Joint statement on Whooping Cough from RCPCH, RCOG, RCM and RCGP

The Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM), Royal College of General Practitioners (RCGP) and Royal College of Paediatrics and Child Health (RCPCH) are issuing advice in a joint statement for worried parents and carers and healthcare professionals on whooping cough, otherwise known as pertussis. 

Whooping cough is a cyclical disease, with spikes occurring every 3-5 years, however we are currently seeing unusually high numbers of cases, which we think is due to a lower than expected uptake of the vaccine that contains protection against whooping cough. The latest data from the UK Health Security Agency shows confirmed cases of whooping cough in England remain higher in the same period compared to previous years. The same trend has been noted in Scotland, Wales and Northern Ireland as shown by data from Public Health Scotland, Public Health Wales and the Public Health Agency. 

Vaccination is the only effective means to protect young babies and children from whooping cough. Infants under 3 months are most at risk of severe disease but are too young to be fully vaccinated. However, vaccine uptake levels have steadily fallen in pregnant women, babies and young children, with significant regional variation in uptake.

Vaccinations save lives

Offer for pregnant women

All pregnant women will be offered pertussis vaccine during every pregnancy, usually between 16 and  32 weeks of their pregnancy. The vaccine which will help protect their baby the first few weeks of its life until they are old enough to have the vaccine at 8 weeks of age. Speak to your midwife if you have any questions or concerns. 

Offer for infants

All babies are given three doses of the 6-in-1 vaccine at 8, 12 and 16 weeks of age to protect against whooping cough and other serious diseases, such as diphtheria and polio, as part of the routine childhood vaccination schedule, with a pre-school booster offered at 3 years 4 months.

For parents and carers

Firstly, the key message for parents, future parents, and carers is to check for vaccination. For pregnant women it’s important to protect your future newborn by being vaccinated. You should make sure all your children are up-to-date with their vaccinations too.

Whooping cough is preventable with vaccination, so this outbreak shows once again the paramount importance of engaging with vaccination programmes - they're in place for everyone's safety. We would urge all parents to check their children's vaccinations - and their own - are up-to-date, and if they're not, to make an appointment as soon as possible. It is also important for pregnant mothers to check their vaccination status and get vaccinated if they have not been immunised. 

If you, or a member of your family, does exhibit symptoms of whooping cough - especially a heavy wheezing cough that disrupts sleep, or a change in the colour of the face - then seek medical assistance.

Symptoms

Whooping cough can affect babies, children and adults. It starts like many viral illnesses with cold-like symptoms: a runny nose and coughing spasms with worsening severity sometimes worse at night or with a gasping sound, ‘whoop’ and occasionally difficulty in breathing. It’s very important to seek help early especially if symptoms are severe, having an effect on breathing and skin colour turning more dusky and blue. 

Contact your GP if: 

  • You have general concerns around infectivity to others  or vaccination
  • Your GP may offer you a remote consultation to assess the severity of your symptoms 

Ask for an urgent GP appointment or call 111 if:

  • Your baby is under 6 months old and has symptoms of whooping cough
  • You or your child have a very bad cough that is getting worse
  • You've been in contact with someone with whooping cough and you're pregnant
  • You or your child has been in contact with someone with whooping cough and have a weakened immune system
  • Whooping cough can spread very easily. It's best to call the GP before you go in. They might suggest talking over the phone or taking you to an isolation room instead of sitting in the waiting room. 

You can check symptoms on 111 online (for children aged 5 and over) or call 111 (for children under 5).

Key messages for healthcare professionals

In the context of the re-emergence of pertussis, UKHSA has updated guidance for healthcare professionals on the public health management of pertussis cases. 

Midwives

The RCM is urging all midwives to speak to pregnant women about getting vaccinated against this disease. Midwives should routinely check the immunisation status of women and birthing people and record this information in their notes. Midwives already know the importance of speaking to women in their care about vaccinations and can advise on the importance of vaccination, discuss any concerns, and signpost for further counselling and to be vaccinated.

Obstetricians

Obstetricians should advise all pregnant women to take up the pertussis vaccine, explaining the protection this offers their baby in the first two months and providing reassurance around any concerns that women may have around vaccines in pregnancy. 

Paediatricians

Assessing children’s immunisation status should form part of any assessment. When vaccines are not up-to-date, the reason should be established and appropriate intervention taken.  Parents or carers may have delayed or refused vaccines for a variety of reasons so they should be offered the opportunity to discuss their concerns.

General practitioners

GPs should be aware of children’s immunisation status when they present at the GP surgery. If vaccines are not up-to-date, then enquiries can  be made, and the vaccinations that are missing can be offered. This can be done immediately, or at a routine baby clinic.  It should also be possible to scrutinise GP practice vaccination data to identify those children who have missed their vaccinations, to then tag their notes and offer vaccination opportunistically when they present for other issues.

Call to Governments to improve vaccination uptake

Across the UK, uptake of routine vaccinations is decreasing year on year. Concerningly we are failing to meet the WHO target uptake rates.

We welcome the recently published NHS Vaccination Strategy and recommend the swift implementation of its proposals to improve vaccine uptake. We encourage the publication and implementation of updated nation-wide strategies and frameworks in jurisdictions which have not done so already. 

NHS England, and equivalent bodies across the nations must prioritise public facing targeted campaigns to improve vaccine coverage. This is the only way to consign these harmful illnesses to the history books.

Further information