Why is this vaccine recommended for pregnant women?
In 2012 the UK experienced a nationwide outbreak (epidemic) of pertussis (whooping cough), a highly infectious disease that can cause serious complications including death, especially in young babies. In 2012 there were over 9,300 cases in England alone – more than ten times as many as in recent years. The causes of this are not clear. In the years since 2012 there has been a fall in cases, but numbers are still high compared to the years before the 2012 epidemic (see the graph at the bottom of this section). 14 babies under three months old died of pertussis in 2012, and another 18 died between 2013 and 2016. There were no deaths from pertussis in 2017, and no deaths in the first nine months of 2018. Babies under three months of age are most vulnerable to severe disease.
Vaccination of mothers can protect babies from pertussis. In the UK, a temporary programme began in October 2012 to offer pertussis vaccination to pregnant women. In July 2014 it was recommended that this programme should continue for at least 5 more years, owing to continuing high levels of pertussis in the UK. A similar programme is now offered in the US, Australia, and some other European countries. Around 70% of pregnant women in England currently receive the whooping cough vaccine. Out of the 18 babies who have died of pertussis since the start of 2013, 16 were born to mothers who had not been vaccinated against pertussis.
In this film, experts talk about why it is important for pregnant women to be vaccinated against pertussis. Since the film was made the UK government advice has changed. Pregnant women can now be vaccinated any time after 16 weeks of pregnancy (rather than just in the third trimester). Pregnant women will usually be told about the vaccine at their routine 20-week scan.
Why are newborn babies vulnerable?
In the UK babies currently get protection against whooping cough as a result of their routine vaccinations at 2, 3 and 4 months (the 6-in-1 vaccine). However, newborn babies are vulnerable until they have had at least 2 doses of the vaccine (i.e. until they are 3-4 months old). Babies under 3 months old are at greatest risk of complications and death from pertussis.
Vaccinating babies at birth does not offer them the best protection against pertussis, for two reasons. Firstly, newborn babies’ immune systems do not respond well at this age to the first dose of pertussis vaccine. Secondly, vaccination does not offer immediate protection. It takes several days to respond to the vaccine, and at least two doses of vaccine are needed to give high levels of protection.
Even people who were vaccinated against pertussis as babies can catch the disease. It can then be passed on to those they come into contact with, including newborn babies. In years like 2012-2016 when there were thousands of cases of pertussis, newborn babies are at a much higher risk of catching this life-threatening disease. Read a BBC news article about an Australian mother who passed pertussis on to her newborn baby .
How does vaccination of pregnant women help to protect their babies?
Vaccination during during weeks 16 to 32 of pregnancy helps the mother make antibodies to fight pertussis. It takes about two weeks for antibody levels to peak. These antibodies are then transferred through the placenta to the baby, who then has the mother’s own protection against the disease in their blood right from birth. Very small quantities of pertussis antibodies may also be transferred to the baby through breast milk. In addition, the mother is protected against catching pertussis and passing it to her newborn baby. Pregnant women can be vaccinated any time up until they go into labour, but vaccination before week 32 is advised because it takes about two weeks for antibodies to pass across to the unborn baby. Overall, vaccinating women during pregnancy is the best way to protect newborn babies who are too young to be vaccinated themselves.
The protection offered by the mother’s antibodies lasts only a few months. It is therefore important for babies to get their routine immunisations at 2, 3 and 4 months so that they continue to be protected (the 6-in-1 vaccine).
It is recommended that women have the pertussis vaccine in each pregnancy, even if they have been vaccinated in a previous pregnancy.
What vaccine is given to pregnant women?
The vaccine offered to pregnant women in the UK is called Boostrix-IPV. This is also used as a pre-school booster vaccine, and protects against diphtheria, tetanus and polio as well as pertussis. The vaccine does not contain any live bacteria or viruses, and cannot cause any of the diseases it protects against.
Boostrix-IPV can safely be given to pregnant women at the same time as the flu vaccine. See the Patient Information Leaflet .
Click here for an accessible text version of this graph
Source: Public Health England Archive and Public Health England pertussis reports