Immunizing pregnant women against pertussis has been a powerful tool adopted in many countries to effectively reduce morbidity and mortality from whooping cough in young infants when they are most vulnerable to complications and death. One of the main trade-offs, however, may be that maternally derived antibodies modify or modulate the infant's own antibody responses to routine childhood vaccines, although whether this is both a quantitative and a qualitative phenomenon, and its long-term clinical and epidemiological implications remain largely unclear. This review will summarize our current understanding of the impact of pertussis vaccination during pregnancy not only on the quantity but also the quality and longevity of the infant's antibody responses to pertussis and non-pertussis-related vaccine antigens in the primary immunization series. We will discuss the underlying mechanisms proposed to explain how maternal antibodies may have a modulating effect, and the existing data across different settings on whether this phenomenon has had any significant clinical consequences. Finally, we will outline potential strategies to further explore and/or mitigate these interactions in the future, including the key gaps in knowledge that must still be addressed to fully optimize maternal and early childhood immunization programs worldwide.