Maternal Immunization Strategies Against Pertussis

Maternal immunisation against pertussis offers passive protection via transplacental transfer of antibodies, safeguarding neonates during the vulnerable early weeks of life before primary vaccination can be administered. This strategy has been widely adopted in both high-income and resource-limited settings to reduce infant morbidity and mortality from Bordetella pertussis. Acellular pertussis vaccines given in pregnancy boost maternal IgG titres against key pertussis antigens, which are then delivered to the fetus. While this confers immediate postnatal protection, it may also attenuate the infant’s serological response to routine primary vaccines, a phenomenon termed immunological blunting. Optimising antigen composition, dosing schedules and gestational timing has become central to maximising maternal and neonatal immunity. Robust safety data underpin public health recommendations, and ongoing evaluation addresses emerging challenges such as pathogen adaptation and coverage gaps.

Research from Nature Portfolio

Recent modelling work has integrated meta-analytic estimates of infant pertussis risk following maternal vaccination with explicit representations of blunting mechanisms. The analysis shows that although maternal immunisation transiently reduces antibody responses to the primary pertussis series, the overall decrease in infant infection risk remains substantial. Moreover, epidemiological dynamics can mask blunting effects for several years after introduction of maternal programmes, emphasising the importance of extended follow-up to assess long-term impacts on primary vaccine effectiveness. These insights reaffirm the net benefit of maternal vaccination while highlighting key metrics for surveillance and policy refinement.

Maternal Immunization Strategies Against Pertussis publication trend

The graph below shows the total number of articles in maternal immunization strategies against pertussis across all publications each year (not limited to Nature Index journals).

Technical terms

Transplacental antibody transfer: The passage of maternal immunoglobulin G across the placenta to the fetus, conferring passive immunity.

Acellular pertussis vaccine (aP): A formulation containing purified Bordetella pertussis antigens (for example, pertussis toxin and filamentous haemagglutinin) used to elicit protective immunity with fewer adverse events than whole-cell vaccines.

Immunological blunting: Attenuation of an infant’s antibody response to primary vaccination due to high levels of maternally derived antibodies.

Vaccine effectiveness (VE): The reduction in disease incidence among vaccinated individuals compared with unvaccinated ones under field conditions.

Memory B-cell response: The generation of antigen-specific B lymphocytes that persist after primary immunisation and rapidly produce antibodies upon re-exposure.

References

1. The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-centre, randomised, controlled, double-blind, phase 4 trial. The Lancet Infectious Diseases (2025).
2. Maternal pertussis immunization and the blunting of routine vaccine effectiveness: a meta-analysis and modeling study. Nature Communications (2024).
3. Optimising the timing of whooping cough immunisation in mums (OpTIMUM) through investigating pertussis vaccination in pregnancy: an open-label, equivalence, randomised controlled trial. The Lancet Microbe (2023).
4. Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants. Clinical Infectious Diseases (2017).