Open access to ‘UK Health Security Agency (UKHSA) Pertussis Update’

The UK Health Security Agency (UKHSA) recently presented a national update on Pertussis at the iHV Evidence-based Practice Conference on 3 July 2024. With UKHSA’s permission, we have now made the recording of this session ‘open access’ so it can be shared and viewed more widely with health visitors and health visiting team members across the UK.

UKHSA is calling on frontline clinicians to promote the uptake of the pertussis vaccine. Pregnant women should receive a pertussis-containing vaccination between 20- and 32-weeks’ gestation and with every pregnancy. Health visitors have a crucial role in discussing vaccinations with pregnant women and promoting vaccine uptake.

Watch the recording of the UKHSA Pertussis Update at iHV Evidence-based Practice Conference here.

In her presentation, Dr Helen Campbell (Lead Clinical Scientist at the UKHSA Immunisation team) highlights the clinical features of pertussis:

It is a bacterial infection affecting the lungs
Initial symptoms resemble a cold, such as a runny nose and sore throat
After about a week, severe coughing bouts can develop, typically worse at night (known as the 100-day cough)
Young babies may make a distinctive ‘whoop’ sound or have difficulty breathing after coughing.

Helen shared a very powerful video which shows a young baby who is experiencing a long bout of coughing and whooping: https://youtu.be/S3oZrMGDMMw (WARNING: this video may be upsetting for some viewers).

New data published by UKHSA show a concerning increase in Pertussis cases:

May 2024: 2,591 confirmed cases
April 2024: 2,106 confirmed cases
March 2024: 1,427 confirmed cases
February 2024: 920 confirmed cases
January 2024: 555 confirmed cases

This brings the total number of cases from January to May 2024 to 7,599.

Sadly, there have been 9 infant deaths since the current outbreak began in November last year with one death in December 2023 and eight deaths between January and May 2024.

Young babies are at the highest risk of severe complications and death from pertussis. Evidence from England shows that vaccination at the right time in pregnancy is highly effective, giving 92% protection against infant death. However, the latest uptake data for the vaccination offered to pregnant women shows a decline:

March 2024: 58.9% coverage
March 2017: Peak coverage of 72.6%

Timely vaccination during pregnancy and in childhood is crucial to protect vulnerable and young babies from serious diseases. Babies should receive three doses of the 6-in-1 vaccine at 8, 12, and 16 weeks, followed by a pre-school booster. Health visitors have a vital role in:

recommending pertussis vaccination
checking vaccine status
providing guidance on where and when to obtain vaccinations
addressing any queries parents or caregivers may have.

For further information and to access UKHSA resources on Pertussis, click here.

UKHSA has recently published a powerful new blog post by Jenny, a parent who shares her terrifying experience of her three week old daughter, Layla and her struggle with pertussis.

UKHSA encourages timely vaccination as whooping cough cases rise

Yesterday, the UK Health Security Agency (UKHSA) published a news story urging timely whooping cough vaccination in pregnancy and in childhood to protect vulnerable young infants from serious disease:

Pregnant women are offered a whooping cough vaccine in every pregnancy, ideally between 20 and 32 weeks – protecting their baby from birth in the first months of their life when they are most vulnerable and before they can receive their own vaccines.
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.

New data published yesterday by UKHSA shows cases of whooping cough continue to increase with 2,591 cases confirmed in May. This follows 555 cases in January 2024, 920 in February, 1,427 in March and 2,106 in April – bringing the total number of cases from January to May 2024 to 7,599.

Sadly, there have been 9 infant deaths since the current outbreak began in November last year (one in December 2023 and 8 between January to end May 2024). Young babies are at highest risk of severe complications and death from whooping cough. Evidence from England shows that vaccination at the right time in pregnancy is highly effective, giving 92% protection against infant death.

From January to May 2024, while most cases (53.4%, 4,057) were in those aged 15 years or older who usually get a mild illness, high numbers (262) continue to be reported in babies under 3 months of age who are at greatest risk from the infection.

Whooping cough cases have been rising across England, as well as in many other countries, since December 2023 due to a combination of factors. Whooping cough is a cyclical disease that peaks every 3 to 5 years. The last cyclical increase occurred in 2016. However, in common with other diseases, cases fell to very low numbers during the pandemic due to restrictions and public behaviours. A peak year is overdue and the impact of the pandemic also means there is reduced immunity in the population.

The latest uptake data for the vaccination offered to pregnant women to protect newborn infants against whooping cough continues to decline – with coverage in March 2024 at 58.9% compared to the peak coverage (72.6%) in March 2017.

Timely vaccination in pregnancy and in childhood are both important to protect vulnerable young infants from serious disease. All babies are given three doses of the 6-in-1 jab at 8, 12 and 16 weeks of age to protect against whooping cough and other serious diseases such as diphtheria and polio, with a pre-school booster offered at 3 years 4 months.

Whooping cough, clinically known as pertussis, is a bacterial infection which affects the lungs. The first signs of infection are similar to a cold, such as a runny nose and sore throat, but after about a week, the infection can develop into coughing bouts that last for a few minutes and are typically worse at night. Young babies may also make a distinctive ‘whoop’ or have difficulty breathing after a bout of coughing, though not all babies make this noise which means whooping cough can be hard to recognise.

If anyone in your family is diagnosed with whooping cough, it’s important they stay at home and do not go into work, school or nursery until 48 hours after starting antibiotics, or 2 weeks after symptoms start if they have not had antibiotics. This helps to prevent the spread of infection, especially to vulnerable groups, including infants. However, vaccination remains the best protection for babies and children.

UKHSA Blog

Alongside the updated data, UKHSA also published a powerful new blog post, “Whooping cough: my daughter spent the third week of life in an induced coma”. In this blog post, Jenny, from Hampshire, shares the story of her daughter Layla and her struggle with whooping cough at 3-weeks-old.

Read the UKHSA blog post

Health visitors’ role to promote uptake of the pertussis vaccine

UKHSA is calling for frontline clinicians to promote uptake of the pertussis vaccine. Pregnant women can have a pertussis-containing vaccination between 20 and 32 weeks’ gestation – they should also be vaccinated with every pregnancy.

Health visitors have a vital role to play in discussing vaccinations with parents and caregivers and promoting vaccine uptake. As a universal service, they visit every family, building trust through regular visits, often in the family’s home. Resources are available for health visitors and their team members to support communication around vaccines with pregnant women.

Pertussis (Whooping cough) case numbers in England continue to rise

Worrying new 2024 data published by the UK Health Security Agency (UKHSA) show an increase in cases of pertussis across all regions in England this year.

UKHSA are calling for frontline clinicians to promote uptake of the pertussis vaccine. Pregnant women can have a pertussis-containing vaccination between 16 and 32 weeks’ gestation – they should also be vaccinated with every pregnancy.

Pertussis is a serious disease that can lead to pneumonia and permanent brain damage. Infants who are too young to be fully protected through vaccination are at greatest risk of serious complications or, rarely, death. A large majority of infants who develop symptoms of pertussis will require hospitalisation.

The UKHSA has published an updated briefing note which summarises current epidemiology, trends in vaccine coverage and an update to national public health guidance during periods of heightened transmission.

UKHSA warn that incidence of pertussis is highest in infants under the age of 3 months, with 181 laboratory-confirmed cases identified between January and April 2024, and state that “this is of particular concern since these infants are at greatest risk of severe disease and are too young to benefit from complete vaccination”.

The most recent data show that there were 8 deaths reported in infants who developed pertussis in England between January to April 2024. Since the introduction of pertussis vaccination in pregnancy, from 2013 to the end of April 2024, there have been 29 deaths in total among infants with confirmed pertussis who were all too young to be fully protected by infant vaccination. Of the 29 infants that died, 23 had mothers who were not vaccinated at any point in pregnancy.

In the context of the current increase in pertussis case numbers, UKHSA’s briefing note contains useful updates on:

National guidance on the public health management of pertussis during periods of heightened transmission.
NICE Clinical Knowledge Summary and the NHS website which clarify approaches to, and requirements for testing for case confirmation and surveillance.
Guidance on the management of outbreaks in nurseries and other childcare settings for Local Authority Health Protection Teams.

General Practices remain the core providers for this vaccination programme. However, health visitors have a vital role to play in discussing vaccinations with parents and caregivers and promoting vaccine uptake. As a universal service, they visit every family, building trust through regular visits, often in the family’s home. Resources are available for health visitors and their team members to support communication around vaccines with pregnant women.

UKHSA are also calling for help to bolster uptake through the routine childhood vaccination programme. Vaccination against pertussis through the routine programme is offered at 8,12 and 16 weeks of age, with a preschool booster offered in primary care settings. This offers direct protection to infants and children against severe outcomes from pertussis.

Health visitors can promote vaccine uptake by checking vaccine status, as well as providing guidance on where and when to obtain them, and addressing any queries parents or caregivers may have. It’s important that parents and care givers are given the opportunity to ask questions about their child’s vaccinations with a trusted practitioner. This is a crucial part of the health visitor’s role. Trusted healthcare professionals provide the best support for parents and pregnant women regarding vaccinations. Health visitors, by building trusting relationships with families, are essential in boosting vaccine confidence and ensuring the success of the childhood vaccination programme.

Read the updated UKHSA briefing note here

Read our recent Voices blog from Dr Helen Campbell, Lead Scientist, Immunisation Division, UKHSA

Whooping cough infections rise

New data published by the UK Health Security Agency (UKHSA) shows there has been a continued increase in pertussis (whooping cough) cases at the start of this year, with 553 confirmed in England in January, compared with 858 cases for the whole of last year (2023).

The increase in whooping cough across England is occurring after a prolonged period of low case numbers due to restrictions and reduced social mixing patterns during the COVID-19 pandemic. Cases of whooping cough rise cyclically every few years, with the last peak year in 2016 recording 5,949 cases. The current increase is coming at a time when there has been a steady decline in uptake of the vaccine in pregnant women and in children.

Vaccination programme for children and pregnant women

In response to increasing case numbers, the UKHSA is reminding mums-to-be to get protected against whooping cough so that their young baby has protection from birth against this serious disease and to ask their midwife if they are unsure. UKHSA is also urging parents to check that their children are vaccinated against whooping cough, which is offered to all infants at 8, 12 and 16 weeks of age (as part of the 6-in-1 combination vaccine) with an additional dose included in the pre-school booster vaccine.

This reminder is part of the UKHSA’s new Childhood Immunisation Campaign urging parents to check the vaccination status of their children against measles and other serious diseases. This campaign went live across a range of media channels at the start of this week. Parents are being asked to respond to invites from the NHS or to book an appointment with their GP practice if their child has not received all their routine vaccines.

Data for January show that there were 22 infants aged under 3 months diagnosed with whooping cough. These infants, who are too young to be fully vaccinated, are at greater risk of severe disease, including death. UKHSA is strongly encouraging expectant mothers to take up the maternal vaccine. Vaccination of pregnant women is 97% effective at preventing death in young infants from whooping cough.

Useful links

NHS Vaccinations and when to have them

NHS Whooping cough information

UKHSA launches campaign as measles cases continue to rise

The UK Health Security Agency (UKHSA) has launched a new multi-media marketing campaign across England to remind parents and carers of the risk of their children missing out on protection against serious diseases that are re-emerging in the country – with an urgent call to action to catch up on missed vaccinations.

The campaign went live today (4 March) with a powerful video advert told from the perspective of children and in their voices. “Our generation’s risk of illnesses like measles and whooping cough is rising” they tell their parents and carers looking straight into camera – “If we’re not vaccinated, we’re not protected.”

The campaign theme and materials, based on insight and feedback from parents in the North West, were developed by UKHSA in partnership with DHSC Marketing, Liverpool City Council, NHS England, NHS North West and NHS Greater Manchester.

The campaign comes as the latest weekly update today on measles cases in England shows there have been another 69 cases in the past week, bringing the total number of laboratory confirmed measles cases reported since 1 October 2023 to 650.

Professor Helen Bedford, Professor of Children’s Health at UCL Great Ormond Street Institute of Child Health (GOS ICH) and iHV Expert Adviser: Immunisations, said:

Every year, vaccination saves millions of children’s lives, so it is a huge concern that uptake of vaccines has been in decline in England for the past ten years. This has left many children and young people unprotected against potentially serious diseases and we are already seeing numbers of cases of measles and whooping cough increasing. However, we can prevent this taking further hold. Vaccines are free, highly effective and have a good safety record – and it is never too late to catch up if they have been missed. We owe it to our children to ensure they are protected.

Uptake levels of childhood vaccines offered through the routine NHS vaccination programme in England have been falling over the past decade across all vaccines, including whooping cough, measles, mumps and rubella, polio, meningitis and diphtheria – with England no longer having the levels of population immunity recommended by the World Health Organization that is needed to prevent outbreaks. Crucially, lower vaccine uptake within communities is directly linked to wider health inequalities.

To counter this decline, UKHSA is co-ordinating its national marketing campaign with an NHS operational MMR catch up campaign. Areas with low uptake will be a focus for support and parents of children aged from six to 11 years will be contacted directly and urged to make an appointment with their child’s GP practice for any missed MMR vaccines.

In addition to the TV advert, the campaign will be seen across a range of channels and formats including radio advertising, digital display, online and on social media. Additional advertising will be seen in the West Midlands, North West and London where there are larger pockets of low uptake. The campaign will be supported by a number of key stakeholders, including local authorities and NHS organisations.

Also listen our our recent podcast with Professor Helen Bedford - Stemming the measles surge