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Maternal and infant immunity against Bordetella pertussis, Norway, 2020 to 2023

Margrethe Greve-Isdahl1,2, Thea Kristine Rogne Møller2, Terese Bekkevold2

  • 1University of Oslo, Oslo, Norway.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|December 19, 2025
PubMed

Insights

A high number of pregnant women and infants under three months have low pertussis (whooping cough) antibody levels, indicating significant susceptibility. These findings support maternal pertussis vaccination during pregnancy in Norway.

Area of Science:

  • Immunology
  • Public Health
  • Vaccinology

Background:

  • Pertussis (whooping cough) poses a significant health risk to young infants.
  • Norway's current infant vaccination schedule uses an acellular pertussis vaccine (aP) in a hexavalent formulation at 3, 5, and 12 months.

Purpose of the Study:

  • To assess pertussis susceptibility in mothers and infants to inform vaccination strategies.
  • To evaluate the impact of maternal antibodies on infant response to pertussis vaccination.

Main Methods:

  • Prospective observational study of 366 mother/infant pairs (2020-2023).
  • Blood samples collected from mothers (late pregnancy), cord blood, and infants (pre-vaccination and post-vaccination).
  • Multiplex immunoassay used to measure IgG antibody levels against pertussis antigens, diphtheria, and tetanus.

Main Results:

  • 48% of pregnant women had low anti-pertussis toxin (PT) IgG levels (<5 IU/mL).
  • 72% of infants under 3 months had low anti-PT IgG levels before their first vaccine dose.
  • Infants responded well to vaccination; no blunting effect observed from high maternal antibodies.
  • Infants born to mothers boosted within 2 years pre-pregnancy showed low anti-PT IgG levels (58% <5 IU/mL).

Conclusions:

  • A substantial proportion of pregnant women and young infants exhibit low pertussis immunity, suggesting high susceptibility.
  • Findings support the implementation of pertussis vaccination during pregnancy in Norway to protect infants.
  • Maternal vaccination may be crucial for maintaining adequate infant antibody levels against pertussis.

Keywords:
Whooping coughantibodieschildhood immunisation programmematernal vaccination

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