Canada advises a whooping cough shot in every pregnancy

Canada’s national immunization guide recommends that every pregnant person be offered a Tdap vaccine in every pregnancy, ideally between 27 and 32 weeks of gestation, to protect newborns from whooping cough.

The advice comes from the Canadian Immunization Guide, which is published by the Public Health Agency of Canada. It says the vaccine should be offered “in every pregnancy,” regardless of a person’s earlier immunization history.

Whooping cough, also called pertussis, is a bacterial infection of the airways. The Public Health Agency of Canada says symptoms can appear five to 21 days after exposure and can last six to more than 12 weeks.

It usually starts like a cold, with a fever, runny nose, red watery eyes and a mild cough. Over the next one to six weeks, and sometimes up to 10, the cough can turn into severe fits that make it hard to breathe. Some people make a high-pitched “whoop” sound as they gasp for air, and vomiting after coughing is common.

Infants are the most vulnerable. The agency says complications are more common in babies and can include lung infections, seizures, brain injury and death. Babies may not cough or whoop at all. Instead, they may feed poorly, pause in their breathing or turn blue.

That is the reason for vaccinating during pregnancy. Babies cannot receive their own pertussis vaccine until they are two months old, and the routine series is not complete until they are older. A dose given late in pregnancy is meant to cover that gap.

The guide says the ideal window is 27 to 32 weeks. It adds that vaccination earlier, between 13 and 26 weeks, may be considered in some situations, such as an increased risk of preterm delivery or travel.

Provincial guidance echoes the national timing. HealthLink BC says the best time is 27 to 32 weeks, and that the shot can be given as early as 13 weeks and up until delivery. Manitoba’s chief provincial public health officer also lists 27 to 32 weeks as the best time and recommends the vaccine in every pregnancy.

Nova Scotia Health says Tdap should be offered in every pregnancy at 27 to 32 weeks, and that someone who is not vaccinated during pregnancy should get it as soon as possible after the birth. It also says caregivers and close contacts should keep their own pertussis immunizations up to date.

In British Columbia, the province says pregnant people receive the vaccine free in every pregnancy, even if they have had it before. Free access, eligibility and booking steps differ across the country, and several provincial pages were not available when this article was prepared. Check your own province’s immunization page or ask your prenatal care provider about cost and where to get the shot.

The Tdap vaccine is not only for pregnancy. The national guide recommends a dose of Tdap for adolescents at 14 to 16 years of age as the first 10-year booster. It also says all adults should receive one dose of Tdap if they have not previously received a pertussis-containing vaccine in adulthood.

Babies follow a separate schedule. The guide recommends a combined vaccine at two, four and six months, with another dose between 12 and 23 months. A booster is recommended for children between ages four and six.

Anyone who is diagnosed with whooping cough is usually treated with antibiotics, which the agency says reduce severity and spread. People are no longer contagious five days after starting the right antibiotic, and the agency advises isolating until then.

This article is based on official guidance from the Public Health Agency of Canada, HealthLink BC, the Manitoba chief provincial public health officer and Nova Scotia Health, and is provided for general public information. It’s not a substitute for medical advice, if you have questions about how this applies to you, talk to your doctor or pharmacist.

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Sources: Canadian Immunization Guide, pertussis vaccine; Public Health Agency of Canada, whooping cough; HealthLink BC, Tdap vaccine; Manitoba, vaccines and pregnancy; Nova Scotia Health, preventing pertussis.