The under appreciated need for maternal and newborn immunization: call to action

Abstract

In spite of clear evidence regarding the safety and efficacy of maternal and neonatal immunization, the accetance of maternal influenza and pertussis immunization and neonatal Hepatitis B vaccination has been disappointingly slow to reach optimal levels in the United States. Maternal influenza disease is associated with increased birth defects, premature delivery, and the delivery of small for gestational age infants. Influenza immunization has been recommended for all women who are or will be pregnant, regardless of trimester, during influenza season (October through May), but only about half receive them. Concerns about influenza immunization clearly overlook the solid data regarding the overall association between influenza immunization and decreased mortality and morbidity for both mothers and infants. Pertissis disease in infants under 2 months of age is associated with significantly increased morbidity and mortality. Pertussis incidence in the US has seen a significant increase in the past two decades in most age groups including that of parents and siblings. Recommended attempts to decrease infant pertussis infection include both maternal immunization and immunization of individuals who are expected to come in contact with these newborn infants (cocooning). Transmission of maternal Hepatitis B infection to their infants is associated with a significant incidence of chronic disease with subsequent cirrhosis and death. The administration of both Hepatitis B immune globulin and a “birth dose” of Hepatitis B vaccine have been demonstrated to be very safe and effective in preventing infant acquisition of Hepatitis B infection from infected mothers. A birth dose of Hepatitis B vaccine should be administered to every newborn.