Prenatal Pertussis Vaccine Coverage Edges Up in England as Regional Gaps Persist
England’s prenatal pertussis vaccination programme continued to climb in the first quarter of the 2026 to 2027 financial year, but coverage still varied sharply by geography, ethnicity and deprivation. Quarterly coverage reached 72.3%, up 1.1 percentage points from the same quarter a year earlier, with monthly values of 72.1% in April 2026, 72.4% in May and 72.5% in June.
The figures matter because maternal vaccination remains the fastest route to protecting newborns during the narrow window before infant immunisation begins. Pertussis is most dangerous in early infancy, when physiologic vulnerability is high and the routine infant schedule has not yet had time to build immunity. Maternal antibody transfer across the placenta is the biologic bridge the programme relies on, and the design is straightforward: vaccinate during pregnancy, then carry passive protection into the first months of life.
A single statistic captures the central problem. Coverage is improving, but it is still uneven.
London Trails Far Behind the South West While Uptake Rises in the Capital
Commissioning-region data show a spread that remains difficult to ignore. Coverage ranged from 65.3% in London to 81.0% in the South West, a gap of 15.7 percentage points. The South East recorded 78.0%, the Midlands 70.8%, the North East and Yorkshire 73.3%, the East of England 71.9% and the North West 70.4%.
London deserves particular attention because its trajectory has been markedly upward, even if it still sits below the national average. Coverage in the capital has risen gradually from 35.5% in September 2023 to 66.0% in June 2026. In public health terms, that is a major recovery, yet it also shows how far some areas remain from the kind of uptake that would narrow infant susceptibility more reliably.
Integrated Care Board results reveal even wider variation. Coverage ranged from 55.5% in Birmingham and Solihull to 83.4% in Dorset, a span of 27.9 percentage points. Differences of this size usually point to a combination of access, record completion, local workflow, continuity of care and the timing of vaccine offers during antenatal contacts. The programme depends not only on willingness to vaccinate, but on whether the opportunity is presented early enough and documented accurately enough for coverage to be counted.
Data quality matters here because the denominator is built from women who delivered in the survey month, excluding miscarriages and stillbirths, while the numerator captures vaccination from week 16 of pregnancy through delivery. If delivery dates or vaccine dates are missing from the record, coverage can be distorted in either direction. Both major GP IT suppliers provided data for the quarter, with national GP practice participation at 99.1% in April 2026 and 98.6% in both May and June.
Ethnicity and Deprivation Continue to Shape Uptake
The pattern by ethnicity was stark. Coverage varied by 40.1 percentage points between ethnic groups, from 85.7% in Other Ethnic Group Chinese to 45.6% in Black or Black British Caribbean. White British coverage reached 78.6%, White Irish 72.4% and Asian or Asian British Indian 79.5%. At the lower end, Black or Black British African coverage was 61.7%, Black or Black British any other Black Background 56.4%, Asian or Asian British Pakistani 56.1% and Mixed White Black Caribbean 54.3%.
Those differences should not be read as biologic; they reflect unequal access, unequal system contact and uneven success in converting antenatal encounters into completed vaccination. Pregnant patients who receive consistent continuity of care are more likely to encounter the vaccine on time, while fragmented care pathways can leave eligible women without a documented offer or without a completed dose before delivery. In a programme built around a precise gestational window, every missed visit carries a real consequence for infant protection.
Deprivation followed the same gradient. Coverage was 81.6% in the least deprived decile and 61.8% in the most deprived, a 19.8 percentage point difference. The stepwise pattern across deciles was steady: 67.4% in decile 2, 71.3% in decile 3, 72.8% in decile 4, 74.4% in decile 5, 76.7% in decile 6, 77.9% in decile 7, 78.8% in decile 8 and 80.0% in decile 9.
These gradients are familiar in immunisation, but the stakes feel especially acute in pregnancy because the vaccine serves two patients at once. Maternal benefit is secondary; the principal objective is infant protection through intra-uterine antibody transfer until the baby can begin the routine pertussis schedule at 8 weeks of age. When coverage lags in deprived communities or specific ethnic groups, the children most exposed to barriers in care also remain the least likely to receive passive protection at birth.
Record Systems Are Now Part of the Coverage Story
A new point-of-care app developed by NHS England was introduced in September 2024 to record vaccination events, and the Record a Vaccination service has improved data flows into general practice. That change may partially explain the rise in reported coverage in recent months. Better capture does not create vaccination, but it does make existing activity more visible and can improve the fidelity of the national picture.
The programme was first offered to pregnant women in October 2012 after a period of increased pertussis activity and a national outbreak declaration in 2012. Subsequent JCVI advice expanded the opportunity to offer vaccination from gestational week 16, with operational preference from around 20 weeks, after the fetal anomaly scan. Since 2019, the programme has been routine in England.
Even with those structural gains, the latest quarter leaves several practical questions open at the bedside and in service delivery. London’s progress shows that coverage can recover when systems begin to work better, but the scale of the remaining gap suggests that access alone is not enough. Antenatal teams, general practice and data systems still need to align so that a vaccine recommended in pregnancy is not lost to timing, documentation or uneven outreach.
The quarter’s numbers also make clear that national averages can hide clinically important pockets of under-protection. In a programme designed to prevent disease, hospitalisation and deaths in young infants, the most concerning part of the dataset is the persistence of low uptake in specific regions and populations where pertussis prevention would likely have the greatest downstream value.
The report closes on a familiar but unresolved problem: coverage is improving, yet the gains are not evenly distributed, and the gap between the best-performing and worst-performing populations remains wide enough to matter for infant risk.