This Shocking Vaccine Could Save Your Newborn from Whooping Cough—But Are You Missing It?

In 2024, Germany experienced a significant surge in whooping cough cases, recording the highest incidence since the disease became reportable in 2013. With nearly 122 cases per 100,000 inhabitants, infants under one year of age were particularly vulnerable, and experts anticipate similarly high numbers for 2025. To combat this highly contagious disease, it is crucial to vaccinate expectant mothers against the causative agent, the bacterium Bordetella pertussis. A groundbreaking study led by researchers from Charité – Universitätsmedizin Berlin and Radboud University has revealed that maternal antibodies are not only present in the blood of newborns but also in their nasal mucosa, where pathogens commonly enter the body. This important finding was published in The Lancet Microbe.

Whooping cough can have a severe, even fatal, course in newborns, and in Germany, the first of three necessary vaccine doses can only be administered starting at two months of age. While infants start to gain their own immunity after the second vaccination, typically occurring around four months, pregnant women are advised to receive the whooping cough vaccine to provide their unborn child with protection during the critical early months of life. The transfer of maternal antibodies through the placenta represents a safe and effective method of indirect immunization effective from birth.

Prof. Beate Kampmann, Director of the Institute of International Health at Charité and Scientific Director of the Charité Center for Global Health, expressed surprise at the study's results: "We knew that maternal antibodies are passed on by way of the placenta. We were surprised, however, to find that we could also detect them in the nasal mucosa of newborns – in a manner that is gentle on the children. This underlines the effectiveness of indirect vaccination." The study was designed alongside her colleagues from the MRC Unit in The Gambia and her Dutch colleague, Prof. Dimitri Diavatopoulos.

Understanding Vaccination Responses

In the international study, 343 pregnant women in Gambia were vaccinated with either a whooping cough or a tetanus vaccine. The findings demonstrated that maternal antibodies against whooping cough were detectable in both the blood and nasal mucosa of infants whose mothers received the whooping cough vaccine. The researchers at the Medical Research Council Unit The Gambia also analyzed blood and nasal secretions from around 160 newborns before and after their routine vaccination with different types of pertussis vaccines.

Results indicated that infants who received a whole-cell pertussis vaccine at 8, 12, and 16 weeks of age exhibited a stronger immune response compared to those given an acellular vaccine. Prof. Kampmann explained, "A whole-cell vaccine contains the complete but inactivated pertussis bacterium, while an acellular vaccine contains only a few purified components of the bacterium. Acellular vaccines generally cause fewer side effects but typically offer shorter-lasting protection. Our results suggest that the whole-cell pertussis vaccine also provides longer-lasting protection."

The research team emphasizes the need for further studies to understand the implications of these findings for clinical protection and vaccination strategies. While the acellular vaccine has been in use in Europe since 2005, many low- and middle-income countries still prefer the whole-cell vaccine. "According to our findings, countries that use whole-cell vaccines for children should continue to do so," concluded Prof. Kampmann. Importantly, vaccinating pregnant women with the acellular vaccine remains crucial, regardless of the type of vaccine subsequently administered to children. Both types can prevent whooping cough in newborns in over 90% of cases.

In Germany, the Standing Committee on Vaccination (STIKO) has recommended whooping cough vaccination for pregnant women during the last trimester since 2020. However, the current vaccination rate stands at only around 50%, significantly below the recommended target. Prof. Kampmann stated, "Our results show that vaccination during pregnancy provides double protection for infants in their most vulnerable phase of life. In light of rising case numbers, this serves as a strong argument for making full use of the available vaccination offerings."

Despite advancements in vaccination, whooping cough remains a deadly disease worldwide, claiming between 200,000 and 300,000 lives each year, predominantly among young children in low- and middle-income countries where access to effective vaccines is limited. In response, the research team aims to conduct further studies to improve existing pertussis vaccines and evaluate the efficacy of new ones.