Whooping cough in infants is a respiratory infection whose severe forms affect almost exclusively babies under six months old. In 2024, France experienced an unusually large resurgence, with eight infant deaths recorded by Santé publique France, compared with one the previous year. The main protective measure identified by the Haute Autorité de santé is vaccination during pregnancy.
Whooping cough in infants: what do the official figures say?
Santé publique France relies on two complementary systems: the RENACOQ hospital network and the Sentinelles network, which monitors community-based medicine. Both recorded an exceptional year in 2024.
- In 2024, 537 hospitalized cases were reported among infants under 12 months old.
- Eight infant deaths were recorded that year, compared with one in 2023.
- A total of 46 deaths across all age groups were identified through electronic death certificates, including 21 children under 5 years old.
- The Sentinelles network recorded the highest rate in community settings since monitoring began, at 244 cases per 100,000 inhabitants.
These figures reflect a resurgence of the epidemic, not a medical novelty. Whooping cough occurs in cycles, with peaks every three to five years. Vaccination has sharply reduced its incidence since the 1960s, without eradicating it.
Why the youngest babies bear the brunt
The age distribution is clear-cut. Between 2013 and 2024, among hospitalized infants under 12 months old, 83% were under 6 months old and 56% were under 3 months old.
The explanation is simple. The first vaccine dose is given at 2 months, and the second at 4 months. Before then, the child has no personal vaccine protection. They depend entirely on antibodies passed on by their mother and the immunity of those around them.
Babies born prematurely are particularly vulnerable, because the transfer of maternal antibodies occurs mainly at the end of pregnancy. We have covered their situation in detail in our article on prematurity in France.
Recognizing whooping cough in a baby
In infants, the disease does not look like the classic description. The coughing fit followed by a loud inspiratory whoop, known as the whooping sound, is often absent before six months of age.
The warning signs are different.
- A cough that persists, worsens at night, and occurs in repeated fits.
- Breathing pauses, sometimes without any coughing at all.
- A change in the color of the face during coughing fits.
- Difficulty breastfeeding or vomiting after coughing.
- The absence of fever, which is common and misleading.
Any prolonged cough in a baby under three months warrants prompt medical advice, especially if an adult close to the baby has been coughing for several weeks. Contagiousness is very high during the first few days.
Confusion with other winter respiratory infections is common. Our article on the bronchiolitis prevention campaign helps distinguish between the different clinical presentations.
Vaccination during pregnancy: the main lever
On July 22, 2024, in response to the resurgence, the Haute Autorité de santé strengthened its recommendations. The central measure concerns pregnant women.
Vaccination is recommended from the second trimester of pregnancy, ideally between 20 and 36 weeks of amenorrhea, and no later than one month before delivery. The antibodies cross the placenta and protect the child during the first few weeks.
The effectiveness reported by the HAS exceeds 90% against severe cases and newborn deaths. This is the highest level of protection documented for this disease before the age of two months.
Coverage is increasing significantly in France. According to data published by Santé publique France, it rose from 43.4% in 2023 to 62.3% in 2024 among pregnant women.
Cocooning when the pregnancy was not covered
If vaccination did not take place during pregnancy, the HAS recommends vaccinating the mother before she leaves the maternity unit. The so-called cocooning strategy then takes over.
It involves vaccinating those close to the infant: parents, siblings, grandparents, and people who regularly care for the child. A booster is recommended if the last vaccination was more than five years ago.
Healthcare and early-childhood professionals in contact with babies under six months are subject to the same rule. This question of the people around the baby is part of the broader issue of the role of close relatives during the first few weeks, which we discuss in our article on grandparents and the baby.
Non-vaccination measures remain useful: handwashing, keeping your distance from people who are coughing, and caution in enclosed, crowded places during the first few weeks. We explain them in detail in our article on a newborn’s first outings.
The infant vaccination schedule
Whooping cough vaccination is mandatory in France for children born since January 1, 2018. It is included in the hexavalent vaccine.
- First dose at 2 months.
- Second dose at 4 months.
- Booster at 11 months.
The HAS emphasizes a practical point: these appointments should not be postponed. Each week of delay prolongs the period of vulnerability. Later boosters are scheduled at 6 years, between 11 and 13 years, and then at 25 years. The complete schedule is included in our article on vaccination for babies in France.
What is the situation with the epidemic in 2025 and 2026?
Preliminary data published by Santé publique France for 2025 indicate a marked decline in the circulation of the bacterium after the 2024 peak. This decline is consistent with the cyclical nature of the disease.
It does not invalidate the recommendation. A low cycle mechanically sets the stage for the next cycle, allowing unimmunized people to accumulate. Infant protection therefore depends on coverage being maintained over time, not on a one-off response to an epidemic.
Infant vaccination coverage remains high in France, at 91.8% for three doses by 21 months in the cohort born in 2023. The weak point is among adults, who often forget their boosters.
Key takeaways
- 2024 saw a major resurgence, with 8 infant deaths in France.
- More than half of hospitalized babies are under 3 months old.
- Vaccination between 20 and 36 weeks of amenorrhea protects the child before their first dose.
- If not, cocooning those around the baby takes over, with a booster after the age of five.
- A prolonged cough in a baby under three months old requires medical advice.
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Sources
- Santé publique France, whooping cough surveillance data, RENACOQ and Sentinelles networks, 2024 data and preliminary 2025 data.
- French National Authority for Health, “Resurgence of whooping cough: the HAS strengthens vaccination recommendations to protect newborns and infants,” July 22, 2024.
