Whooping cough - vaccination
and Sabine Schrör, medical journalist and Florian Tiefenböck, doctorMartina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.
More about the expertsFlorian Tiefenböck studied human medicine at the LMU Munich. In March 2014, he joined as a student and has supported the editorial team with medical articles ever since. After receiving his medical license and practical work in internal medicine at the University Hospital Augsburg, he has been a permanent member of the team since December 2019 and, among other things, ensures the medical quality of the tools.
More posts by Florian Tiefenböck All content is checked by medical journalists.The whooping cough vaccination is one of the most important vaccinations in childhood. Doctors usually give them as part of the six-fold vaccination. Older children, adolescents and adults should have the vaccination refreshed. So they are still protected. Read everything you need to know about vaccination against whooping cough here.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. A37
Whooping cough vaccination: why is it important?
Whooping cough (pertussis) is an acute bacterial infection. It mainly affects the upper respiratory tract. Whooping cough used to be a childhood disease. In the meantime, adolescents and adults are also getting sick from it.
Whooping cough is accompanied by violent, convulsive coughing fits up to attacks of suffocation. Whooping cough can be life-threatening, especially in babies under six months of age. Doctors therefore recommend vaccination very early (from the 2nd month of life).
The vaccination recommendation is also based on the fact that whooping cough can lead to serious complications. These include pneumonia, otitis media, and seizures. In individual cases, the lack of oxygen caused by whooping cough can cause permanent damage such as paralysis, visual and hearing impairments as well as mental damage. Babies are particularly at risk here too.
Because of these complications, some of which are life-threatening, vaccination against pertussis is very important. It ensures that the body can quickly fight the pathogens in the event of a whooping cough infection.
Whooping cough vaccination: what happens with it
In the whooping cough vaccination, a so-called dead vaccine is administered. The pertussis vaccine in particular usually no longer contains real cell material (acellular). The whooping cough vaccination instead consists of individual components (extract) such as filamentous hemagglutinin and pertussis toxoid. The latter is basically a “detoxified” bacterial toxin from the Bordatella pertussis pathogen.
These so-called antigens cannot make you sick. However, they stimulate the immune system to produce specific antibodies. If the person concerned becomes infected later with the "real" whooping cough pathogens, the body can fight them quickly and specifically: The vaccinated person stays healthy.
With the pertussis vaccination, the vaccine is injected directly into the muscle (intramuscularly). The doctor usually places the syringe in the upper arm or lateral thigh muscle (vastus lateralis muscle). The sting can hurt a little. After vaccination, however, those affected rarely have symptoms (see below: Side effects).
The whooping cough vaccination is usually carried out together with five other vaccinations as a so-called six-fold vaccination. It is effective against whooping cough, diphtheria, tetanus, polio, Haemophilus influenzae type b and hepatitis B.
Who should get the whooping cough vaccination?
The Standing Vaccination Commission (STIKO) at the Robert Koch Institute recommends vaccinating all children from the age of two months against whooping cough. According to the new STIKO recommendations, children receive the pertussis vaccination according to the so-called 2 + 1 scheme - i.e. three vaccine doses instead of the previous four. Then the basic immunization is completed. The whooping cough vaccination should be refreshed several times later.
Even with fully vaccinated children and adolescents whose last vaccination was more than five years ago, a new whooping cough vaccination can be useful if there is a risk of infection. If a child has direct contact with sick people in the same household, a new whooping cough vaccination can be useful.
More and more adults get whooping cough. They then often infect infants and the elderly, who can make whooping cough severe and life-threatening. That is why the STIKO has been recommending a one-time whooping cough vaccination for all adults since 2009. Vaccination should be given at the same time as vaccination against tetanus and diphtheria. There is no single vaccine against whooping cough.
The following people should definitely receive whooping cough vaccination:
- Women who want to have children before or during pregnancy (see next section for more on this)
- Close contact persons for pregnant women and newborns and carers (e.g. child minders, parents, siblings, babysitters, grandparents) if possible four weeks before the child is born
- Employees in the health service and in community facilities
Whooping cough vaccination during pregnancy
According to the official STIKO recommendations, not only women who want to have children should be vaccinated against whooping cough. The experts recommend the pertussis vaccination with a Tdap combination vaccine for all pregnant women. This vaccine not only protects against whooping cough, but also against diphtheria and tetanus.
The whooping cough vaccination during pregnancy takes place from the 28th week of pregnancy, i.e. at the beginning of the third trimester. If a premature birth is likely, doctors give the vaccine as early as the second trimester. If there is also a special risk for polio, for example when traveling to a risk area, choose a vaccine that also contains a polio vaccination.
With whooping cough vaccination for pregnant women, the distance to any previous whooping cough vaccination does not matter. The vaccination should always be given.
Studies have shown that whooping cough vaccinations even one to two years before pregnancy are not sufficient to adequately protect the infant. The antibody concentration is then too low at the time of pregnancy.
If a pregnant woman has not been vaccinated against whooping cough by the time the child is born, doctors recommend vaccination in the first few days after the birth. The reason for the vaccination recommendation for pregnant women is obvious: The antibodies formed after the vaccination is transferred to the newborn. The child thus also receives immune protection (“whooping cough nest protection”).
A Tdap vaccination should also always be given in subsequent pregnancies. Despite the possibly shorter interval between vaccinations, according to the current state of knowledge there is no evidence of increased side effects.
Whooping cough vaccination: basic vaccination
For basic immunization, the STIKO has been recommending a so-called 2 + 1 scheme since June 2020. The doctor usually gives all vaccine doses in combination with other vaccinations, namely as a six-fold vaccine: It contains the vaccines against whooping cough, diphtheria, tetanus, polio, Haemophilus influenzae type b and hepatitis B.
- The first vaccination dose is given from the age of 2 months, usually as part of the 3rd preventive medical check-up (U3 check-up).
- The second vaccination dose is given from the age of 4 months.
- The third vaccination dose is scheduled for the 11th month of life.
On the other hand, premature babies born before the 37th week of pregnancy receive four whooping cough vaccinations - four times the sixfold vaccination - as was customary in the past. In addition to the times mentioned above (2nd, 4th and 11th month of life), you will also receive a pertussis vaccination in the third month of life.
Not all vaccines intended for primary immunization are approved for the reduced 2 + 1 vaccination schedule. If there is no suitable vaccine available, doctors will continue to give the vaccination according to the 3 + 1 vaccination schedule (in months of life 2, 3, 4 and 11)!
Refreshing whooping cough vaccination
The whooping cough vaccination won't last a lifetime. Most vaccinated people lose their protective effect after about five to seven years. In order to be protected against whooping cough, regular booster vaccinations are therefore necessary:
- The first booster of whooping cough vaccination is recommended between the ages of five and six years.
- The second booster vaccination should be given between 9 and 16 years of age.
- For adulthood, the experts recommend refreshing the whooping cough vaccination once.
- Special groups of people (employees in health care and community facilities, close contact persons and carers for newborns, pregnant women) receive whooping cough booster vaccination every 10 years
The booster vaccinations are given in combination with other necessary vaccinations. Doctors often use a triple vaccination for whooping cough, diphtheria, and tetanus. If necessary, they also give the quadruple vaccination against whooping cough, diphtheria, tetanus and polio.
Vaccination despite having suffered illness
If a person gets whooping cough, he usually develops a specific defense against the pertussis pathogen. But even this protection does not last for life: Scientists suspect that the immunity lasts for a maximum of 10 to 20 years after having suffered whooping cough.
Even after a whooping cough disease, doctors recommend the whooping cough vaccination!
Whooping cough despite vaccination?
If you do not have the whooping cough vaccination refreshed as recommended, the vaccination protection will be lost. If you then become infected with the pertussis pathogen, you get whooping cough. This happens to many young people and adults who have missed the booster vaccinations.
Very rarely it also happens that the whooping cough vaccination was not sufficient to prevent infection. This is the case, for example, with incomplete basic immunization. Pertussis then usually breaks out in a milder form.
Whooping cough vaccination: side effects
The pertussis vaccine used to contain whole, killed pathogens. Today only cell-free components are used. Therefore, today's whooping cough vaccination is much better tolerated than the old vaccine. Side effects are very rare.
After the whooping cough vaccination, reddening, swelling or small induration can form at the injection site. These local side effects usually subside on their own within a few hours.
In some vaccinated people, the body temperature increases. Some feel weak after the whooping cough vaccination. These side effects will also go away on their own within a short time.
Some children develop screaming fits the first day after the whooping cough vaccination.
In the past, reactions to the pertussis vaccine often included seizures and allergic reactions. Such side effects are very rare today. They also do not lead to consequential damage.
Alternative to whooping cough vaccination?
There is no recognized alternative to whooping cough vaccination. However, if there is an acute risk of infection for people who are in close contact with the sick, they can take preventive medication. Doctors refer to this as chemoprophylaxis. As a precaution, the same antibiotics (mostly erythromycin) are given that are also recommended in the event of an actual illness. A whooping cough vaccination does not replace this measure.
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