THL recommends whooping cough vaccine in pregnancy – the reason is an increase in cases, which may be dangerous for babies

The Finnish Institute for Health and Welfare (THL) directs wellbeing services counties to provide a booster dose of the whooping cough vaccine in pregnancy. The aim is to prevent serious cases of whooping cough in babies.

Whooping cough is dangerous for children aged under 1 year and particularly for newborns, who have not yet had the first dose of whooping cough vaccine given at the age of three months.  

THL therefore recommends a booster dose of whooping cough vaccine between weeks 16 and 32 of pregnancy. Whooping cough antibodies are transferred to the foetus and provide the newborn with protection against whooping cough. If necessary, the vaccine can also be taken at a later stage of pregnancy. 

“It is safe to vaccinate the mother during pregnancy. The vaccine protects the baby well in the first months of life, when the newborn is at greatest risk of developing serious whooping cough,” says Chief Physician Hanna Nohynek from THL.  

THL’s new guidance is based on the increase in the occurrence of whooping cough cases in Finland and elsewhere in Europe, especially in younger age groups. During this year, a total of 1,233 laboratory-confirmed cases of whooping cough have been reported in Finland. It is significantly more than during the same time period before the COVID-19 pandemic, when 200–500 cases were typically reported during the whole year. The laboratory-confirmed cases are likely to represent only a small part of the total number of the disease in the population.

The vaccine can be given during a visit to the maternity clinic during pregnancy monitoring

Wellbeing services counties and maternity and child health clinics will publish information on how the vaccinations of pregnant women will be carried out in the county. The vaccine can be given, for example, as part of the health check scheduled for weeks 22–24 of pregnancy or in connection with some other regular health check. The vaccination is voluntary and free of charge. 

The vaccine offered will be the dtap vaccine, which provides a high level of protection against whooping cough and mortality related to it in infants.  

“Vaccines containing whooping cough components have been used for decades. They are effective against severe disease, but the protection they provide does not last very long. The vaccines are also safe for pregnant women. The child’s vaccine programme will be continued normally regardless of whether the mother has been given the whooping cough vaccine or not,” Nohynek says. 

In the national vaccination programme, the whooping cough vaccines are given to children at the child health clinic at the ages of three, five and 12 months and at the age of 4 years. In addition, the booster vaccine will be offered to all schoolchildren at the age of 14–15 years and to young adults at the age of 25. 

If the adult booster dtap vaccine has already been given during pregnancy, another vaccination is not required. Otherwise, the vaccine is recommended to everyone who is pregnant, starting from week 16 of pregnancy and regardless of when the person got the previous whooping cough vaccine. 

Currently, a dtap booster vaccine during pregnancy is in use in almost all EU countries and in many other high-income countries. In Finland, the new guidance regarding the provision of vaccines during pregnancy is currently in force until the end of January 2025, but it will be continued if necessary. 

Coughing fits a typical symptom of whooping cough, but symptoms in young babies may be atypical

Whooping cough is transmitted through droplets. A person may get it several times in their life as the disease does not provide permanent protection against a new infection.

A typical symptom of whooping cough is a cough that lasts several weeks, even up to 2–3 months, and usually becomes fitful gradually.  

Especially in young children, the cough may be choking and inhaling may become difficult. This is when the whoop sound can be heard at the end of the coughing fit. The child may also vomit at the end of the fit. The patient is usually in good condition and has few symptoms between the coughing fits. 

In young babies, the symptoms of whooping cough may be atypical and the cough may initially be missing altogether. In the beginning, the only symptom may be gagging, vomiting or gaps in breathing. Usually, merely a suspicion of whooping cough is a reason to admit the child into hospital for monitoring, 

The course of the disease can be alleviated with antibiotics if the therapy can be started at an early stage of the disease. 

Additional information 

Diphtheria, tetanus and whooping cough vaccine (DTaP) for adolescents and adults

Diphtheria, tetanus, whooping cough, polio and Hib combination vaccines

Hanna Nohynek
Chief Physician
THL 
tel. +358 29 524 8246 
[email protected] 

Satu Kärkkäinen 
Specialist
THL 
tel. +358 29 524 8261 
[email protected] 

Leif Lakoma
Chief Physician
THL
tel. +358 29 524 7898 
[email protected]