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Pertussis (whooping cough) is a notifiable disease. Guidance on reporting notifiable diseases is available on the UKHSA website (external site).
Information on reporting notifiable diseases in Wales can be found at the All Wales Acute Response service (AWARe): AWARe/ Health Protection Team - Public Health Wales
Pertussis is a highly infectious respiratory disease caused by the Bordetella pertussis bacterium. The infection is transmitted by respiratory droplets. Cases are most infectious during the catarrhal stage. The incubation period is between six to 20 days.
This disease can cause serious illness and death. Individuals at increased risk of severe complications include premature infants, infants under five months and those under a year who have not received their complete course of primary immunisations.
Serious complications of pertussis include pneumonia, temporary pauses in breathing (apnoea) due to severe breathing difficulties, and cerebral hypoxia during coughing paroxysms, which can lead to brain damage. Additional complications include repeated vomiting leading to weight loss, seizures and encephalitis (acute inflammation of the brain).
Minor complications from pertussis infection include nose bleeds, facial oedema, haemorrhages, ulceration of the tongue or surrounding area, and suppurative otitis media.
The pertussis vaccination was introduced into the maternal immunisation programme in 2012. Since its introduction, the vaccine has been very effective in protecting infants against this serious illness, until they can have their first routine childhood vaccination at eight weeks old. The vaccine helps to protect infants through intrauterine transfer of maternal antibodies. The vaccine also helps protect the mother from getting pertussis and lowers the risk of the mother passing it on to their baby.
Pertussis-containing vaccines are offered to children at appropriate intervals as part of the routine childhood immunisation schedule for Wales.
The pertussis vaccine is offered to all pregnant women from 16 weeks of pregnancy. It is ideally offered between 16 and 32 weeks of pregnancy to maximise the likelihood the baby will be protected from birth. The vaccine can be given after 32 weeks, but as the body needs time to make antibodies to be passed on to the unborn baby, it may not give the baby the same level of protection. Pregnant women require vaccination in each pregnancy.
Women who did not receive the pertussis vaccine in their pregnancy can still receive it in the two months following birth (until the child receives their first dose of pertussis-containing vaccine). This will protect the woman and may prevent her from becoming a source of infection for the baby, although it will not provide direct protection of the baby. There is no evidence of risk from vaccinating breast-feeding women with the pertussis vaccine.
Currently, there is no monovalent pertussis vaccine available. From the 1st of July 2024, the pertussis-containing vaccine for pregnant women will switch from the dTaP/IPV quadrivalent (Boostrix-IPV®) to a trivalent vaccine containing tetanus, diphtheria and pertussis (Tdap) called ADACEL®.
Like Boostrix- IPV®, ADACEL® contains the lower doses of pertussis, diphtheria and tetanus, but it does not contain the polio component found in Boostrix-IPV®. However, Boostrix-IPV® (or Repevax®) may still be administered if ADACEL® is unavailable or contraindicated.
Research indicates that infants of mothers vaccinated with dTaP/IPV vaccines during pregnancy had lower, but still protective, polio antibody levels compared to infants of unvaccinated mothers.
In October 2022, the JCVI advised a non-IPV containing pertussis vaccine (Tdap) in the maternal programme to address a potential immunity gap. From 1st July 2024, ADACEL® (Tdap) will replace Boostrix-IPV® (dTaP-IPV) in the maternal programme.
ADACEL® and the quadrivalent (4-in-1) are inactivated (not live vaccines) and thiomersal-free. As inactivated vaccines contain no live organisms, they cannot replicate and cannot cause infection to the mother or the foetus. These vaccines are usually highly effective and have excellent safety records.
The 4-in-1 will continue to be the vaccine used for the pre-school booster vaccination of children, and for the prenatal vaccination of pregnant women for whom ADACEL® is contra-indicated (e.g., due to a history of anaphylactic allergy to latex).
Pertussis-containing vaccination in babies and children is offered with the 6-in-1 (DTaP/IPV/Hib/HepB) vaccine and the 4-in-1 (DTaP/IPV) booster at appropriate intervals according to the NHS routine childhood vaccination schedule for Wales:
Routine immunisation schedules for Wales
Healthcare workers can be an important source of infection to vulnerable infants. Those with direct contact with pregnant women or infants, who have not received a pertussis-containing vaccine in the last 5 years, are eligible for a pertussis-containing vaccine as part of their occupational healthcare. For further information, visit the link below.
Pertussis vaccination for healthcare workers (WHC/2019/024) | GOV.WALES (external site)
The routine immunisation schedule for Wales contains information about routine and non-routine vaccinations.
Home - electronic medicines compendium (external site)
Whooping cough vaccines in pregnancy: ADACEL® (external site) / Boostrix-IPV® (external site) / REPEVAX® (external site)
Pre-school 4 in 1 booster vaccine: Boostrix-IPV® (external site) / REPEVAX® (external site)
Infant 6 in 1 vaccine (infant vaccinations): Infanrix Hexa® (external site) / Vaxelis® (external site)
Schedule guidance in the Green Book chapter 24 Pertussis (external site) supersedes the SmPC.
Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy can be found at the links below.
Joint Committee on Vaccination and Immunisation - GOV.UK (external site) (read JCVI publications and statements: search e.g., pertussis)
Welsh Health Circulars and Welsh Government letters :
Health circulars: 2021 to 2023 | GOV.WALES (external site)
Health circulars: 2024 to 2027 | GOV.WALES (external site)
Online courses and training materials about a number of vaccines and diseases can be accessed via the E-learning page.
Further immunisation training information and resources are available here:
Patient group directions (PGDs) and protocols
PGD templates for vaccines can be found on the Patient group directions (PGDs) and protocols page.
Vaccination surveillance information can be found on the pages below: