More babies could die from whooping cough, expert warns

Professor Sir Andrew Pollard, consultant paediatrician and chairman of the Joint Committee on Vaccination and Immunisation, which advises the Government, said Covid lockdowns may have impacted on the rise in cases, particularly in older children and adults.

But he said the “biggest issue” is actually low vaccination rates, particularly among pregnant women.

Figures for England show 59.3% of pregnant women between October to December 2023 were vaccinated against whooping cough, almost 16% down on the same quarter in 2016/17.

London has particularly low rates, at 36.8%.

The vaccine in pregnancy helps bridge the immunity gap from when babies are born until they themselves can be vaccinated.

Data for 2022/23 shows 91.8% of children have had their whopping cough vaccines by their first birthday, with experts saying this figure also needs to be higher.

Sir Andrew told BBC Radio 4’s Today programme that under-vaccination is putting “the most vulnerable – those who are too young to have been vaccinated – at greatest risk”.

He said the “only thing we can actually do” about rising cases is to ensure higher vaccination rates.

He added: “But very importantly, for this very vulnerable group, those who are too young to be vaccinated, is the vaccination rates in pregnant women.

“Very worryingly, those have fallen from a peak of about 75% of women being vaccinated during pregnancy to under 60% today, and that’s what puts these very young infants at particular risk.”

He said for most of the last decade there have not been many cases of whooping cough “because we’re all protected by the high vaccination rates”.

But as soon as vaccination rates start to fall, “we see cases rising, the same as the situation with the measles outbreak”.

He warned: “The troubling thing is that if we continue to have high rates of spread and low rates of vaccination, there will be more babies severely affected and sadly there will be more deaths.”

It comes after figures released on Thursday showed five babies in England died between January and the end of March after being diagnosed with whooping cough.

More than 2,700 whooping cough cases have been reported across England so far in 2024 – more than three times the number recorded in the whole of last year.

The UK Health Security Agency (UKHSA) figures show there were 2,793 cases reported to the end of March.

That compares to 858 cases for the whole of 2023.

Professor Adam Finn, professor of paediatrics at the University of Bristol, said on Friday: “Receiving the whooping cough vaccine in pregnancy is a very effective way to protect newborns from the disease, which is most dangerous during the early weeks and months of life.

“Babies will get protection from receiving vaccines themselves, but this is only fully in place when they are about five to six months old.

“Like many infections, whooping cough comes in waves or epidemics and there is a serious epidemic happening at the moment.

“Unfortunately, a significant proportion of pregnant women have not been receiving the vaccine and so we are now seeing severe cases among the infants of these women.

“While the reasons for this are certainly multiple and complex, we owe it to these mothers and their children to ensure that they are offered both timely vaccination and the information and explanation, from someone they understand and trust, to enable them to make the right decision and avoid this dreadful and entirely preventable disease by being immunised.”

The bacterial infection, also known as pertussis, affects the lungs and breathing tubes.

Health officials describe whooping cough as a “cyclical disease”, which means it peaks every few years. With whooping cough this is every three to five years.

The last big increase was seen in 2016, but cases dipped to very low numbers during the coronavirus pandemic which means the current peak is “overdue”, the UKHSA said.

When a baby is eight-weeks-old they are offered the six-in-one vaccine, which includes immunisation against whooping cough.

The second dose of the vaccine is offered at 12 weeks and the third is offered at 16 weeks.

When children are three years and four months they will be offered the four-in-one pre-school booster, which protects against the illness.

The first signs of whooping cough are similar to a cold, such as a runny nose and sore throat, but after about a week, the infection can develop into coughing bouts that last for a few minutes and are typically worse at night.

Young babies may also make a distinctive “whoop” or have difficulty breathing after a bout of coughing, though not all babies make this noise which means whooping cough can be hard to recognise.

Dr Michael Head, senior research fellow in global health at the University of Southampton, said immunity from the vaccine can wane over time, which is why high vaccination rates to prevent spread are important.

He said: “A drop in vaccination coverage will be a key factor contributing to this rise in cases of whooping cough.

“It’s vital that vulnerable groups such as babies and pregnant women are up to date with their recommended immunisations, and that includes the pertussis vaccine.

“Outbreaks can occur in cycles, so we tend to see these rises in cases every few years.

“The reasons for that are not fully understood, but population-level waning immunity is likely to contribute to that, hence why a high coverage of vaccination is so important.

“As a disease, whooping cough is as infectious as measles, and more infectious than Covid-19.”