Whooping Cough

If you are pregnant you should get vaccinated to protect your baby

Cases of whooping cough are on the increase – by getting the vaccine while pregnant you can protect your baby
In the last few months, cases of whooping cough (also known as pertussis) have been rising sharply across the UK.

In Northern Ireland, there have been over 10 times as many cases up to the end of August 2012 as compared with the whole of 2011.

Young babies are particularly at risk because they are vulnerable until they can start to be vaccinated against whooping cough at two months of age.

You can help protect your unborn baby from getting whooping cough in the weeks after birth by having the whooping cough vaccination while you are pregnant. Even if you’ve been vaccinated before or have had whooping cough yourself, you still need to get this vaccine.

What is whooping cough?
Whooping cough is a serious disease that causes long bouts of coughing and choking, making it hard to breathe. The ‘whoop’ noise is caused by gasping for breath after each bout of coughing. Whooping cough commonly lasts for two to three months. Young babies are most at risk from whooping cough. For these babies, the disease is very serious and can lead to pneumonia and permanent brain damage. In the worst cases, it can cause death. In the UK more babies have already died this year than in recent years.

How does getting vaccinated during pregnancy protect my baby?
The immunity (antibodies) you develop from the vaccine will be passed to your baby through the placenta. This will help protect your baby in the first few vulnerable weeks of life until he or she is old enough to have the vaccination themselves. Babies are offered whooping cough vaccination at two, three and four months old as part of their routine immunisations.

When should I get the vaccine?
The best time to get vaccinated to protect your baby is during and after week 28 of your pregnancy. If you are in week 28 of your pregnancy or beyond, your GP will arrange for you to get the vaccine. If you don’t hear anything, talk to your GP to make sure you don’t miss out.

If you get the vaccine less than two weeks before giving birth, antibodies may not have had time to develop and be passed to your baby in sufficient quantities. However it will still help protect you and reduce the risk of you infecting your baby.

Your baby will still need to be vaccinated as normal starting at two months old.

Are there any risks to me or my baby if I’m vaccinated while I’m pregnant?
The whooping cough vaccine is not a live vaccine so it can’t cause whooping cough in you or your baby. Having vaccines in pregnancy has been studied in the US and no evidence of risk has been found. It’s much safer for you to have the vaccination than to risk your newborn baby catching whooping cough.

What vaccine will I be given?
No single whooping cough vaccine is available. You will be given a vaccine already used as part of the childhood immunisation schedule that also protects against diphtheria, tetanus and polio.

Are there any side effects from being vaccinated?
You may have some mild side effects from the vaccination, such as swelling, redness or tenderness where the vaccine was given. Serious side effects are extremely rare.

I’m still concerned about having a vaccination while I’m pregnant. Is there an alternative way to protect my baby from whooping cough?
No. Recently some young babies have died before they were old enough to have their first whooping cough vaccination. Their mother’s protection (either through having had whooping cough themselves or through being vaccinated when they were young) had worn off so there was no protection to pass on to the baby. Having the vaccination during pregnancy provides antibodies that will be passed to the baby so he or she has some protection in the first few weeks of life when whooping cough is most serious.

I am going to breastfeed. Won’t that protect my baby?
No, not enough immunity against whooping cough is passed in breast milk to protect your baby.

Why can’t my baby be vaccinated as soon as he or she is born?
Newborn babies don’t make good responses to this vaccine. The earliest your baby can get the vaccine is at two months and three doses are needed to get full protection.

Will the vaccination definitely mean my baby doesn’t get whooping cough?
Although the vaccine won’t completely guarantee that your baby won’t get whooping cough it does make it very unlikely. Having the vaccine is the best way to protect your baby until his or her routine vaccination.

I have heard that I should have the flu vaccine when I am pregnant. Can I have both vaccines and can I have them together?
If you are pregnant during the flu vaccine season, then you should have the flu vaccine as early as possible. If you are over 28 weeks pregnant, then you can and should have both vaccines. You can have them at the same time or separately; the vaccines don’t interfere with each other if given together.

What should I do now?
If you are in week 28 of your pregnancy or beyond and you haven’t heard from your GP, contact them to arrange an appointment. If you are in the earlier stages of pregnancy wait until you hear from them. You can always discuss any queries you may have with your midwife or GP.

Where can I get more information?
More information on whooping cough and the vaccination programme can be found at: www.publichealth.hscni.net/whooping-cough

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Vaccine FAQs

What pertussis vaccine should be given to pregnant women?
Pregnant women should only be offered a single dose of Repevax® vaccine.

Where should the vaccine be given?
The vaccine should be given intramuscularly in the deltoid area of the pregnant woman’s upper arm.

When should the vaccine be given?
The vaccine should be given in the period week 28 to 38 (inclusive) of pregnancy with the period week 28 to 32 being optimal. If not given in this period, vaccination can be given up to delivery.

Is the vaccine safe?
Repevax® is an inactivated viral, bacterial and toxoid vaccine. There is no evidence of risk to pregnancy with inactivated viral or bacterial vaccines or toxoids such as Repevax®. Use of Repevax® in pregnant women to date has not revealed any risk to pregnancy or the unborn child.

Why does the Patient Information Leaflet state that Repevax® should not be used in pregnancy?
This says that the vaccine is not recommended for use in pregnancy because of the routine exclusion of pregnant women from clinical trials, and not because of any specific safety concerns or evidence of harm in pregnancy. Use in pregnancy is not contraindicated.

What if a women received Repevax® during a previous pregnancy?
Pregnant women should be offered immunisation for each pregnancy while the programme is in place.

What about pregnant women carrying more than one child?
The same amount of antibodies should be passed on to each baby after immunisation. Only one dose of Repevax® is needed for each pregnancy.

Can Repevax® be given at the same time as influenza vaccine?
There are no reasons why Repevax® cannot be administered at the same time as influenza vaccine. However, influenza immunisation should not be delayed in order to give Repevax® at the same visit. This is because pregnant women are at risk of severe illness at any stage of pregnancy from influenza.

Can Repevax® be given at the same time as anti-D treatment?
There are no reasons why Repevax® cannot be administered at the same time as anti-D treatment. Is there an alternative way of protecting babies from pertussis? Immunising pregnant women is likely to be the most effective approach to providing protection against pertussis to young infants until they receive their routine immunisations.

What if a baby or someone else in the family may have pertussis?
If pertussis is suspected in a baby or another family member health advice should be sought as early as possible. The Health Protection Agency has published guidelines on the management of cases of pertussis at: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/WhoopingCough/Guidelines/

©2003 - 2011 Dr Paul Fogarty