All pregnant women should be immunized against whooping cough during each pregnancy to protect their newborns from the disease, the CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended.

Clinicians should administer combined tetanus-diphtheria-pertussis vaccine (Tdap) to all pregnant women, regardless of their vaccination history, during the the third or late second trimester, the committee decided in a 14-0 vote. One member of the committee abstained from voting.

The new ACIP recommendations replace 2011 guidance urging all pregnant women, who have not previously been vaccinated, to get a Tdap shot during pregnancy or immediately postpartum, and comes during an ongoing pertussis outbreak that has lead to 32,645 U.S. pertussis cases and 16 deaths as of Oct. 12.

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Health officials believe the U.S. is on track to see the highest number of reported pertussis cases since 1959, with the majority of related deaths occurring in infants.

Administering Tdap during pregnancy confers higher levels of pertussis antibodies to newborns and is safe, yet currently only 2.6% of women receive the vaccination during pregnancy.

“By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines,” the CDC wrote in a press release.

The diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) is administered in five doses at ages 2, 4, 6, and 15 to 18 months, with a final dose administered from ages 4 to 6 years, but before the child starts school.

Mathematical models presented to the ACIP project that vaccinating women with Tdap during pregnancy could reduce pertussis cases by 33%, hospital admissions by 38% and mortality by 49% compared to not vaccinating at all.

ACIP recommendations are not finalized until accepted by the director of the CDC and published in Morbidity and Mortality Weekly Report, and are considered provisional until this time; however, all previous ACIP recommendations have been accepted.