Whooping cough (pertussis) is a contagious and very serious respiratory infection that causes a long coughing illness. Pertussis is still common in Australia, and is one of the most challenging of all vaccine-preventable diseases to control.
In babies and elderly people, whooping cough can lead to pneumonia and can also be life threatening. Babies less than six months of age are at greatest risk of severe disease, and dying from whooping cough if infected by Pertussis under six months of age. The majority of deaths due to whooping cough occur in babies less than six months old. For these young babies infected by Pertussis, the mortality rate is up to 1 in 125. Deaths occur due to pneumonia or brain damage.
Vaccination of pregnant women remains the best protection for babies agains whooping cough. Pertussis vaccination in mothers result in transfer of protective antibodies across the placenta to the baby. There has been much debate around the whooping cough vaccine, and the best time to administer it – in order give the best protection to newborns. Currently newborns do not receive their first vaccine until they are six weeks old. Therefore the best strategy to protect young babies is vaccination during pregnancy. Research shows that pertussis vaccination in pregnancy can reduce whooping cough in infants less than 3 months of age by up to 91%.
Whooping cough vaccination in third trimester of pregnancy
The whooping cough vaccine (dTpa) has been used in pregnant women in the UK and US since 2012, and careful monitoring of this practice (in over 40,000 women) confirms that the vaccine is safe for pregnant women and their unborn babies.
Newborn babies are not able to receive their first vaccination for whooping cough until they are six weeks of age, so maternal vaccination during the pregnancy helps to protect them until they can receive their own. Recent studies have in fact shown that the whooping cough vaccination is most effective when it is given to the pregnant mother in the third trimester at around 28 weeks as it takes two weeks to pass the antibodies to the unborn baby. The Australian Technical Advisory Group on Immunisation recommends that vaccination is best given early in the third trimester in all pregnancies, ideally between 28 and 32 weeks. The Pertussis vaccine can be given later in the third trimester, but protection tot the baby is significantly reduced if given within 14 days of the birth.
There is no need to be concerned about having the vaccination when pregnant, and side effects are minimal. Possible side effects include redness, swelling, pain and tenderness. More severe reactions can be severe swelling, pain, and redness in the arm where the injection was given – but these rarely occur.
Two brands of the whooping cough vaccine available in Australia are Boostrix and Adacel.
What to do to prepare for your baby being born to prevent whooping cough?
- The Whooping Cough is covered by Medicare if it is given by your GP. Unfortunately Medicare does not provide the free vaccine to Obstetricians. Talk to your GP about booking in for a free whooping cough vaccine once you reach 28 weeks.
- The Whooping Cough vaccine is effective for 5 years, but all pregnant women are recommended to have a Whooping Cough vaccine at around 28 weeks during the pregnancy, in order to allow the transfer of passive immunity to the newborn baby.
- Family and friends who will have contact with your newborn should ensure that they have had a Whooping Cough vaccine within the last 5 years. If it has been over 5 years since their Whooping Cough vaccine, or if they have never been vaccinated, then they should get a Whooping Cough vaccination at least two weeks before your baby is due to be born. If you have other children, check to ensure that their vaccinations are up-to-date.
For more information about Whooping Cough or other vaccinations, speak to your Obstetrician who will be able to explain whooping cough in more detail and to discuss any concerns that you may have.
Dr Ken Law is a trusted Brisbane Obstetrician and Gynaecologist with extensive experience attained locally, nationally, and internationally. He is a passionate obstetrician delivering babies at Greenslopes Maternity, providing women with an individualised experience of pregnancy and birth. He is a leading Gynaecologist in Brisbane, utilising the latest minimally invasive techniques including laparoscopy and robotic surgery to treat gynaecological disorders. Dr Ken Law has special interests in colposcopy for abnormal Pap smears, endometriosis, fibroids, ovarian cysts, and prolapse.