Dear Pregnant Mums: the Whooping Cough vaccine is safe and effective for you to receive during pregnancy.

We are told to avoid many things during pregnancy: soft cheeses, raw fish and seafood, unprocessed dairy and most medications. But the whooping cough vaccine is safe during pregnancy.  And it could potentially save your newborn baby’s life.

Q. Why should you get a pertussis booster during pregnancy?
A. So you don’t catch the disease and pass it to your baby at birth.  So that your baby will be born with active immunity to whooping cough.

Pertussis during pregnancy is extremely inconvenient and risky.   A pregnancy booster will provide both mother and baby with antibody protection.

Whooping cough is rife in our communities, and newborn babies are most vulnerable, most at risk to fatal pertussis.  If you get the vaccine in the recommended time-frame; during the last trimester of your pregnancy, you will produce antibodies to pertussis which can cross the placenta to your unborn baby whilst they are still in the womb.  You will also ensure the early appearance of pertussis fighting antibodies in your breast milk.

The placentally transferred antibodies will remain active inside your newborn baby’s bloodstream until they are around 6 to 8 weeks old – providing them with a fighting chance against the disease until they are due for their very own first immunisation against pertussis.  The breastmilk antibodies will help top up the pertussis fighting immunity during this time.

Q.  I plan to breastfeed my baby.  If I have the whooping cough vaccine during pregnancy, will my baby still need their first vaccine?
A.  Yes.  Breastfeeding alone will not protect or prevent pertussis in your baby.  Also, breastfeeding does not increase the length of time that passive immunity (antibodies passed from mother to baby via the placenta) will protect the baby.  It won’t interfere with it either.

Vaccinating during pregnancy effectively closes the 6 week vulnerability window.  This is the time when babies can contract whooping cough and are most at risk of suffering, hospitalisation, complications and death.   Whooping cough deaths occur almost exclusively in babies under 3 months of age, with the majority of deaths in babies under 8 weeks old – babies  too young to be immunised.

NRVS-poster-pertussis

Latest figures from the UK show that 2-4  out of 100 newborns under 3 months old who contract the disease will die.

Q. At what stage of pregnancy is recommended to receive the vaccine?
A. 27 to 36 weeks gestation. This is recommended by several countries across the world such as  Australia,  NZ, the US  and the UK.

Every state in Australia now recommends a whooping cough vaccine booster for pregnant women.  Previously, babies had been given the vaccine at six weeks, four months and six months, but research suggests that a booster given in the last ­trimester of pregnancy may offer the best protection for newborns.

Q. Is the shot safe?
A. Yes it is. Read more about that below.

Q. Is it effective?
A. Yes, it has been proven to produce antibodies during pregnancy which are directly transferred to your baby.  Read more below.

Q. Why not get it after pregnancy?
A. It may be too late.  If your baby contracts whooping cough in the first few weeks of life, they will be without protection.

Q. Why not get it before pregnancy?
A. It is a good idea to be boosted against pertussis before a pregnancy is planned. However, it is difficult to time pregnancy perfectly, and whooping cough antibodies only last so long. If you have not had a recent immunisation or illness, there may not be any immunity for you to transfer.  This is why it is advised during the last weeks of pregnancy – so that you pass a high level of active antibodies to your unborn child.

Pregnancy vaccination is the preferred alternative to postpartum vaccination for preventing infant pertussis.

It’s already recommended by the CDC in the USA and the NHS in the UK.

Its safety is proven here,  here and here.

The last link above is a very large and recent observational study from the UK.  It shows that women who have received pertussis vaccination in the third trimester are not at any increased risk of maternal or neonatal death, stillbirth, pre-eclampsia, eclampsia, haemorrhage, foetal distress, uterine rupture, placenta or vasa praevia, caesarean delivery, low birth rate, neonatal renal failure or any other serious event that can occur naturally during pregnancy.

The pertussis pregnancy booster is also very effective. It ensures that newborns are born with protective pertussis antibodies as shown here and here.

The Cocooning strategy, which involved vaccinating all of the household members around the pregnant mum (but not the pregnant mum) for the purpose of providing a ring of protection around a newborn too young to be immunised, was not entirely effective.

Transmission rates within the household are high, especially for mothers passing the illness on to their children. Therefore, making sure all pregnant women are vaccinated before their baby arrives would, according to calculations, cut the risk in half that a baby would contract pertussis.  70 to 100% of people living in the same house as a person with whooping cough are usually infected.  The evidence for sibling (and other household members) vaccination, though weaker, still points to the value of overall cocooning.

This study outlines the most important reason to get vaccinated from the perspective of preventing deaths.

Essentially, to prevent deaths we need to protect the babies who are too young for the vaccine but at risk of contracting the disease in the birth to 6 week old vulnerability period.

So, whilst cocooning is effective, nothing beats providing the newborn with direct immunity than vaccinating the mother antenatally.

I know what I would do. Get that pregnancy booster like my newborn’s life depended on it.