Whooping cough (pertussis) rates have risen sharply in recent years and babies who are too young to start their vaccinations are at greatest risk. Young babies with whooping cough are often very unwell and most will be admitted to hospital because of their illness. When whooping cough is particularly severe, they can die. Pregnant women can help protect their babies by getting vaccinated – ideally from 16 weeks up to 32 weeks pregnant. If for any reason you miss having the vaccine, you can still have it up until you go into labour. Getting vaccinated while you're pregnant is highly effective in protecting your baby from developing whooping cough in the first few weeks of their life. The immunity you get from the vaccine will pass to your baby through the placenta and provide passive protection for them until they are old enough to be routinely vaccinated against whooping cough at 8 weeks old. The best time to get vaccinated to protect your baby is from 16 weeks up to 32 weeks of pregnancy. This maximises the chance that your baby will be protected from birth, through the transfer of your antibodies before he or she is born. If for any reason you miss having the vaccine, you can still have it up until you go into labour. However, this is not ideal, as your baby is less likely to get protection from you. At this stage of pregnancy, having the vaccination may not directly protect your baby, but would help protect you from whooping cough and from passing it on to your baby. It's understandable that you might have concerns about the safety of having a vaccine during pregnancy, but there's no evidence to suggest that the whooping cough vaccine is unsafe for you or your unborn baby. Pertussis-containing vaccine (whooping cough vaccine) has been used routinely in pregnant women in the UK since October 2012, and the Medicines and Healthcare products Regulatory Agency (MHRA) is carefully monitoring its safety. The MHRA's study of around 20,000 vaccinated women has found no evidence of risks to pregnancy or babies. To date, around 69% of eligible pregnant women have received the whooping cough vaccine with no safety concerns being identified in the baby or mother. A number of other countries, including the US, Argentina, Belgium, Spain, Australia and New Zealand, currently recommend vaccination against whooping cough in pregnancy. Yes, it is. Published research from the UK vaccination programme shows that vaccinating pregnant women against whooping cough has been highly effective in protecting young babies until they can have their first vaccination when they are 8 weeks old. Babies born to women vaccinated at least a week before birth had a 91% reduced risk of becoming ill with whooping cough in their first weeks of life, compared to babies whose mothers had not been vaccinated. An additional benefit is that the protection the mother receives from the vaccination will lower her own risk of infection and of passing whooping cough on to her baby. As there is no whooping cough-only vaccine, the vaccine you'll be given also protects against polio, diphtheria and tetanus. The vaccine is called Boostrix IPV.
Boostrix IPV is similar to the 4-in-1 vaccine – the pre-school booster that's routinely given to children before they start school.
You can read the manufacturer's patient information leaflet for Boostrix IPV (PDF, 91kb).
The licence for Boostrix IPV allows for its use in pregnancy when clearly needed, and when the possible benefits outweigh the possible risks.
It is standard practice with most medicines not to test them on pregnant women. This is why the manufacturer's information leaflet includes this statement, and not because of any specific safety concerns or evidence of harm in pregnancy.
Whooping cough-containing vaccine has been used routinely in pregnant women in the UK since October 2012, and the Medicines and Healthcare products Regulatory Agency (MHRA) is carefully monitoring its safety. The MHRA's study of around 20,000 women vaccinated with Repevax, the whooping cough vaccine previously offered to pregnant women, found no evidence of risks to pregnancy or pregnancy outcome.
Boostrix (similar to Boostrix IPV, but without the polio component) is one of the vaccines routinely recommended in the US for immunisation of pregnant women. There have been no reported safety concerns in the US with the use of the vaccine in pregnancy.
There is no evidence of risk to the pregnant woman or unborn child with inactivated vaccines like Boostrix IPV. An inactivated vaccine is one that does not contain "live" vaccine.
Read more about why vaccines are safe and important.
You may have some mild side effects such as swelling, redness or tenderness where the vaccine is injected in your upper arm, just as you would with any vaccine. These only last a few days. Other side effects can include fever, irritation at the injection site, swelling of the vaccinated arm, loss of appetite, irritability and headache. Serious side effects are extremely rare.
Whooping cough (medically known as pertussis) is a serious infection that causes long bouts of coughing and choking, making it hard to breathe. The "whoop" is caused by gasping for breath after each bout of coughing, though babies do not always make this noise.
Read more about whooping cough symptoms.
Whooping cough is a highly infectious, serious illness that can lead to pneumonia and brain damage, particularly in young babies. Most babies with whooping cough will need hospital treatment, and when whooping cough is very severe they may die.
Research from the vaccination programme in England shows that vaccinating pregnant women against whooping cough has been highly effective in protecting young babies until they can receive their own vaccinations from 8 weeks of age.
In keeping with usual disease patterns, which see cases increasing every 3 to 4 years in England, whooping cough cases have fallen in all age groups since 2012. The greatest fall has been in young babies targeted by the pregnancy vaccination programme.
Cases of whooping cough in older age groups are still high compared to pre-2012 levels. The number of cases was particularly high in 2016, in line with the typical 3- to 4-yearly peak in disease rates.
Babies can be infected by people with whooping cough in these older age groups, so it is still important for pregnant women to be vaccinated to protect their babies.
Yes, they are, but the babies that have been getting whooping cough are generally too young to have started their normal vaccinations, so they are not protected against the disease.
The only way you can help protect your baby from getting whooping cough in their first few weeks after birth is by having the whooping cough vaccination yourself while you are pregnant.
After vaccination, your body produces antibodies to protect against whooping cough. You will then pass some immunity to your unborn baby.
No. The whooping cough vaccine is not a "live" vaccine. This means it does not contain whooping cough (or polio, diphtheria or tetanus), and cannot cause whooping cough in you, or in your baby.
Yes. Whenever you have the whooping cough vaccine, your baby will still need to be vaccinated according to the normal NHS vaccination schedule when they reach 8 weeks old. Babies are protected against whooping cough by the 6-in-1 vaccine.
Yes, you can have the whooping cough vaccine when you get the flu vaccine, but do not delay your flu jab so that you can have both at the same time.
The vaccine is available from your GP, though some antenatal clinics also offer it. You may be offered the vaccination at a routine antenatal appointment from around 16 weeks of your pregnancy.
If you are more than 16 weeks pregnant and have not been offered the vaccine, talk to your midwife or GP and make an appointment to get vaccinated.
Yes, because any protection you may have had through either having whooping cough or being vaccinated when you were young is likely to have worn off and will not provide sufficient protection for your baby.
Yes, you should get re-vaccinated from 16 weeks in each pregnancy to maximise protection for your baby.
Be alert to the signs and symptoms of whooping cough, which include severe coughing fits that may be accompanied by difficulty breathing (or pauses in breathing in young infants) or vomiting after coughing, and the characteristic "whoop" sound.
If you are worried your baby may have whooping cough, contact your doctor immediately.
Read more about whooping cough vaccination in the leaflet Whooping cough and pregnancy (PDF, 183kb) from Public Health England.
Pertussis is on the rise, and outbreaks are occurring across the United States. Infants are most at risk of contracting pertussis and having severe, potentially life-threatening complications from the infection. In fact, the incidence rate of pertussis among infants is higher than the rate in any other age group, and the majority of pertussis-related deaths occur in infants younger than 3 months of age.
Pertussis by the Numbers
- 28,660 Pertussis cases in the United States (18% increase from 2013)
- 6,951 Pertussis cases in California (other states reporting more than 1,000 pertussis cases were Colorado, Michigan, Ohio, Texas, and Wisconsin)
- 2,974 Pertussis cases in infants younger than 6 months of age (10.4% of all reported cases)
Public health efforts are focused on protecting infants until they are old enough to receive their own vaccines to build immunity against pertussis.
For this reason, pregnant women should receive a dose of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during every pregnancy, ideally between 27 and 36 weeks of gestation. By getting the Tdap vaccine during pregnancy, a mother builds antibodies that are transferred to her baby to provide protection against pertussis until the infant can start getting the diphtheria, tetanus, and pertussis (DTaP) vaccine at 2 months of age.
Tdap Vaccine Safety
The Tdap vaccine is safe for both mother and baby at any time during pregnancy, but vaccination is recommended between 27 and 36 weeks of gestation because the maternal immune response to the vaccine peaks approximately two weeks after administration. This recommended timing optimizes passive antibody transfer to the baby and provides the best protection at birth.
Tdap Vaccine Effectiveness
Early evidence shows that infants whose mothers are vaccinated with Tdap during pregnancy are less likely to develop pertussis during the critical first few months of life. One study from the United Kingdom suggests that up to 90% of infants are protected against pertussis when the mother is vaccinated during pregnancy.
Studies suggest that postpartum Tdap vaccination in women is not effective in reducing pertussis in infants 6 months of age or younger.
Talk to Your Pregnant Patients about Tdap Vaccine
If a pregnant patient is unsure about getting the Tdap vaccine, consider using the SHARE mnemonic from the Centers for Disease Control and Prevention (CDC):
- Share specific reasons why the Tdap vaccine is right for pregnant women during every pregnancy.
- Highlight positive experiences (personal or in your practice) that reinforce the benefits of the Tdap vaccine.
- Address your patient’s questions and concerns about the vaccine in plain, understandable language.
- Remind your patient that vaccines protect her and her family from many other serious diseases.
- Explain the potential costs of getting pertussis, especially for infants.