Whooping Cough Vaccine in Pregnancy: NHS Guide, When to Get It, Side Effects, and What It Contains
The whooping cough vaccine offered during pregnancy is one of the most important vaccinations on the NHS antenatal schedule. Babies are too young to have their own whooping cough vaccination until they are 8 weeks old — and that gap leaves them vulnerable to a serious, potentially fatal infection. Getting vaccinated during pregnancy passes protective antibodies to your baby before they are born, giving them passive protection through those critical early weeks. Here is everything you need to know: when to get the jab, what it contains, the side effects, the safety evidence, and how to book it.
This article is for informational purposes only. Always consult your midwife, GP, or healthcare provider for advice specific to your pregnancy.
Why Is the Whooping Cough Vaccine Offered in Pregnancy?
Whooping cough — medically known as pertussis — is a highly infectious bacterial infection that causes prolonged, violent bouts of coughing and choking, making it hard to breathe. The distinctive ‘whooping’ sound is the gasp for air after each coughing fit, though young babies do not always make this noise.
For older children and adults, whooping cough is serious but usually survivable. For very young babies — particularly those under 8 weeks old — it can be fatal. Most babies with whooping cough require hospital admission. Whooping cough cases in England have been rising, and the youngest babies who have not yet started their vaccination schedule remain the most at risk.
The NHS has offered the whooping cough vaccine to pregnant women since October 2012. The strategy works by vaccinating the mother during pregnancy so that her immune system produces antibodies against whooping cough, which then cross the placenta and enter the baby’s bloodstream before birth. This provides the baby with passive immunity from birth until they are old enough to receive their own vaccinations at 8 weeks old.
When Do You Get the Whooping Cough Vaccine in Pregnancy?
According to NHS guidance, the timing is:
| Timing | What the NHS Recommends |
| From 16 weeks | The vaccine can be given from 16 weeks of pregnancy |
| Ideally at 20 weeks | The vaccine is usually offered around the time of the mid-pregnancy scan (around 20 weeks) |
| Before 32 weeks (strongly recommended) | Getting the vaccine before 32 weeks gives the best chance of antibodies transferring to the baby before birth |
| After 32 weeks (still possible) | You can still have the vaccine after 32 weeks; protection for the baby is reduced but not zero |
| After birth (last resort) | Vaccination after birth can protect you from passing whooping cough to your baby but does not give the baby direct antibody protection |
The reason timing matters is the biology of antibody transfer. Antibody levels peak approximately two weeks after vaccination. For maximum antibody transfer to the baby via the placenta, you want peak antibody levels to occur well before delivery. Vaccinating before 32 weeks gives this transfer time to work. If you are 20 weeks pregnant and have not been offered the whooping cough vaccine, contact your midwife or GP surgery.
What Vaccine Is Used for Whooping Cough in Pregnancy?
There is no single-disease whooping cough vaccine available in the UK — the vaccine is always a combination product that protects against several diseases simultaneously.
The NHS currently offers:
- ADACEL: The primary vaccine offered to pregnant women in the UK. ADACEL protects against three diseases: whooping cough (pertussis), diphtheria, and tetanus. This is offered first.
- Boostrix IPV: Offered if ADACEL is unavailable or not suitable for you. Boostrix IPV protects against four diseases: whooping cough, diphtheria, tetanus, and polio. Boostrix IPV is similar to the 4-in-1 pre-school booster routinely given to children before they start school.
Both vaccines are inactivated — they do not contain live bacteria and cannot cause whooping cough. The vaccine previously offered to pregnant women in the UK was called Repevax; this was replaced by Boostrix IPV and subsequently by ADACEL as the primary option. If you were vaccinated in a previous pregnancy with Repevax or Boostrix IPV, the current vaccine may be different — you should still be offered a vaccine in each pregnancy.
What Is In the Whooping Cough Vaccine?
The whooping cough vaccine used in pregnancy contains inactivated (non-live) components — specifically, purified proteins from the bacteria that cause whooping cough, diphtheria, and tetanus, along with inactivated polio virus (in Boostrix IPV). None of these components are alive; they cannot cause the diseases they protect against.
Boostrix IPV specifically contains: inactivated pertussis antigens (HaemaAgglutinin, Pertactin, fimbriae types 2 and 3 — the proteins that trigger immune response without the live bacteria), diphtheria and tetanus toxoids, and inactivated poliovirus types 1, 2, and 3.
Boostrix IPV also contains small amounts of neomycin and polymyxin (antibiotics used in the manufacturing process). If you have a known allergy to either of these antibiotics, inform your midwife or clinician before receiving the vaccine. It also contains phenylalanine — relevant for anyone with phenylketonuria (PKU), a rare genetic condition.
Is the Whooping Cough Vaccine a Live Vaccine?
No. The whooping cough vaccine offered in pregnancy is not a live vaccine. It contains inactivated (killed) components of the bacteria that cause whooping cough, diphtheria, and tetanus — not live or weakened bacteria. Inactivated vaccines cannot replicate in the body and cannot cause the diseases they protect against. This is why it is considered safe for use in pregnancy, unlike some live vaccines (such as MMR) which are not given during pregnancy.
Is the Whooping Cough Vaccine Safe in Pregnancy?
The evidence base for the safety of the whooping cough vaccine in pregnancy is extensive:
- The vaccine has been routinely offered to all pregnant women in the UK since October 2012
- The Medicines and Healthcare products Regulatory Agency (MHRA) conducted a study of approximately 20,000 women vaccinated with Repevax (the previous version of the whooping cough vaccine in pregnancy) and found no evidence of any risks to pregnancy outcomes — no increased risk of stillbirth, low birth weight, pre-eclampsia, or other complications
- Tommy’s Charity, whose information is reviewed by qualified midwives, states: ‘there is nothing to suggest that the whooping cough vaccine is unsafe for you or your unborn baby’
- Both ADACEL and Boostrix IPV are inactivated vaccines — they do not contain live bacteria and therefore present no theoretical risk of infecting either mother or baby
- Boostrix (the version without the polio component) is one of the vaccines routinely recommended in the US for vaccination of pregnant women, with no reported safety concerns
It is standard practice in medicine not to test new medicines on pregnant women in clinical trials, which is why the manufacturers’ information leaflets include cautionary language about use in pregnancy. This is not because of known safety concerns — it is simply because pregnant women are not included in the standard trial populations. The clinical safety evidence from over a decade of routine use in the UK is reassuring.
Whooping Cough Vaccine Side Effects
Like all vaccines, the whooping cough vaccine can cause side effects. The vast majority are mild, normal immune responses, and resolve on their own within a few days. Serious side effects are extremely rare.
Common Side Effects
- Swelling, redness, or tenderness at the injection site (upper arm) — the most commonly reported side effect
- High temperature (fever)
- Headache
- Tiredness and fatigue
- Nausea or loss of appetite
- Irritability
- General flu-like symptoms
These side effects are normal signs that your immune system is responding to the vaccine. NHS Inform Scotland notes that paracetamol (taken at the standard dose) can help manage discomfort, and that side effects typically resolve within 72 hours.
Serious Side Effects
Serious side effects are extremely rare. A severe allergic reaction (anaphylaxis) is a very rare possibility with any vaccine — this is why you will be asked to wait a short period after the injection before leaving. Healthcare providers administering vaccines are trained to respond to this.
If you experience any side effects that concern you, or that last longer than a few days, contact your GP, midwife, or call 111. You can also report any suspected side effects of the whooping cough vaccine through the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk.
Do I Need the Vaccine Even If I Was Vaccinated as a Child?
Yes. The NHS recommends the whooping cough vaccine to all pregnant women regardless of their previous vaccination history. This is because:
- Immunity from childhood vaccinations wears off over time and is unlikely to provide sufficient protection in adulthood
- A previous whooping cough infection also does not provide reliable long-term protection
- Even if you were vaccinated in a previous pregnancy, you are recommended to receive the vaccine again in each new pregnancy — the goal is to maximise the antibody levels in each baby before birth
Receiving the vaccine again when you are already up to date with your diphtheria and tetanus vaccinations is safe and appropriate.
Will My Baby Still Need to Be Vaccinated?
Yes. The vaccination you receive in pregnancy provides temporary passive protection for your baby through transferred antibodies. It does not replace the baby’s own vaccination schedule. Your baby will still need their own vaccinations at 8 weeks old as part of the standard NHS childhood immunisation programme — including the 6-in-1 vaccine that provides active protection against whooping cough, among other diseases.
Passive protection from your antibodies bridges the gap from birth to 8 weeks. The baby’s own active immunisation then takes over and provides longer-term protection.
How to Book the Whooping Cough Vaccination
The whooping cough vaccine is offered as part of your standard NHS antenatal care:
- You should be offered the vaccine at a routine antenatal appointment, typically around 20 weeks (or any appointment from 16 weeks onwards)
- It is usually offered by your midwife or GP surgery
- If you are 20 weeks pregnant and have not been offered the vaccine, contact your midwife or GP surgery to arrange an appointment
- In Scotland, NHS Inform at nhsinform.scot provides information on booking through your GP or midwife
- You can have the whooping cough vaccination at the same time as the flu jab if both are due — though the NHS advises not to delay your flu jab while waiting to have both together
The vaccine is free on the NHS for all pregnant women. There is no need to purchase it privately.
Whooping Cough Vaccine and the Newborn
Protecting a newborn before they are old enough for their own vaccinations is the entire purpose of the pregnancy vaccination programme. Until the 8-week NHS vaccinations, a baby has no active immune protection against whooping cough — they rely entirely on the passive antibodies transferred from their mother during pregnancy.
Research from the vaccination programme in England confirms the strategy is working: since 2012, there has been a significant fall in whooping cough cases in young babies — the greatest fall in any age group. The greatest protection comes from vaccination between 16 and 32 weeks of pregnancy, which allows time for peak antibody levels to transfer to the baby before birth.
Frequently Asked Questions
When do you get the whooping cough vaccine in pregnancy?
The NHS offers the whooping cough vaccine from 16 weeks of pregnancy. It is usually given around the 20-week mid-pregnancy scan. The NHS recommends having it before 32 weeks to give the best chance of antibodies passing to your baby before birth. If you miss this window you can still have it later, but it becomes less protective for the baby.
Is the whooping cough vaccine a live vaccine?
No. The whooping cough vaccines used in pregnancy in the UK (ADACEL and Boostrix IPV) are inactivated vaccines — they contain killed bacterial proteins and cannot cause whooping cough. They are safe to give during pregnancy precisely because they do not contain live organisms.
What are the side effects of the whooping cough vaccine?
Common side effects include swelling, redness, or tenderness at the injection site, fever, headache, tiredness, and nausea. These are mild and normal, typically resolving within 72 hours. Paracetamol can help. Serious side effects are extremely rare.
What is in the whooping cough vaccine?
The primary vaccine currently offered (ADACEL) contains inactivated components protecting against whooping cough, diphtheria, and tetanus. Boostrix IPV (offered if ADACEL is unavailable) also includes inactivated polio. Neither contains live bacteria. Boostrix IPV contains small amounts of neomycin and polymyxin from manufacturing — inform your clinician if you have allergies to these antibiotics.
Do I need the whooping cough vaccine if I was vaccinated as a child?
Yes. Childhood vaccination immunity wanes over time and does not provide sufficient protection in adulthood or transfer adequate antibodies to your baby. The NHS recommends the vaccine in every pregnancy, regardless of previous vaccinations or previous whooping cough infection.
Where can I get the whooping cough vaccine?
Through your midwife or GP surgery as part of your standard NHS antenatal care. If you have not been offered it by 20 weeks, contact your midwife or GP. It is free on the NHS.
Final Thoughts
The whooping cough vaccine in pregnancy is one of the most effective interventions available for protecting newborn babies during the most vulnerable weeks of their lives. Over a decade of use in the UK, a large-scale MHRA safety study, and the evidence of dramatically reduced whooping cough cases in young babies since 2012 all point to the same conclusion: this vaccine is safe, effective, and important. If you have not been offered it by 20 weeks of pregnancy, proactively contact your midwife or GP — the window from 16 to 32 weeks is when it provides the greatest protection for your baby.This article is for informational purposes only. Consult your midwife or GP for advice specific to your pregnancy.