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08.01.2026 13:58

Whooping cough vaccination during pregnancy strengthens the immune system in newborns

Manuela Zingl GB Unternehmenskommunikation
Charité – Universitätsmedizin Berlin

In 2024, Germany recorded the highest number of whooping cough cases since reporting became mandatory in the year 2013. With almost 122 cases per 100,000 inhabitants, infants under one year of age were the most affected age bracket, while experts are expecting similarly high case numbers for 2025. Protection against this highly contagious disease in the first months of life is provided by vaccinating expectant mothers against the pertussis pathogen - the bacterium Bordetella pertussis. This represents a safe and effective method of indirect immunization as researchers led by Charité – Universitätsmedizin Berlin and Radboud University now show in The Lancet Microbe*.

Vaccination as from the 22nd week of pregnancy can save lives worldwide

In 2024, Germany recorded the highest number of whooping cough cases since reporting became mandatory in the year 2013. With almost 122 cases per 100,000 inhabitants, infants under one year of age were the most affected age bracket, while experts are expecting similarly high case numbers for 2025. Protection against this highly contagious disease in the first months of life is provided by vaccinating expectant mothers against the pertussis pathogen - the bacterium Bordetella pertussis. As researchers led by Charité – Universitätsmedizin Berlin and Radboud University have now shown for the first time, maternal antibodies are not only found in the blood, but also in the nasal mucosa of newborns. The international study has been published in The Lancet Microbe*.

Whooping cough can run a fatal course in newborns. In Germany, they can receive the first of three required vaccine doses at the earliest from the age of two months. As from the second vaccination, which infants receive at around four months of age, they have their first own protection. In Germany and most European countries, pregnant women are advised to be vaccinated against whooping cough to bridge the gap until then. Expectant mothers pass on their protective antibodies to their unborn child via the placenta. This represents a safe and effective method of indirect immunization that is effective from birth.

A research team under the auspices of Prof. Beate Kampmann, Director of the Institute of International Health at Charité and Scientific Director of the Charité Center for Global Health, has now been able to prove for the first time that the antibodies transmitted by the mother are not only present in the blood but also in the nasal mucosa of newborns – which is precisely where the pathogens enter the body. "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," as Beate Kampmann states, who developed the design of the current study together with colleagues at the MRC Unit in The Gambia and her Dutch colleague Prof. Dimitri Diavatopoulos.

Different immune responses depending on the type of vaccine

Within the context of the international study, 343 pregnant women in Gambia, West Africa, were vaccinated with either a whooping cough or tetanus vaccine. Maternal antibodies against whooping cough were detectable in both the blood and nasal mucosa of infants whose mothers had received the appropriate vaccination. The researchers at the Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine continued to examine blood and nasal secretions from around 160 newborns before and after their routine pertussis vaccination with different types of vaccine.

The study showed that babies who had received a whole-cell pertussis vaccine at 8, 12, and 16 weeks of age developed a stronger immune response on average than those who had received an acellular vaccine. "A whole-cell vaccine contains the complete but inactivated pertussis bacterium, while an acellular vaccine contains only a few purified components of the bacterium," as Beate Kampmann explains. "Acellular vaccines generally cause fewer side effects, while usually providing shorter-lasting protection. Our results suggest that the whole-cell pertussis vaccine also provides longer-lasting protection."

The research team emphasizes that further investigation is needed to determine the implications of the current findings for clinical protection and vaccination strategies in different situations. The acellular vaccine has been used in Europe since 2005, while most low- and middle-income countries continue to opt for the whole-cell vaccine. "According to our findings, countries that use whole-cell vaccines for children should continue to do so," as international health expert Beate Kampmann concludes. "It remains crucial, however, to vaccinate pregnant women with the acellular vaccine, regardless of which type of vaccine is subsequently given to children. Both types are capable of preventing whooping cough in newborns in more than 90 percent of all cases."

The significance for public health

In Germany, since 2020, the Standing Committee on Vaccination (STIKO) has recommended whooping cough vaccination for pregnant women at the beginning of the last trimester of pregnancy. Nevertheless, the vaccination rate is significantly below the recommended target value at around 50 percent. "Our results show that vaccination during pregnancy provides double protection for infants in their most vulnerable phase of life. In view of rising case numbers, this is a strong argument for making good use of the vaccination offerings," as Beate Kampmann.

Even today, whooping cough remains a deadly disease in many parts of the world. Every year, between 200,000 and 300,000 people die from it, mainly young children in low- and middle-income countries where good vaccines are not always available. Consequently, the research team is planning further studies to help improve existing pertussis vaccines and test the efficacy of new vaccines.

*Anja S et al. Mucosal immune responses to Bordetella pertussis in Gambian infants after maternal and primary vaccination: an immunological substudy of a single-centre, randomised, controlled, double-blind, phase 4 trial. The Lancet Microbe 2026 Jan 7. doi:10.1016/j.lanmic.2025.101219

About the study

The immunological study is part of the Gambian Pertussis Study (GaPs), a phase IV randomized, controlled, double-blind study conducted in The Gambia. Researchers included the MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Radboud University in the Netherlands, and Charité – Universitätsmedizin Berlin.

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Wissenschaftliche Ansprechpartner:

Prof. Beate Kampmann
Director of the Institute of International Health
Scientific Director of the Charité Center Global Health
Charité – Universitätsmedizin Berlin
t: +49 30 450 565 712

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Originalpublikation:

*Anja S et al. Mucosal immune responses to Bordetella pertussis in Gambian infants after maternal and primary vaccination: an immunological substudy of a single-centre, randomised, controlled, double-blind, phase 4 trial. The Lancet Microbe 2026 Jan 7. doi:10.1016/j.lanmic.2025.101219

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Weitere Informationen:

https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(25)00147-8/fullt...
https://internationale-gesundheit.charite.de/en/
https://globalhealth.charite.de/en/
https://www.lshtm.ac.uk/research/units/mrc-gambia
https://www.imprint-network.co.uk/

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Merkmale dieser Pressemitteilung:
Journalisten, Wissenschaftler, jedermann
Biologie, Ernährung / Gesundheit / Pflege, Medizin
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