Research and analysis

Prenatal pertussis vaccination coverage in England from January to March 2025, and annual coverage for 2024 to 2025

Updated 26 June 2025

Applies to England

Main points

This report evaluates prenatal pertussis vaccine coverage for women who delivered in the January to March 2025 quarter and estimates annual coverage for the 2024 to 2025 financial year. 

The main findings were that:

• annual coverage was 65.6%, compared to 58.6% in 2023 to 2024, 60.7% in 2022 to 2023 and 64.7% in 2021 to 2022

• annual coverage by commissioning region was lowest in London (48.2%) and highest in the South East (73.8%)

• annual coverage was highest in White British women (73.0%) and lowest in Black or Black British Caribbean women (39.0%)

• coverage for quarter 4 was 71.3%, which was 12.1 percentage points higher than the mean coverage for the same quarter in the 2023 to 2024 financial year

• coverage for quarter 4 was 69.8% in January, 71.8% in February and 72.6% in March

• monthly coverage has been steadily increasing since April 2024, although it remains below the historic peak of 76.2% reported in December 2016. The increase in coverage may be partially explained by improved data flows [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 data for pertussis vaccine coverage in pregnant women in England for the period January to March 2025, updating the previous data reported for October to December 2024 (1); it also presents annual coverage data for the whole of the 2024/25 financial year.

The pertussis vaccine has been offered to pregnant women since 1 October 2012 (2) following 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 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 and May 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 reported in the data tables associated with this report.

Annual vaccine coverage for England was calculated by summing the 12 monthly numerators and denominators for the financial year (April 2024 to March 2025). This is different from reports showing annual data on, and prior to, the 2018 to 2019 financial year, where a separate annual extraction (based on the same coding specification) was used to report the annual coverage.

For ethnicity, monthly data was collated for the annual period and coverage calculated by ethnic group according to ONS 2011 census categories. For the ethnicity analysis in this report, we excluded those registered patients without an ethnicity code. In total, we excluded 61,980 of the total 460,833 (13.4%) women recorded as having delivered in the 2024 to 2025 financial year. Coverage in excluded women was 61.7% (38,211 out of 61,980).

Participation and data quality

All GP IT suppliers provided data for the January to March 2025 period. National GP practice participation was at 99.1% (January 2025),  99.0% (February 2025) and 99.0% (March 2025).

Results

Coverage in the 2024 to 2025 financial year

The main findings for the 2024 to 2025 financial year were that:

• annual coverage was 65.6%. This is 7.0 percentage points higher than coverage for the 2023 to 2024 financial year

• annual coverage varied by 25.6 percentage points between commissioning regions, from 48.2% in London to 73.8% in the South East

• annual coverage varied by 48.1 percentage points between ICBs, from 34.3% in North Central London to 82.4% in Shropshire, Telford and Wrekin

Coverage by ethnicity in the 2024 to 2025 financial year

The main findings for coverage by ethnicity in the 2024 to 2025 financial year were that:

• annual coverage varied by 34.0 percentage points between ethnic groups

• coverage was the highest in White British (73.0%) and Chinese women (72.9%) (Table 1)

• coverage was the lowest in Black or Black British (Any other background) (46.4%) and Black or Black British Caribbean women (39.0%) (Table 1)

Table 1. Annual pertussis vaccination coverage by ethnic group, April 2024 to March 2025

Ethnicity group	Coverage (%)
White British	73.0
Chinese	72.9
Asian or Asian British - Indian	68.9
White Irish	65.1
Mixed - White and Asian	63.2
Asian or Asian British - Any other Asian background	62.5
Mixed - Any other mixed background	56.2
Mixed - White and Black African	54.8
Asian or Asian British - Bangladeshi	54.4
Asian or Asian British - Pakistani	53.9
Black or Black British - African	53.6
White - Any other White background	51.4
Mixed - White and Black Caribbean	50.7
Black or Black British - Any other Black background	46.4
Black or Black British - Caribbean	39.0

Coverage in quarter 4 of the 2024 to 2025 financial year

The main findings for quarter 4 of the 2024 to 2025 financial year were that:

• quarterly coverage was 71.3%. This was 12.1 percentage points higher than coverage reported for the same quarter in the 2023 to 2024 financial year

• monthly coverage varied across the quarter and was 69.8% in January, 71.8% in February and 72.6% in March (Table 2, Figure 1, see data tables)

• compared with data from the 2023 to 2024 financial year, national coverage was 10.0 percentage points higher in January 2025, 12.9 percentage points higher in February 2025 and 13.7 percentage points higher in March 2025

• quarterly coverage varied by 15.9 percentage points between commissioning regions, from 61.6% in London to 77.5% in the South East

• although coverage was lowest in London commissioning region, London has shown the greatest incline of 24.1 percentage points in the last year

• during this quarter, prenatal pertussis vaccine coverage by Integrated Care Board (ICB) ranged from 47.2% (North Central London, January 2025) to 87.8% (Shropshire, Telford and Wrekin, February 2025) (Table 2)

Table 2. Monthly pertussis vaccination coverage (%) in pregnant women by ICB in England, January to March 2025

ICB Code	ICB Name	January 2025	February 2025	March 2025	January to March 2025
QE1	Lancashire and South Cumbria	66.8	68.6	69.5	68.3
QF7	South Yorkshire	69.5	69.5	74.0	70.9
QGH	Herefordshire and Worcestershire	73.8	79.3	77.9	76.9
QH8	Mid and South Essex	67.6	68.2	68.7	68.1
QHG	Bedfordshire, Luton and Milton Keynes	69.6	69.4	65.0	68.1
QHL	Birmingham and Solihull	57.0	60.7	56.6	58.1
QHM	North East and North Cumbria	74.4	75.9	77.4	75.9
QJ2	Derby and Derbyshire	69.8	69.3	80.5	72.8
QJG	Suffolk and North East Essex	62.8	63.9	72.9	66.5
QJK	Devon	75.8	77.5	82.8	78.6
QJM	Lincolnshire	71.7	75.5	84.9	77.4
QK1	Leicester, Leicestershire and Rutland	71.2	72.8	74.7	72.9
QKK	South East London	61.5	66.2	66.3	64.5
QKS	Kent and Medway	75.1	75.1	75.6	75.3
QM7	Hertfordshire and West Essex	73.2	74.6	74.6	74.1
QMF	North East London	54.1	59.9	60.7	58.1
QMJ	North Central London	47.2	53.8	57.6	52.7
QMM	Norfolk and Waveney	81.0	81.1	80.7	81.0
QNC	Staffordshire and Stoke-on-Trent	76.0	79.9	76.9	77.5
QNQ	Frimley	69.2	71.1	72.0	70.8
QNX	Sussex	79.3	81.1	79.6	80.0
QOC	Shropshire, Telford and Wrekin	83.9	87.8	83.4	84.9
QOP	Greater Manchester	64.0	65.1	65.7	64.9
QOQ	Humber and North Yorkshire	81.1	80.8	80.7	80.9
QOX	Bath and North East Somerset, Swindon and Wiltshire	75.3	75.7	82.8	77.7
QPM	Northamptonshire	71.6	75.7	80.3	75.8
QR1	Gloucestershire	69.4	69.4	72.0	70.2
QRL	Hampshire and Isle of Wight	79.5	79.4	80.5	79.8
QRV	North West London	59.1	61.1	64.5	61.5
QSL	Somerset	73.3	78.2	78.2	76.5
QT1	Nottingham and Nottinghamshire	72.7	74.1	72.6	73.1
QT6	Cornwall and The Isles of Scilly	66.6	67.8	83.9	72.5
QU9	Buckinghamshire, Oxfordshire and Berkshire West	79.6	78.0	75.7	77.7
QUA	Black Country	63.8	63.9	66.3	64.7
QUE	Cambridgeshire and Peterborough	71.1	72.0	75.9	72.9
QUY	Bristol, North Somerset and South Gloucestershire	78.7	81.4	81.0	80.3
QVV	Dorset	80.2	80.9	81.4	80.8
QWE	South West London	69.2	74.9	72.3	72.0
QWO	West Yorkshire	71.4	71.1	69.2	70.6
QWU	Coventry and Warwickshire	73.7	76.8	78.1	76.2
QXU	Surrey Heartlands	76.4	81.6	80.9	79.7
QYG	Cheshire and Merseyside	71.8	74.3	71.3	72.4
Total	Total	69.8	71.8	72.6	71.3

Figure 1. Monthly pertussis vaccination coverage (%) in pregnant women (England), 2016 to 2025

Figure 2. Monthly pertussis vaccination coverage (%) in pregnant women by NHS commissioning region, April 2019 to March 2025 [Note 1]

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

Discussion

This report evaluates pertussis vaccine coverage data for women who delivered in the period January to March 2025 (quarterly data) and between 1 April 2024 and 31 March 2025 (annual data).

Monthly prenatal pertussis vaccine coverage in the fourth quarter of financial year 2024/25 was 69.8% in January, 71.8% in February and 72.6% in March. From January to March 2025, the difference in monthly coverage between the highest and lowest ICB was 40.6 percentage points. 

Annual vaccine coverage was 65.6% in the 2024/25 financial year. By ethnicity, coverage was highest in White British women (73.0%) and lowest in Black or Black British Caribbean women (39.0%).

Limitations to the data presented in this report may explain 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 (10) and delivery are often scanned or archived, rather than coded in an extractable format. Furthermore, a comparison of this denominator data with national data on live births (11) indicates that in 2021, this data represented about 71% of the population of pregnant women.

Continued support in the delivery of this important programme has been sought from:

• service providers (GP practices and maternity units)

• screening and immunisation teams

• health protection teams (HPTs)

Screening and immunisation teams and HPTs 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, it is essential that GPs and practice nurses 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, it is important that providers ensure doses of vaccines given to individual women are also communicated to the woman’s GP. 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. UKHSA (2024). ‘Prenatal pertussis vaccination coverage in England from October to December 2023’. Health Protection Report: volume 18, number 3

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). Provisional births in England and Wales

12. UKHSA (2022). ‘Pregnancy: How to help protect you and your baby’