Protecting Your Baby Before Birth
Your baby’s immune system starts getting a helping hand long before they’re born. Here’s how a few important vaccinations during pregnancy can help protect your little one during their most vulnerable first months.
Pregnancy is an exciting time, filled with preparations for your baby’s arrival. Between antenatal appointments, preparing the nursery and getting everything ready for those first precious weeks, there’s a lot to think about.
One important part of preparing for your baby’s arrival is making sure that both you and your baby are protected against certain preventable infections.
Some vaccines given during pregnancy do more than protect the mother. They also allow protective antibodies to pass through the placenta to the developing baby, providing valuable immunity during those first few months of life, before your little one is old enough to receive their own vaccinations.
At Peak Family Practice, we recommend discussing three important vaccines during pregnancy: whooping cough (pertussis), respiratory syncytial virus (RSV) and influenza (flu).
1. Whooping Cough Vaccine (Adacel Quadra)
When: Ideally between 26 and 32 weeks of pregnancy
Whooping cough, also known as pertussis, is a highly contagious respiratory infection that can be particularly dangerous for newborn babies.
While older children and adults may experience a prolonged, troublesome cough, young babies can become seriously unwell. Pertussis can cause severe coughing episodes, breathing difficulties, pauses in breathing (apnoea), pneumonia and, in rare cases, death.
Why vaccinate during pregnancy?
Babies in South Africa receive their first routine pertussis-containing vaccine at approximately six weeks of age. However, they need several doses over the following months to develop stronger protection.
This leaves a vulnerable window between birth and the time their own immunity develops.
When a pregnant mother receives a pertussis booster, her immune system produces antibodies that cross the placenta and enter her baby’s circulation. These antibodies provide important protection against whooping cough during the first months of life.
The pertussis vaccine is recommended during every pregnancy, even if you’ve previously been vaccinated or received the vaccine during an earlier pregnancy.
Adacel Quadra protects against four infections:
Tetanus
Diphtheria
Pertussis (whooping cough)
Polio
The vaccine can be administered during the third trimester, with timing ideally planned to maximise the transfer of antibodies to your baby before birth.
2. RSV Vaccine (Abrysvo)
When: Between 28 and 36 weeks of pregnancy, with timing guided by your healthcare provider
Respiratory syncytial virus, or RSV, is an extremely common respiratory virus.
For most adults and older children, RSV causes symptoms similar to those of an ordinary cold. However, in young babies, particularly those under six months of age, RSV can cause more serious lower respiratory tract infections.
These include bronchiolitis, which affects the small airways in the lungs, and pneumonia.
RSV is one of the leading causes of hospitalisation for respiratory illness in infants.
How does the RSV vaccine protect your baby?
Abrysvo is a maternal RSV vaccine designed to protect babies against serious RSV-related respiratory illness during their first months of life.
When administered during pregnancy, the vaccine stimulates the mother’s immune system to produce antibodies against RSV.
These antibodies cross the placenta and are transferred to the baby before birth.
This means your baby arrives with a supply of protective antibodies, helping reduce their risk of developing severe RSV-related lower respiratory tract disease during those vulnerable early months.
Unlike routine childhood vaccinations, which are given directly to the baby, maternal RSV vaccination provides protection before your baby is even born.
Maternal RSV vaccination should be discussed during each pregnancy, taking into account the timing of delivery, RSV season and the most appropriate prevention strategy for your baby.
Can the RSV and whooping cough vaccines be given together?
Both vaccines are recommended during the later stages of pregnancy.
Where practical, we prefer to space Adacel Quadra and Abrysvo at least two weeks apart, as there is some evidence that administering them together may slightly reduce the immune response to the pertussis component.
However, if there is concern about premature delivery or limited time before birth, your doctor can help you decide on the most appropriate vaccination schedule.
3. Influenza (Flu) Vaccine
When: During any trimester of pregnancy, ideally before the influenza season
Influenza is sometimes dismissed as just another winter illness, but true influenza can cause significant illness, particularly during pregnancy.
Pregnancy brings natural changes to the immune system, heart and lungs, making pregnant women more vulnerable to complications from influenza.
These can include pneumonia, hospitalisation and an increased risk of pregnancy complications.
Why is the flu vaccine important?
The influenza vaccine provides two important benefits.
Firstly, it protects you. Vaccination reduces your risk of influenza and its complications during pregnancy.
Secondly, it helps protect your baby. Antibodies produced in response to the vaccine cross the placenta and provide some protection against influenza during your baby’s first months of life.
This is especially important because babies cannot receive their own influenza vaccination until they are six months old.
The inactivated influenza vaccine can safely be administered during any trimester of pregnancy.
Protecting Your Baby Doesn’t Stop With Mom
The Importance of Vaccinating Partners, Grandparents and Caregivers
While maternal vaccination provides an important first layer of protection, the people spending time with your newborn also play a role in keeping them healthy.
Newborn babies have immature immune systems and are particularly vulnerable to respiratory infections.
Many of these infections are introduced into the household by adults or older children who may have only mild symptoms.
This is why we encourage families to think about vaccination as something that extends beyond the expectant mother.
Who should consider vaccination?
We recommend reviewing the vaccination status of everyone who will have regular close contact with your newborn, including:
Partners and fathers
Grandparents
Nannies and other caregivers
Siblings and other household members
Anyone who will regularly help care for your baby
Whooping Cough Boosters for Family Members
When: Ideally at least two weeks before baby’s arrival
Whooping cough is often spread to newborn babies by the people closest to them.
Adults may not realise they have pertussis because the infection doesn’t always cause the characteristic ‘whooping’ sound associated with the illness. Sometimes it presents simply as a persistent cough.
Research has shown that household members are a major source of pertussis infection in young infants.
For this reason, we recommend that adults who will have close contact with a newborn review their pertussis vaccination history.
Those who have never received an adult Tdap-containing vaccine may benefit from a booster before the baby’s arrival.
Children and siblings who are up to date with their routine childhood vaccinations generally do not require an additional pertussis booster solely because a new baby is joining the family.
Flu Vaccination for the Whole Household
When: Annually, ideally before flu season or at least two weeks before baby’s arrival when appropriate
Influenza spreads easily within households.
Because babies under six months cannot yet receive their own influenza vaccine, protecting the people around them is particularly important.
We recommend annual influenza vaccination for household members and regular caregivers, especially those who will be spending significant time with your newborn.
Vaccination helps reduce the likelihood of influenza illness and can contribute to reducing the risk of exposing your baby.
Creating a Protective Cocoon Around Your Baby
You may have heard the term ‘cocooning’ when discussing newborn vaccinations.
Cocooning refers to the practice of ensuring that the people who spend the most time around a newborn are appropriately vaccinated.
The idea is simple: by reducing the risk of infection among parents, grandparents, siblings and caregivers, we help create an additional layer of protection around a baby who is still too young to be fully vaccinated.
However, cocooning works best as an additional protective measure, rather than a replacement for vaccination during pregnancy.
Maternal vaccination is especially valuable because it provides antibodies directly to the baby before birth.
Together, maternal vaccination, up-to-date household vaccinations and sensible infection-prevention measures provide several complementary layers of protection.
Other simple precautions remain important, including good hand hygiene, avoiding close contact with your baby when unwell, and asking visitors with coughs, fevers or other respiratory symptoms to postpone their visit.
Planning Your Vaccinations During Pregnancy
With several vaccines recommended during the second half of pregnancy, timing is important.
Ideally, we like to discuss your vaccination plan well before your third trimester so that there’s enough time to schedule the appropriate vaccines.
Our team can help you decide when each vaccine should be administered, taking into account your gestational age, expected delivery date, medical history and the time of year.
If you’re already approaching your due date and haven’t received these vaccinations, please don’t worry. There may still be opportunities to provide protection, and we can help you work out the best approach for your individual circumstances.
A Healthy Start Begins Before Birth
The first few months of your baby’s life are a time of enormous growth and development, but they’re also a period when their immune system is still learning to protect them.
Vaccination during pregnancy is one of the ways we can give babies a healthier start.
By protecting yourself during pregnancy and encouraging those closest to your baby to keep their vaccinations up to date, you’re helping create a safer environment for your little one from the very beginning.
At Peak Family Practice, we’re here to help you plan your vaccinations during pregnancy and prepare your family for your baby’s arrival.
If you’re expecting a baby, or you’re a partner, grandparent or caregiver who would like to check which vaccinations are recommended, our team would be happy to assist.
