Welcome to “Remember When Kids Just Died?” A daily two-part tour through every vaccine-preventable disease, starting with polio on September 1, 2026. Each disease gets two posts: the pre-vaccine era, when parents enjoyed the character-building experience of burying their children, and the post-vaccine era, when we ruined everything by making childhood survivable. Cramming both into one post felt disrespectful, to the corpses and the Nobel Prizes.
Once Upon a Time, in a Land Without DTaP
Gather ’round for a bedtime story from a magical era historians call “before 1948.” A simpler time. A purer time. A time when your baby could catch a cold that gradually escalated into weeks of coughing so violent it snapped ribs, burst blood vessels in the eyes, and occasionally ended in death by suffocation, and the neighbors would nod knowingly and drop off a casserole.
We called it whooping cough. Doctors called it pertussis, from the Latin for “intense cough,” because Latin makes everything sound classier, including watching a two-month-old go apneic on your kitchen floor.
Between 1940 and 1945, the United States dutifully reported more than a million cases of pertussis, an average of 175,000 a year (CDC Pink Book). In some years it was even chirpier, back when everyone was busy worrying about the Depression and didn’t have time to also worry about their kid crowing like a rooster at 3 a.m.
Stage One: “It’s Just a Little Cold”
Pertussis is a shy, retiring disease at first. The first week or two, the “catarrhal stage,” because doctors love a word nobody uses at parties, looks exactly like the common cold. Runny nose. Sneezing. Maybe a low fever. A cough so mild it wouldn’t warrant a second look (CDC Pink Book).This is the disease’s little joke. It’s letting you relax. It’s letting you send your kid to school, church, the grocery store, and the neighbor’s newborn’s baby shower.
In the pre-vaccine era, an entire town could be seeded with pertussis before anyone realized, which is charming if you enjoy epidemics and inconvenient if you enjoy children.
Stage Two: The Whoop
Then, around week two, the fun really begins. Welcome to the paroxysmal stage, where “paroxysm” is medical for “please make it stop.” Here is the actual clinical description, which I could not improve on if I tried: bursts of numerous, rapid coughs, apparently caused by the child trying desperately to expel thick mucus from their airway. The paroxysm ends with a long, gasping inspiration that produces a characteristic high pitched whoop, described by one 19th century observer as sounding “like the crowing of a cock, or the rapid passage of air through a narrow brazen tube” (Gavi).
During the attack, the child may turn blue. They may vomit. Their eyes may bulge. Infants may go bradycardic, heart rate crashing, or simply stop breathing altogether (CDC Pink Book). Between attacks, they look totally fine. This is another one of pertussis’s delightful features: it lets you catch your breath just long enough to hope it’s over, and then it comes back. For up to twelve weeks. This is why the Chinese called it “the 100-day cough,” which is a much more honest branding.
Stage Three: Still Coughing, Somehow
Then comes the “convalescent stage,” which is Latin for “still coughing, but with slightly less enthusiasm.” This stage can last weeks to months. Physicians of the era noted that severe post-cough vomiting frequently led to malnutrition in infants (Cherry, PubMed).
So to recap: your baby coughs so hard they vomit, then can’t keep food down, then wastes away, and this goes on for a fiscal quarter. Truly the halcyon days.
The Body Count
Here’s where the sarcasm gets harder, so I’ll just lay it out. In the pre-vaccine era, pertussis killed roughly 7,300 Americans a year on average, the vast majority infants (Cherry, PubMed). Between 1926 and 1930 alone, more than 36,000 Americans died of it (Gavi). And between 1940 and 1944, whooping cough killed more American children than measles, scarlet fever, diphtheria, polio, and meningococcal disease combined (Cherry, PubMed). Combined.
Every single disease you’ve heard of? Pertussis was outperforming them at killing children. This is the pediatric equivalent of a supergroup, and pertussis was headlining.
Infants took the worst of it. The deaths often looked like the one James Watt described in 1812 when he lost his own son: increasingly violent coughing fits, a swelling face, desperate snatches for air, and finally a child who “stopped struggling for breath by stopping to breathe at all” (Gavi).
There is no wellness influencer alive today who has ever written a sentence that hit that hard.
Sources
Centers for Disease Control and Prevention. Chapter 16: Pertussis, Pink Book. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-16-pertussis.html
Gavi, the Vaccine Alliance. Whooping cough: a history. https://www.gavi.org/vaccineswork/whooping-cough-history
Cherry JD. Pertussis in the preantibiotic and prevaccine era, with emphasis on adult pertussis. Clinical Infectious Diseases. https://pubmed.ncbi.nlm.nih.gov/10447027/