Maternal immunisation in pregnancy to protect newborn infants

Abstract

Although maternal tetanus immunisation has been effectively implemented for many years in the developing world,1 there has been a renewed global interest in maternal immunisation programmes over the past several years.2–5 This has been driven partly by the severity of the 2009 H1N1 influenza pandemic in pregnant women and the safety provided by the widespread maternal immunisation programme implemented in response to the pandemic.6 7 It has also been increasingly appreciated that maternal immunisations are an excellent way to provide protection to young infants before their own primary immunisation series would begin. There are several reasons that immunising pregnant women is an attractive vaccination strategy. First, by immunising the pregnant woman there is the potential to prevent the targeted infection in both the pregnant woman and her infant. This approach is often referred to as a ‘two-fer’ with protection for two individuals with the administration of only one vaccine. Second, there is a particular window of susceptibility in infants before the onset of infant immunisation that maternal immunisation could help to bridge. Third, during gestation, pregnant women are often more accessible to medical care than in other times of their lives, making vaccine implementation during this time more efficient. Finally, pregnant women should not be excluded from potentially beneficial vaccines based solely on their pregnancy status. They should ethically reap the benefits of effective vaccines. The goal of this report is to focus on four specific vaccines that are targeted for maternal immunisation. Two of the vaccines, influenza and pertussis, are already being administered to pregnant women as part of recommended national immunisation programmes. Two additional vaccines, group B Streptococcus (GBS) and respiratory syncytial virus (RSV) vaccines, are in clinical trials in pregnant women and it is anticipated that one or both would be available for routine use in the …