Antenatal pertussis vaccination — RACGP Fellowship MCQ

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EasyWomen's health and O&GAntenatal pertussis vaccinationRACGP Fellowship

A 35-year-old pregnant woman at 24 weeks' gestation attends for antenatal care in rural New South Wales. She asks which vaccine is recommended now to protect the newborn from whooping cough. What would you advise?

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Correct answer: B — Give pertussis-containing vaccine during this pregnancy

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · E = shown as D · C = shown as E

Current Australian guidelines (Immunisation Handbook, Department of Health) unambiguously recommend that pregnant women receive a single dose of pertussis-containing vaccine (dTpa such as Boostrix or Adacel) between 20 and 32 weeks' gestation. This patient at 24 weeks is optimally placed for vaccination. Antenatal pertussis vaccination provides ~90% protection to newborns aged 3–4 months through direct passive immunity (transplacental antibody transfer). Delaying vaccination until after delivery (B) provides no neonatal protection. MMR (C) and varicella (D) are live vaccines and are contraindicated in pregnancy. Waiting until 6 months (E) misses the critical period when infants are most vulnerable and unable to mount their own immune response; the infant schedule begins at 2 months. Option A is the single correct answer.

Reference: Australian Immunisation Handbook, Department of Health and Aged Care. Pertussis (whooping cough) vaccination in pregnancy – recommendations for pregnant women. Updated June 2026. https://immunisationhandbook.health.gov.au/recommendations/pregnant-women-are-recommended-to-receive-a-single-dose-of-pertussis-containing-vaccine-in-each-pregnancy