New Lancet Microbe research shows maternal vaccination delivers antibodies to newborns’ nasal defenses, a critical breakthrough for infant health
A landmark international clinical trial published in The Lancet Microbe shows that vaccinating pregnant people against whooping cough (pertussis) does far more than boost antibodies in a baby’s bloodstream — it also delivers antibodies right to the nasal mucosa, where the pertussis bacterium first invades. This discovery has significant implications for preventing severe disease in newborns too young to be vaccinated themselves.
The study — formally titled “Mucosal immune responses to Bordetella pertussis in Gambian infants following maternal and primary vaccination” — is the result of a phase 4, randomized, controlled, double-blind immunological trial involving 343 mothers and their infants. It was conducted by an international team including Dimitri Diavatopoulos, Janeri Fröberg, Beate Kampmann, and colleagues on behalf of the GaPs Study Team.
Why This Matters for Babies
Whooping cough, caused by Bordetella pertussis, remains a major killer of infants worldwide, especially in low- and middle-income countries. Estimates suggest hundreds of thousands of deaths annually, most among babies too young to start their own vaccine series.
Until now, research established that antibodies from vaccinated mothers cross the placenta and circulate in an infant’s blood after birth. But this study is the first to show that these maternal antibodies also appear in the baby’s nasal mucosa — the very site where pertussis bacteria latch on and begin infection. The presence of those mucosal antibodies suggests enhanced frontline defense against early bacterial colonization. This could be a game-changer for reducing hospitalizations and deaths in newborns during their most vulnerable weeks.
“The fact that these antibodies reach the nasal mucosa of the baby has not been demonstrated before and highlights how effective this vaccination is,” explained Dr. Dimitri Diavatopoulos, lead immunologist on the study.
The Lancet Microbe paper also compared how infants’ own immune systems responded after they received different primary pertussis vaccines on standard schedules. It confirmed that infants vaccinated with whole-cell pertussis vaccines at 8, 12, and 16 weeks developed more robust and longer-lasting immune responses than those who received acellular versions.
- Whole-cell vaccines contain the entire inactivated bacterium and stimulate a broader immune reaction.
- Acellular vaccines include only purified bacterial components, tend to cause fewer side effects, but have been associated with less durable immunity.
Postdoctoral researcher Janeri Fröberg noted that while acellular vaccines are widely used in high-income settings (such as Europe since 2005), whole-cell vaccines continue to be prevalent in many lower-resource countries and may offer more sustained protection — a crucial consideration for global health strategies.
Expert and Global Health Context
The World Health Organization (WHO) currently recommends continuing the use of whole-cell pertussis vaccines in countries where they are already established, because of their greater duration of immunity. This new trial strengthens that recommendation, especially for settings where access to healthcare and repeated boosters is limited.
The researchers caution that additional clinical studies are still needed to translate mucosal antibody findings into direct measures of disease prevention — such as fewer severe cases or reduced transmission — but they emphasize the strong immunological signal observed in this trial.
For the Latino communities in the United States and across the hemisphere, this science underscores several priorities:
- Vaccination during pregnancy — ideally between 27–36 weeks’ gestation — remains one of the most effective proven strategies to protect infants before they can begin their own shots.
- Ensuring equitable access to maternal vaccines can help close gaps in infant mortality and severe disease, especially among communities with lower prenatal care coverage.
- Clear communication between obstetric care providers and families about the benefits of maternal pertussis vaccination can build trust and save lives.
This Lancet Microbe trial provides robust new evidence that maternal pertussis vaccination does more than pass antibodies into a baby’s blood: it appears to fortify the very tissue where infection begins. Combined with data showing stronger infant immune responses following whole-cell vaccines, these findings should inform global immunization policies and strengthen public health messages for families worldwide.
Dr. Don García: “You should get vaccinated against the flu as soon as possible”.
