Newborns are most vulnerable to pertussis before they are old enough for their own vaccines, and maternal vaccination passes protective antibody across the placenta. The established recommendation is a dose of Tdap in every pregnancy, ideally between 27 and 36 weeks, regardless of the woman's prior vaccination or the interval since her last dose.
The protection is per-pregnancy because maternal antibody wanes, so a dose given years earlier does not cover a new baby. Offer it at the routine third-trimester visit and record it.
- Offer Tdap in every pregnancy, ideally at 27–36 weeks, whatever the vaccination history.
- Repeat it each pregnancy — maternal antibody wanes and does not carry to the next baby.
- The aim is to protect the newborn in the window before their own vaccines begin.
- Vaccinating close household contacts adds a further layer where feasible.
Why it matters
Newborn pertussis is most dangerous before the infant's own vaccines start, and maternal antibody is the only cover for that window.
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