Whooping cough vaccination in pregnancy

Why are pregnant women advised to have the whooping cough vaccine?

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 two months old.

When should I have the whooping cough vaccine?

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.

Is the whooping cough vaccine safe in pregnancy?

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 60% 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.

Is whooping cough vaccination in pregnancy working?

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 two months 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.

Which whooping cough vaccine will I be given?

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 manufacturer's leaflet says there's no information on the use of Boostrix IPV in pregnancy. Should it be used in pregnancy?

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. Experience in the US has identified no safety concerns 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 inactivated and "live" vaccines.

What are the side effects of the whooping cough vaccine?

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.

What is whooping cough?

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 don't always make this noise.

Read more about whooping cough symptoms.

Should I be concerned about whooping cough?

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 two months of age.

In keeping with usual disease patterns, which see cases increasing every three to four 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 three to four-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.

Watch a video describing how nasty whooping cough can be.

But aren't babies vaccinated against whooping cough to protect them?

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.

So, how can I protect my baby?

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.

Will the whooping cough vaccine in pregnancy give me whooping cough?

No. The whooping cough vaccine is not a "live" vaccine. This means it doesn't contain whooping cough (or polio, diphtheria or tetanus), and can't cause whooping cough in you, or in your baby.

Will my baby still need to be vaccinated against whooping cough at two months if I've had the vaccine while pregnant?

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 two months old. Babies are protected against whooping cough by the 5-in-1 vaccine.

Can I have the whooping cough vaccine at the same time as the flu jab?

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.

How can I get the whooping cough vaccination?

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.

I was vaccinated against whooping cough as a child, do I need to get vaccinated again?

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.

I was vaccinated against whooping cough in a previous pregnancy, do I need to be vaccinated in my current pregnancy?

Yes, you should get re-vaccinated from 16 weeks in each pregnancy to maximise protection for your baby.

How do I spot whooping cough in my 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.