

In the Northeast, some parts of northern New England were expecting up to 10 inches of snow. A windy, potentially icy storm was headed to the region, and could soak some parts of the six states while piling snow in others, forecasters said.

And with plowable snow expected to coat large parts of Pennsylvania, crews began to treat snow lanes along the 565-mile Pennsylvania Turnpike system on Monday, said the agency’s press secretary, Marissa Orbanek. Vehicle restrictions on the turnpike system’s Northeast Extension, from the Lehigh Valley to Clarks Summit, will be imposed at 5 a.m. Tuesday.

More than 600 equipment operators and safety workers are available to help clear the turnpike’s 2,900 miles of snow lanes, Orbanek said. The turnpike’s winter staffing schedule began in mid-November, and 23 maintenance sheds are staffed around the clock.

“We really prepare for snow all year long,” Orbanek said.

In Chicago, Don Herrian was among the crowds of travelers at O’Hare on Sunday, hoping to make it back home after Thanksgiving as hundreds of flights were delayed and canceled following a winter storm in the Great Lakes region.

The 76-year-old retiree from Ardmore, Oklahoma, had visited his daughter and her family in Indianapolis. He said his first flight was three hours late, and his connecting flight to Oklahoma City from Chicago was already running another two hours behind.

“It is what it is,” Herrian said. “It’s congested, but that’s expected due to the snow, the delays and the holidays.”

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Roads leading to O’Hare were packed Sunday with slow-moving vehicles even after the roads had been cleared of snow. Inside, delayed travelers crowded into gate seating areas, restaurants and sports bars to pass the time. Others grabbed spots on the floors of the terminals, snacking, knitting or scrolling their phones.

Planes were being de-iced at several airports across the country on Sunday, including at Ronald Reagan Washington National Airport and Minneapolis–Saint Paul International Airport, according to the Federal Aviation Administration.

Over 12 inches of snow had fallen since Saturday in areas close to Lake Michigan. Hundreds of churches in western Michigan told worshippers to stay home or watch services online.

In Wisconsin, utility crews worked to restore power to thousands of people. We Energies reported more than 6,000 power outages, with more than half in Milwaukee and South Milwaukee. The airport in Des Moines, Iowa, reopened on the critical travel day after a Delta Connection flight landing from Detroit slid off an icy runway. No injuries were reported, and passengers were transported to the terminal by bus.

By early Sunday evening, over 400 flights into and out of Detroit Metro Airport were delayed and over 45 were canceled, according to FlightAware.

Elsewhere in Iowa, gusty winds on Sunday were blowing snow back onto roads, extending hazardous travel conditions, the National Weather Service said.

“We did have areas of Iowa and Illinois that saw over one foot of snow,” said meteorologist Andrew Orrison.

Over 16 inches of snow fell in Fort Dodge, Iowa, according to the National Weather Service.

Orrison said snow in the Great Lakes region was tapering off, but the new storm was heading to the mid-Atlantic and Northeast, with up to a foot (30 centimeters) of snow by Tuesday.

“It’s going to be the first snowfall of the season for many of these areas, and it’s going to be rather significant,” Orrison said. “The good news is that it does not look like the major cities at this point are going to be looking at any significant snowfall.”

Schreck reported from Chicago. Associated Press reporters Jamie Stengle in Dallas and Mark Scolforo in Harrisburg, Pennsylvania, and photojournalist Nam Y. Huh in Chicago contributed to this report.

By MATTHEW PERRONE, AP Health Writer

WASHINGTON (AP) — For many children, the experience of getting their first pair of glasses is an inevitable milestone, the first in a lifetime of visits to the eye doctor.

But what if those lenses could actually help preserve the child’s vision and reduce the chances for more serious eye problems in adulthood?

That’s the promise of a new type of lens approved by the Food and Drug Administration in September. While the technology has previously been available in Europe, Asia and other parts of the world, it’s now rolling out in the U.S.

Here’s what to know about the new approach.

What is myopia and why is it increasing?

Myopia, commonly called nearsightedness, is when people can clearly see objects at close range but struggle with distant objects, which often appear blurry or indistinct.

Studies conducted around the world have shown rising rates of myopia, which researchers have associated with increased time indoors looking at screens, books and other objects held close to the eyes.

In the U.S., 30% to 40% of children will have myopia by the time they finish high school, according to Dr. Michael Repka, a professor and pediatric ophthalmologist at the Johns Hopkins School of Medicine.

Until now, doctors had few options for treating the condition.

“It was typically and simply: ‘Your child needs to wear glasses and they’ll live with it,’” Repka said. “’It will be lifelong and it will likely get worse over the next few years.’”

How do the new lenses work?

The specialized glasses, sold under the brand Essilor Stellest, are approved by the FDA to slow nearsightedness in 6- to 12-year-olds.

The FDA said it cleared the lenses based on company data showing children experienced a 70% reduction in the progression of their myopia after two years.

Over time, myopia causes the eye to grow longer, worsening vision and increasing the risk of tears to the retina — the light-sensitive tissue at the back of the eye that is essential for vision.

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The new lenses use 11 concentric rings filled with tiny raised dots to refocus light onto the retina in a way that is believed to slow elongation of the eye.

“Whether this hypothesis is ultimately proven to be true, of course, matters only in part,” Repka said, noting that the lenses appear to work regardless of how the underling science works.

In the company study, children wearing the lens showed a 50% reduction in eye lengthening when measured after two years. Currently, researchers in the U.S. and other countries are conducting their own independent studies to confirm those results.

Ophthalmologists say the potential benefits go beyond preserving vision to heading off some long-term consequences of severe myopia, which can include cataracts, glaucoma and retinal detachment that can lead to blindness.

“Now we have a way to slow that down and maybe we can prevent kids from having that really elongated eye that puts them at risk for blindness,” said Dr. Rupa Wong, a Honolulu-based pediatric ophthalmologist.

How much will the lenses cost?

The suggested retail price is $450, according to EssilorLuxottica, the company that makes the lenses.

Major U.S. vision insurance providers are expected to cover the lenses for children who meet the prescribing criteria.

How do the new lenses compare to older treatments?

The only other FDA-approved product to slow myopia are contact lenses made by a company called MiSight. The daily disposable lenses, approved in 2019, use a similar approach intended to slow the progression of nearsightedness in children ages 8 to 12.

But Gupta says many parents and physicians are likely to prefer the glasses.

“A lot of people might be hesitant to put a child as young as 8 in contact lenses, so the glasses offer a really nice alternative,” she said.

Some doctors prescribe medicated eye drops intended to slow myopia, but those are not approved by the FDA.

Which children are good candidates?

Under the FDA’s approval decision, the lenses can be prescribed to any child with myopia who’s within the recommended age range. There were no serious side effects, according to FDA, although some children reported visual disturbances, such as halos around objects while wearing the lenses.

The studies that the FDA reviewed for approval were conducted in Asia. Repka said U.S. ophthalmologists and optometrists may want to see some additional research.

“I think before it becomes widely used, we will need some data in the United States” showing that the lenses work, said Repka, who is conducting a U.S.-based study of the new lenses supported by the National Institutes of Health.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.