Chapter 4 - Immunobiological aspects of vaccines in pregnancy: Infant perspective

Abstract

Vaccination in pregnancy is an effective means of protecting infants from infections until the period of greatest susceptibility of severe disease has passed, or until protection has been achieved by routine infant vaccinations. However, it is becoming increasingly recognized that vaccination may have additional implications for the infant other than passive protection via placental antibody transfer. Here we consider two aspects of recent debate with regards to infant health following vaccination in pregnancy: Firstly, we discuss the potential interference of maternally-derived vaccine-specific antibody with infant responses to primary vaccination, and consider the underlying mechanisms for this inhibitory effect, the age at which it disappears, and the clinical implications; Secondly, it has been observed that significantly higher vaccine-specific secretory IgA is present in the breastmilk of women who have been vaccinated in pregnancy, and we therefore discuss the potential for additional protection to be conferred to the newborn via alteration of breastmilk composition.