Shingles vaccination

and pregnancy Your questions answered on how to help protect your baby the safest way to protect yourself and your baby

There is a lot of whooping You may have thought whooping cough around at the moment cough had died out but the number and babies who are too young of cases in England and Wales to start their vaccinations are at started to increase from late 2011. greatest risk. In 2012 there were ten times as many cases as would be expected in Expectant mothers can help a peak year of disease. Of particular protect their babies by getting concern was the rising number of themselves vaccinated against cases in young babies who are at whooping cough from week 16 highest risk of severe complications. of their pregnancy, usually after their twenty week scan. To protect their babies from this serious disease all pregnant women The vaccination programme are being offered the whooping introduced in 2012 has already cough vaccine. This programme has protected many young babies been in place since 1 October 2012 against whooping cough but and is highly effective at protecting because the disease continues to babies until they can have their first circulate at high levels in older vaccine at two months of age, as the age groups, pregnant mothers graph shows. However, whooping still need to be vaccinated. It is cough levels are still high in older important to be vaccinated with age groups, so it’s important that every pregnancy. babies continue to be protected. 300 Incidence of whooping cough programme is Vaccination Incidence of whooping cough per 100, 000 infants under 3 months of age 200 Peak levels of disease before 2012 introduced in pregnancy in babies under 3 months 250 150 100 50 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 The incidence of laboratory confirmed cases of whooping cough in infants under three months of age in England 2 | Whooping cough and pregnancy

Don’t take the risk Act now to protect your baby from whooping cough from birth ■ Whooping cough is a serious disease that can lead to pneumonia and permanent brain damage. Most young babies with whooping cough will be admitted to hospital and they are at risk of dying from the disease. Deaths from whooping cough are rare in the UK but more babies died in 2012 than in previous recent years. ■ Young babies are particularly at risk of serious disease and they remain vulnerable until they can be vaccinated against whooping cough from two months of age. You can help protect your unborn baby against whooping cough in its first weeks by having the whooping cough vaccination while you are pregnant. You should have the vaccination even if you’ve been vaccinated before or have had whooping cough yourself. ■ The best time to get vaccinated to protect your baby is from week 28 to week 32 of your pregnancy – but you can have the vaccine up to 38 weeks if you miss the recommended time. ■ Uptake of the vaccine amongst pregnant women has been very encouraging and the vaccination programme has been very effective in protecting young babies against whooping cough. ■ Talk to your midwife or GP and make an appointment to get vaccinated. ■ Your baby will still need to be vaccinated as normal when he or she reaches two months of age. Whooping cough and pregnancy | 3

What is whooping cough? The causes of this increase are Whooping cough (also known as not yet fully understood but are pertussis) causes long bursts of being investigated. Of greatest coughing and choking, making it importance is the protection of hard to breathe. The ‘whoop’ noise young babies who are the most is caused by gasping for breath likely to suffer badly if they catch after each burst of coughing. the disease. We can protect these Young babies don’t always do babies by vaccinating women this which can make it difficult to once they reach week 28 of their recognise the disease. Whooping pregnancy. This will help protect cough commonly lasts for two to the baby from birth until its first three months. Babies under one routine vaccine is due at two year of age are most at risk from months of age. whooping cough. For these babies, the disease is very serious and can Are we the only country to lead to pneumonia and permanent have this problem? brain damage. In the worst cases, it Argentina, Australia, Belgium, can cause death. Canada, Ireland, Israel, New Zealand, Spain, UK and USA are all experiencing similar problem with Getting vaccinated rising numbers of cases and deaths from week 16 of your of young children. All of these pregnancy will help countries now recommend the protect your baby maternal pertussis vaccination. Are there any risks to me or Why are we seeing more my baby if I’m vaccinated outbreaks? while I’m pregnant? On average, in the last ten years The Medicines and Healthcare (2002-2011) in England and Wales, products Regulatory Agency 800 cases of whooping cough (MHRA) in the UK has completed were reported every year with over a large study of the safety of 300 babies having to go to hospital the vaccine in pregnancy. This and four babies dying. During study, including nearly 18,000 2012, however, cases of whooping vaccinated women, found no risks cough rose sharply with nearly to pregnancy associated with the 10,000 cases and 14 baby deaths. vaccine and rates of normal, healthy 4 | Whooping cough and pregnancy

The vaccination births were as seen programme is highly specific to having in unvaccinated the vaccine during women. Similar effective at protecting pregnancy. vaccines are babies against whooping also routinely cough from birth and How does recommended getting during pregnancy women still need to vaccinated during in the US where no be vaccinated pregnancy protect risks to pregnancy have my baby? been found. The whooping cough The immunity you acquire from the vaccine is not a live vaccine so it vaccine will be passed to your baby can’t cause whooping cough in through the placenta. This will help those who have the vaccine or protect your baby in the first few in their babies. It’s safer for you vulnerable weeks of its life until to have the vaccine than to risk he or she is old enough to have your newborn baby catching the vaccine at two months of age. whooping cough. Babies are offered whooping cough vaccination at 2, 3 and 4 months Are there any side effects of age as part of their routine from having the vaccine whilst immunisations. pregnant? You may have some mild side effects from the vaccine that are common, such as swelling, redness or tenderness where the vaccine is given. Serious side effects are extremely rare, especially in adults. There are no safety concerns Whooping cough and pregnancy | 5

Will the vaccine definitely has some protection in the first mean my baby doesn’t get few weeks of life when whooping whooping cough? cough is most serious. No vaccination guarantees 100% protection but this programme has Why can’t my baby be been in place since October 2012 vaccinated as soon as it’s born? in the UK and published studies Even if immunised immediately, have shown that the vaccine is your baby would not be protected over 90% effective in protecting from birth as it takes up to two your baby from whooping cough weeks to develop a response until his or her vaccinations start at to the vaccine and babies need two months of age. three doses to build up full protection. Your baby will still need How long will my vaccination their routine vaccinations protect my baby from from two months of age whooping cough? The immunity your newborn baby I’m still concerned about gets from your vaccination will having a vaccination while help protect it through the very I’m pregnant. Is there an early weeks of life until it can alternative way to protect my have its first routine vaccination baby from whooping cough? at two months of age. Your baby Unfortunately, there is no effective will still need the full course of alternative. In recent years, most three routine whooping cough of the whooping cough deaths in vaccinations to protect them until the UK have been in young babies they have their pre-school booster before they were old enough to dose three years later. have their first whooping cough vaccination. Any protection you I had the vaccination as a may have had through either child and I am going to breast having had whooping cough or feed. Won’t that protect being vaccinated when you were my baby? young may have worn off. Having Unfortunately, breast feeding the vaccine during pregnancy won’t provide enough provides antibodies that will be protection for your baby against passed to your baby so he or she whooping cough. 6 | Whooping cough and pregnancy

Whooping cough is I’m expecting twins – what should I do? a serious disease in One vaccination will help protect young babies that can all your babies, no matter how lead to permanent many you are expecting. brain damage What if I get pregnant again What should I do now? soon after the birth of If you are in week 28 of your my baby? pregnancy or beyond and you You should get re-vaccinated from haven’t heard from your midwife week 16 of any pregnancy. or GP, contact them to arrange an appointment at the earliest When will I get the opportunity. If you are in the vaccination? earlier stages of pregnancy wait If you are pregnant, you should until you hear from them. have your vaccination at a routine antenatal visit from weeks I’ve heard that I should 28 and 32. If you are already have the flu vaccine when 28 weeks pregnant or over you I am pregnant. Can I have can have your vaccination at your both vaccines together? next routine visit or make an If you are pregnant during the appointment with your GP if you flu season, then you should have wish to have it sooner. the flu vaccine as early as possible As there is no whooping cough- in your pregnancy. If you are only vaccine, the vaccine you will 28 weeks and over, then you can be offered also protects against and should have both vaccines. polio, diphtheria and tetanus. It is You can have them at the same the same vaccine that is routinely time or separately; the vaccines given to children before they don’t interfere with each other start school. if given together. How late in my pregnancy can I have the vaccination? Where can I get more The vaccination should be given information? any time after 28 weeks right up www.nhs.uk/vaccinations to 38 weeks of pregnancy. Whooping cough and pregnancy | 7

What you need to know and pregnancy ■ Whooping cough is a serious disease in babies in whom it can lead to complications resulting in hospitalisation and even death ■ Expectant mothers can protect their babies from birth by having the whooping cough vaccination whilst pregnant ■ The best time to get vaccinated is between weeks 28 and 32 of the pregnancy ■ The number of babies infected with whooping cough has fallen since vaccination in pregnancy was introduced ■ But pregnant mothers still need to get vaccinated because the disease remains at high levels in older children and adults ■ In a recent UK study of nearly 18,000 vaccinated pregnant women there was no increased risk to their pregnancies or babies from vaccination © Crown copyright 2016 DOH1331 3ap 30k June 2015 (TAU) Produced by Williams Lea for Public Health England First published May 2014. The text of this document may be reproduced without formal permission or charge for personal or in-house use. To order more copies of this leaflet visit www.orderline.dh.gov.uk or phone: 0300 123 1002, minicom: 0300 123 1003 (8am to 6pm, Monday to Friday) www.nhs.uk/vaccinations