Research and analysis

Prenatal pertussis vaccination coverage in England from October to December 2024

Updated 24 April 2025

Applies to England

Main points

This quarterly report evaluates prenatal pertussis vaccine coverage for women who delivered in the October to December 2024 quarter, the third quarter of the 2024 to 2025 financial year (2024/25). The main findings were that:

• coverage was 67.1% in October, 67.4% in November and 68.2% in December 2024

• coverage for quarter 3 was 67.6%, which was 8.3 percentage points higher than quarter 3 coverage in the 2023/24 financial year

• coverage by Integrated Care Board (ICB) ranged from 32.6% (North Central London, November 2024) to 86.1% (Shropshire, Telford and Wrekin, October 2024)

• coverage has consistently increased over the past 8 months, since April 2024

• coverage in the London NHS commissioning region has gradually increased from 35.5% in September 2023 to 51.6% in December 2024

• the increase in coverage nationally and in London may be partially explained by improved data flows (see Note 1)

Note 1. A new point of care app developed by NHSE to record vaccination events was introduced in September 2024. The Record a Vaccination service (RAVs) has improved dataflows into general practice, which may partially account for the increase in coverage reported in recent months.

Introduction

This report presents vaccine coverage in pregnant women in England for the period October to December 2024, updating previous report that covered July to September 2024 (1).

The pertussis vaccine has been offered to pregnant women since 1 October 2012 (2) following a period of increased pertussis activity in all age groups, including infants under 3 months of age, and the declaration of a national pertussis outbreak in April 2012 (3).

In June 2014, the Joint Committee on Vaccination and Immunisation (JCVI) advised it should continue for a further 5 years (4). In February 2016, the JCVI considered new evidence demonstrating that vaccination earlier in pregnancy would increase opportunities during pregnancy for vaccination, without detrimentally affecting the protection afforded to the infant (5, 6). Based on this, JCVI advised that vaccination could be offered from gestational week 16, although for operational reasons vaccination should ideally be offered from around 20 weeks, on or after the foetal anomaly scan (7).

This advice was implemented from April 2016 as was offering the vaccine through general practice as well as some maternity services. In 2019, following the JCVI recommendation, the prenatal pertussis vaccine became a routine programme in England (8).

The prenatal pertussis vaccination programme aims to minimise disease, hospitalisation and deaths in young infants through the intra-uterine transfer of maternal antibodies, until they can be actively protected by the routine infant programme with the first dose of pertussis vaccine scheduled at 8 weeks of age (9).

Methods

General practice (GP) level pertussis vaccine coverage data is automatically uploaded via participating GP IT suppliers to the ImmForm website each month. ImmForm data is validated and analysed by the UK Health Security Agency (UKHSA) to check data completeness, identify and query any anomalous data and describe epidemiological trends. Since April 2016 (implementation date varied by GP IT supplier), the following monthly data has been collected:

• denominator: number of women who delivered in the survey month, excluding miscarriages and stillbirths, regardless of gestational age
• numerator: number of women receiving pertussis vaccination between week 16 of pregnancy and delivery

For accurate denominators to be extracted from GP IT systems by the automated survey and precise coverage estimates to be calculated, it is important that the medical records of all women who have given birth have the following fields completed:

• the date of delivery
• the date of receipt of a pertussis-containing vaccine at or after week 16 of pregnancy, regardless of the setting where the vaccine was administered
• where relevant, fields indicating stillbirth or miscarriage

Coverage by NHS commissioning region (based on the 2019 NHS England configurations), ICB and sub-ICB are available.

Participation and data quality

All GP IT suppliers provided data for the months of October to December 2024. National GP practice participation was at 99.0% in October, 98.9% in November and 98.9% in December 2024.

Results

Monthly coverage was 67.1% in October 2024, 67.4% in November 2024 and 68.2% in December 2024. Coverage has increased in recent months, having risen by 9.3 percentage points since April 2024. This increase may be partially explained by improved data flows (see Note 1 above). Overall coverage for quarter 2 was 64.4% (Table 1, Figure 1.

During this quarter, coverage by ICB ranged from 32.6% (North Central London, November 2024) to 86.1% (Shropshire, Telford and Wrekin, October 2024)(Table 1). By commissioning region, coverage was highest in the South East (76.1%, November 2024) and lowest in London (47.1%, October 2024). Coverage in London has been gradually increasing and has risen from 35.5% in September 2024 to 51.6% in December 2024, an increase of 16.1 percentage points.

Data on coverage by NHS commissioning region, ICB and Sub ICB is available in the data tables associated with this report.

Table 1. Monthly pertussis vaccination coverage (%) in pregnant women by ICB in England, October to December 2024

ICB code	ICB name	October 2024	November 2024	December 2024
QE1	Lancashire and South Cumbria	67.2	68.1	67.1
QF7	South Yorkshire	73.1	70.7	72.6
QGH	Herefordshire and Worcestershire	71.3	76.8	72.9
QH8	Mid and South Essex	72.2	73.0	73.4
QHG	Bedfordshire, Luton, and Milton Keynes	67.1	65.8	67.9
QHL	Birmingham and Solihull	58.2	58.0	58.8
QHM	North East and North Cumbria	69.3	71.9	73.4
QJ2	Derby and Derbyshire	80.6	78.0	72.4
QJG	Suffolk and North East Essex	60.9	54.4	60.9
QJK	Devon	75.5	77.5	78.4
QJM	Lincolnshire	71.0	71.1	68.4
QK1	Leicester, Leicestershire and Rutland	65.5	67.2	72.1
QKK	South East London	56.1	59.2	58.7
QKS	Kent and Medway	72.9	73.6	74.8
QM7	Hertfordshire and West Essex	71.9	70.0	68.9
QMF	North East London	40.7	41.7	44.1
QMJ	North Central London	32.9	32.6	43.0
QMM	Norfolk and Waveney	79.9	77.8	76.7
QNC	Staffordshire and Stoke-on-Trent	71.3	73.0	76.1
QNQ	Frimley	64.6	67.7	70.3
QNX	Sussex	75.6	77.5	78.8
QOC	Shropshire, Telford and Wrekin	86.1	84.0	81.8
QOP	Greater Manchester	63.6	64.8	64.8
QOQ	Humber and North Yorkshire	79.9	82.4	83.1
QOX	Bath and North East Somerset, Swindon and Wiltshire	75.5	71.9	76.2
QPM	Northamptonshire	60.7	66.0	64.0
QR1	Gloucestershire	67.9	69.5	71.3
QRL	Hampshire and Isle of Wight	79.1	79.2	76.4
QRV	North West London	46.9	47.1	51.0
QSL	Somerset	66.9	67.8	69.6
QT1	Nottingham and Nottinghamshire	73.5	73.5	70.1
QT6	Cornwall and Isles of Scilly	72.5	65.9	61.8
QU9	Buckinghamshire, Oxfordshire, and Berkshire West	78.5	78.9	76.5
QUA	Black Country	63.4	64.4	63.0
QUE	Cambridgeshire and Peterborough	73.3	70.4	74.2
QUY	Bristol, North Somerset, and South Gloucestershire	80.0	77.2	76.4
QVV	Dorset	79.2	77.0	77.0
QWE	South West London	59.8	59.8	64.4
QWO	West Yorkshire	72.0	70.8	72.7
QWU	Coventry and Warwickshire	65.4	66.5	71.1
QXU	Surrey Heartlands	77.5	75.1	75.2
QYG	Cheshire and Merseyside	71.6	71.8	68.4
Total		67.1	67.4	68.2

Figure 1. Monthly pertussis vaccination coverage (%) in pregnant women (England), 2017 to 2024

Figure 2. Monthly pertussis vaccination coverage (%) in pregnant women by NHS commissioning region, April 2019 to September 2024 [Note 1]

Note 1. Data from the smallest IT supplier was excluded between November and December 2019.

Discussion

This is the third quarterly report of the 2024/25 financial year and evaluates pertussis vaccine coverage for women who delivered from October to December 2024. Monthly prenatal pertussis vaccine coverage went from 67.1% in October 2024 to 67.4% in November 2024 and 68.2% in December 2024. From October to December 2024, the difference in coverage between the highest and lowest ICB was 53.5 percentage points. Coverage was lowest in the London commissioning region, although has increased by 16.1 percentage points since April 2024.

Comparisons to peak coverage may not be reflective of actual changes in coverage but may be due to improvements in data flows.

Limitations to the data presented in this report may explain the some of the observed variability in coverage at the local level and over time. First, completeness of data is reliant on the recording of delivery dates in the mother’s medical records and a recent study in England suggests that maternity notes regarding pregnancy and delivery are often scanned or archived, rather than coded in an extractable format (10). Furthermore, a comparison of this denominator data with national data on live births (11) indicates that, in 2022, this data represented about 73% of the population of pregnant women. Recent improvements in the capture of pertussis vaccine events delivered in maternity units may result in improvements in coverage, but these will not start to be visible in these reports until data becomes available for women delivering after September 2024.

Continued support in the delivery of this important programme has been sought from service providers (GP practices and maternity units), Screening and Immunisation Teams, and Health Protection Teams. Screening and Immunisation Teams should continue to update service providers on the current epidemiology of the disease and the need to maintain and improve coverage achieved thus far.

If coverage, and ultimately the impact of the programme itself, is to be accurately monitored, GPs and practice nurses must continue to ensure that vaccination and date of delivery are recorded in the patient’s GP record. In areas that have commissioned maternity units to offer pertussis vaccines in pregnancy, providers must ensure doses of vaccines given to individual women are also communicated to the woman’s GP where these are not captured in automated systems. Maternity units not offering pertussis vaccines to pregnant women should continue to discuss its importance, make use of available resources (12) and signpost women to their GP to receive the vaccine.

GPs, practice nurses, obstetricians and midwives should continue to encourage pregnant women to receive the pertussis vaccine – ideally between weeks 20 and 32 of their pregnancy (but up to term) – so as to optimise protection for their babies from birth (7).

References

1. ‘Prenatal pertussis vaccination coverage in England from July to September 2024’. Health Protection Report: volume 18, number 11.

2. DHSC (2012). Pregnant women to be offered whooping cough vaccination.

3. A national “level 3” incident had been declared in April 2012 in response to the ongoing increased pertussis activity. A level 3 incident is the third of 5 levels of alert under the UKHSA’s Incident Reporting and Information System (IERP) according to which public health threats are classified and information flow to the relevant outbreak control team is coordinated; a level 3 incident is defined as one where the public health impact is significant across regional boundaries or nationally.

4. JCVI (2014). Minute of the meeting on 4 June 2014.

5. Eberhardt CS, Blanchard-Rohner G, Lemaitre B, Boukrid M, Combescure C, Othenin-Girard V and others (2016). ‘Maternal immunization earlier in pregnancy maximizes antibody transfer and expected infant seropositivity against pertussis’. Clinical Infectious Diseases: volume 62, pages 829 to 836.

6. JCVI (2016). Minute of the meeting on 3 February 2016.

7. UKHSA. The Green Book, chapter 24: Pertussis.

8. JCVI (2019). Minute of the meeting on 5 June 2019.

9. UKHSA. ‘Complete routine immunisation schedule’.

10. Llamas A, Amirthalingam G, Andrews N, and Edelstein M (2020). ‘Delivering prenatal pertussis vaccine through maternity services in England: what is the impact on vaccine coverage?’ Vaccine: volume 38, issue 33, pages 5,332 to 5,336.

11. Office for National Statistics (2022). Births in England and Wales.

12. UKHSA (2022). Pregnancy: How to help protect yourself and your baby.