Pregnant women are using Reddit not primarily to reject the maternal Tdap vaccine, but to ask questions that often remain unanswered after a prenatal appointment, according to a qualitative study published August 12, 2026, in PLOS Global Public Health. Researchers who examined 86 English-language Reddit posts found that expectant mothers most often sought practical information, reassurance about vaccine safety, or guidance on how to protect a newborn from pertussis, the respiratory infection commonly known as whooping cough. The findings suggest that online discussions about maternal vaccination may reveal a gap between the information healthcare providers deliver and the details pregnant patients need to make confident decisions.
The maternal Tdap vaccine protects against tetanus, diphtheria, and pertussis. In the United States, health authorities recommend that pregnant women receive a dose during every pregnancy, ideally between 27 and 36 weeks of gestation, with vaccination commonly encouraged earlier in that window. The purpose is not only to protect the mother. During pregnancy, vaccine-induced antibodies can cross the placenta and provide the fetus with temporary passive immunity. This protection is particularly important during the first months after birth, when infants are too young to receive their own routine pertussis vaccinations and are especially vulnerable to severe disease, respiratory complications, hospitalization, and death.
Pertussis is caused by the bacterium Bordetella pertussis, which spreads through respiratory droplets and aerosols produced by coughing, sneezing, and close conversation. Infection can begin with symptoms resembling an ordinary cold before developing into prolonged coughing fits. In young infants, however, the classic “whoop” may be absent. Babies can instead experience apnea, difficulty feeding, cyanosis, or sudden respiratory failure. Maternal immunization reduces the likelihood that a newborn will become infected during this high-risk period by transferring immunoglobulin G antibodies across the placenta. This transfer is mediated largely by the neonatal Fc receptor, a transport system whose activity increases during the later stages of pregnancy.
Despite the biological rationale and established safety record of Tdap vaccination in pregnancy, uptake remains incomplete. The study authors note that approximately 55 percent of eligible pregnant women in the United States received the vaccine in 2023. To explore why expectant mothers may still have questions or uncertainty, Soojung Jo of Purdue University and colleagues searched Reddit for English-language posts published between October 2020 and October 2023. They used combinations of the terms “Tdap,” “pertussis,” or “whooping cough” with “pregnant,” then restricted the sample to posts written from the perspective of a pregnant woman, published before delivery, and focused primarily on maternal Tdap vaccination.
The resulting posts often reflected uncertainty about timing, previous vaccination, and the duration of antibody protection. One user asked whether a Tdap injection received six years earlier would provide antibodies during a current pregnancy. Another described being told by a physician that vaccination was unnecessary because the patient had received Tdap shortly before becoming pregnant, but remained worried that the baby might not be protected. These concerns reflect a technically complicated point: antibody levels can decline over time, and the goal of vaccination during pregnancy is to maximize the concentration of pertussis-specific antibodies available for transfer to the fetus before birth. A dose in each pregnancy is therefore recommended even when a woman has been vaccinated previously.
Other discussions centered on possible adverse effects. A pregnant user described nausea, vomiting, diarrhea, chills, and other symptoms after receiving Tdap and asked whether others had experienced a similar reaction. Such posts illustrate how people may turn to peer communities when they need immediate context for symptoms but cannot quickly reach a clinician. Tdap can cause common short-term reactions such as pain at the injection site, fatigue, headache, fever, or muscle aches. Serious adverse events are rare, but symptoms during pregnancy can be especially alarming because they may be interpreted as threats to the fetus. The researchers say healthcare professionals should explain expected reactions in advance and clearly distinguish them from symptoms requiring medical evaluation.
The analysis also identified a smaller number of posts expressing reluctance or refusal. One pregnant woman wrote that her doctor had repeatedly recommended Tdap but that she declined it at every appointment. However, compared with online conversations about several other vaccines, the researchers found fewer overtly negative views or explicit examples of vaccine hesitancy. Rather than treating every question as evidence of opposition, the findings suggest that many pregnant women are attempting to evaluate risk, reconcile conflicting information, and understand how vaccination affects their newborn. That distinction may matter for public health communication: a patient asking whether a vaccine is safe is not necessarily refusing it, but may need a precise explanation grounded in both evidence and personal circumstances.
A recurring topic was whether partners, relatives, and friends should also receive Tdap before meeting the baby. In some posts, pregnant women described disagreements with family members who were unwilling to be vaccinated or who believed that a previous dose protected them for a decade. These conversations reflect the concept of “cocooning,” in which people surrounding an infant are vaccinated to reduce the chance of transmitting pertussis. Although maternal vaccination is the primary strategy for transferring antibodies before birth, immunizing close contacts can provide an additional layer of protection, particularly because adults may carry and transmit pertussis without recognizing the infection. At the same time, recommendations for previously vaccinated adults can vary according to national guidance, exposure history, and the specific circumstances of the newborn, making individualized clinical advice important.
The researchers caution that Reddit cannot be treated as a representative survey of pregnant women in the United States. The sample included only 86 posts, all written in English, and the authors could not independently verify the identity, medical history, vaccination status, or clinical outcomes of the people posting. Reddit users may also differ from the broader population in age, health literacy, access to care, and willingness to discuss sensitive experiences publicly. Nevertheless, qualitative analysis of online conversations can identify recurring questions that conventional vaccination statistics cannot show. The posts provide a window into the moments when patients feel uncertain—after receiving conflicting advice, while experiencing symptoms, or when trying to persuade a hesitant relative to help protect a newborn.
Jo and colleagues recommend that healthcare providers present maternal Tdap as part of routine prenatal care while addressing the specific issues that appeared repeatedly in the discussions: safety, the ideal timing of vaccination, the reason a dose is recommended during each pregnancy, and the mechanism by which antibodies protect the infant. They also argue that public health campaigns should speak to family members and other close contacts, rather than placing the entire burden of education on pregnant women. Clear explanations could help transform online searches from a source of anxiety into a starting point for informed conversations with clinicians. As pertussis continues to threaten infants during the narrow interval before their own immunizations begin, understanding the questions people ask may be as important as repeating the recommendation itself.
Subject of Research: People
Article Title: Pregnant women’s needs regarding the Tdap vaccine: Insights from Reddit discussions
Web References: https://doi.org/10.1371/journal.pgph.0006924
References: Jo S, Ringenberg TR, Hurley JW (2026) Pregnant women’s needs regarding the Tdap vaccine: Insights from Reddit discussions. PLOS Global Public Health 6(8): e0006924.
Keywords: maternal Tdap vaccine, pregnancy, pertussis, whooping cough, maternal immunization, newborn protection, vaccine communication, Reddit, passive immunity, public health
