Maternal Immunization Research Articles

Feasibility, acceptability, and preliminary efficacy of yoga to improve maternal mental health and immune function during the COVID-19 crisis (Yoga-M2 trial): a pilot randomized controlled trial.

Women are vulnerable during pregnancy as they experience multiple physical and psychological problems which can lead to stress and poor quality of life ultimately affecting the development of the fetus and their health during and after pregnancy. Prior evidence suggests that prenatal yoga can improve maternal health and well-being and can have a beneficial effect on immune system functioning. To date, no study has been conducted in a rural, low-resource setting in India to assess the feasibility, acceptability, and preliminary efficacy of a yoga-based intervention on perceived stress, quality of life, pro-inflammatory biomarkers, and symptoms of upper respiratory tract infections. To address this gap and assess whether a yoga-based intervention could improve maternal mental health and immunity during the COVID-19 crisis (Yoga-M2 trial), a single-blind individual randomized parallel group-controlled pilot trial with a 1:1 allocation ratio was implemented. We randomly allocated 51 adult pregnant women, with gestational age between 12-24 weeks in the Yoga-M2 arm (n = 25) or the enhanced usual care arm (EUC) (n = 26). Feasibility and acceptability were assessed using the process data and In-Depth Interviews (IDIs) with the trial participants and yoga instructors. Multiple linear regression was used to compare follow-up scores for quantitative outcomes. A three-month follow-up assessment was completed for 48 out of 51 participants (94.12%). We did not find any statistically significant difference between both arms in total Perceived Stress Scale scores, quality of life (Eq-5D-5L index), and serum C Reactive Protein levels at the three-month follow-up assessment. The critical barriers to practicing yoga were lack of knowledge about the benefits of yoga, lack of 'felt need' to practice yoga, lack of time to practice, lack of space, lack of transport, and lack of peer group to practice yoga. Despite this, women who regularly practiced yoga described the benefits and factors which motivated them to practice regularly. The learnings from this trial will help design the explanatory trial in the future and the study findings can also be used by the primary health care system to deliver yoga-based interventions in the newly created health and wellness centers. This trial was prospectively registered with the Clinical Trials Registry of India on 25 January 2022. https://www.ctri.nic.in/Clinicaltrials/showallp.php?mid1=65173&EncHid=&userName=CTRI/2022/01/039701. Trial registration number: CTRI/2022/01/039701.

Oral and intranasal Ad5 influenza vaccination induces hemagglutinin-specific and influenza neutralizing antibodies in serum and milk of pregnant and lactating ferrets

Abstract Pregnant women and young children are at increased risk for severe influenza infection. While there are intramuscular (IM) inactivated influenza vaccines available to pregnant individuals, IM immunization may not be an ideal route to boost neutralizing antibodies in breastmilk (BM). Therefore, innovative vaccine strategies are needed to increase BM antibodies that promote neonatal protection against influenza. We hypothesize that maternal mucosal immunization stimulates a protective influenza-specific antibody response, by generating antibodies in both blood and BM. To test this, we immunized pregnant and lactating ferrets at two weeks prepartum and two weeks postpartum with an H1N1 hemagglutinin (HA) adenovirus type 5 (Ad5) vaccine via oral or intranasal routes. We detected HA-specific IgG antibodies in dam serum and HA-specific IgG and IgA antibodies in secreted milk after oral and intranasal immunization by ELISA and chemiluminescence assays. We demonstrated that serum and BM from oral and intranasally immunized dams neutralized influenza virus in vitro. Additionally, ferret kits born to oral and intanasally immunized dams had HA-specific IgG antibodies in circulation at 5–6 weeks of life. These preclinical data led to the announcement by Vaxart, Inc. that they will test their oral tablet vaccine in human lactating mothers to determine if vaccination induces BM antibodies. Future work includes using our ferret model to determine the relationship between BM antibody quantity and function and neonatal protection against influenza. An easy-to-deliver mucosal vaccine that boosts systemic and mucosal protective antibodies in the maternal-neonatal dyad is an ideal strategy for protection of these vulnerable populations. Bill and Melinda Gates Foundation grant INV-22595D

Kecemasan Orang Tua dan Imunisasi Dasar dimasa Pandemi Covid-19

The COVID-19 pandemic situation has led to the temporary closure and/or delay of immunization services for community health centers in some areas. Parental anxiety about the risk of COVID-19 transmission is one of the factors in reducing immunization achievements, especially basic immunization. Parents' anxiety about the risk of COVID-19 transmission at this time is an obstacle that makes parents send their children for immunization. The purpose of this study was to determine the relationship between parental anxiety and completeness of basic immunization for infants during the Covid-19 pandemic at the Menteng Health Center. The design of this study used a cross sectional design. This research was conducted at the Menteng Health Center in July 2022. The population of this study were parents who had babies 0-12 months at the Menteng Health Center, Palangka Raya city and the sample size was 60 people using purposive sampling technique. . The test used in this study is the Chi-square test. The results showed that there was a relationship between maternal anxiety and immunization for infants during the COVID-19 pandemic (p value = 0.006 < 0.05). Therefore, for Puskesmas to improve health promotion regarding the importance of immunization, as well as socialize a series of health guidelines and protocols, such as the Guidelines for Immunization Services during the COVID-19 Pandemic for the provision of safe immunization services, safe immunization practices, and implementation of Standard Operating Procedures. Infection Prevention and Control in public health centres.

The non-specific effects of maternal immunization on birth outcomes: The evidence, mechanisms, and the implications.

Preterm birth (PTB) and stillbirth remain two of the most important causes of death, morbidity, and disability in childhood. Despite efforts to reduce PTB and stillbirth worldwide, rates of these adverse outcomes remain persistently elevated, independent of income setting. There is an urgent need for more effective interventions to reduce associated neonatal and early childhood morbidity and mortality. Maternal vaccines are a well-established strategy used for prevention of pathogen-specific disease in mothers and infants through transplacental antibody transfer. Beyond these pathogen-specific benefits, some studies have also identified non-specific effects (NSEs) of maternal vaccination protecting against several adverse birth outcomes, including PTB and stillbirth. This paper will review the evidence supporting the NSEs of maternal vaccination on birth outcomes, describe the possible underlying mechanisms, outline the research gaps, and summarize the significance from a global health perspective.

Influence of Timing of Maternal Pertussis Immunization on the Avidity of Transferred Antibodies in Term and Preterm Neonates.

The timing of maternal pertussis vaccination influences the titers of cord-blood anti-pertussis antibodies. Whether it affects their avidity is unknown. We demonstrate in 298 term and 72 preterm neonates that antibody avidity is independent of the timing of maternal vaccination, whether comparing second with third trimester or intervals before birth.

Evaluation of Pertussis Antibody Levels (Anti-PT IgG-Anti-FHA IgG) and Associated Factors in Maternal and Cord Blood

Pertussis has a very high mortality and morbidity rate in early infancy. There are many strategies to protect babies from pertussis, maternal immunization is one of them. In this study, it was aimed to evaluate pertussis toxin immunoglobulin G (anti-PT IgG) and filamentous hemagglutinin immunoglobulin G (anti-FHA IgG) levels of pertussis antibody in maternal and cord blood samples and also to evaluate the factors that may be associated with maternal antibody positivity. This descriptive study was conducted between 1 July and 31 October 2020. In the study, anti PT IgG and anti-FHA IgG levels were investigated by enzyme-linked immunosorbent assay (ELISA) method in 154 maternal and 154 cord blood samples. Microbiological analyzes were performed in Hacettepe University Faculty of Medicine Central Laboratory and results of 10 IU/mL and above were considered positive. Factors that could affect antibody positivity were questioned with the data collection form. "Package for Social Sciences (SPSS)" package program version 25.0 was used for statistical analysis of the data. Chi-square and Fisher's exact tests were used for statistical analysis of categorical variables. Continuous numerical variables were analyzed with the Pearson correlation test. Logistic regression analysis was used to evaluate the factors affecting positivity. The natural logarithm of the continuous variables was taken to ensure their conformity to the normal distribution, and conformity to the normal distribution was evaluated with the Kolmogorov-Smirnov test. The results were presented at a 95% confidence interval, at a significance level of p<0.05. The mean age of the mothers included in the study was 30. Of newborn babies, 52.6% were girls and 98.7% had normal birth weights. Of deliveries, 95.5% were term and 82.5% were cesarean section. Anti-PT IgG positivity and anti-FHA IgG positivity in maternal blood were 18.8% and 48.1%, respectively. Anti-PT IgG and anti-FHA IgG positivity in cord blood samples were 38.3% and 55.8%, respectively. Anti-PT IgG positivity was 2.6 times higher in mothers who had healthcare worker relatives compared to those who did not. Anti-FHA IgG positivity was 3.2 times higher in mothers aged 25 and younger than in mothers aged 26- 35. In addition, mothers aged 36 and over were 4.4 times more anti-FHA IgG positive than the mothers aged 26-35. Anti-FHA IgG antibody positivity was found 7.3 times more in those living in extended families than those living in nuclear families. Anti-PT IgG and anti-FHA IgG levels in maternal and cord blood samples were highly positively correlated. Mothers in the study had low pertussis antibody levels, indicating that newborns are at risk for infection. Maternal immunization with pertussis-containing vaccine is the most appropriate and cost-effective strategy to protect the newborn against pertussis. Many countries have been using pertussis-containing vaccines in maternal immunization safely for many years. Replacing the tetanus-diphtheria vaccine (Td), which is included in the routine pregnancy immunization program in Türkiye, with tetanus-diphtheria-pertussis (Tdap) may be appropriate to protect the mother and newborns from pertussis infection.

Characterization of maternal immunity following vaccination of broodstock against IHNV or Flavobacterium psychrophilum in rainbow trout (Oncorhynchusmykiss)

Infectious hematopoietic necrosis (IHN) is a significant viral disease affecting salmonids, whereas Flavobacterium psychrophilum (Fp), the causative agent of bacterial coldwater disease (BCWD), remains one of the most significant bacterial pathogens of salmonids. We explored maternal immunity in the context of IHN and BCWD management in rainbow trout (Oncorhynchus mykiss) aquaculture. Two experimental trials were conducted where different groups of female broodstock were immunized prior to spawning with an IHNV DNA vaccine or a live attenuated F. psychrophilum (Fp B.17-ILM) vaccine alone, or in combination. Progeny were challenged with either a low or high dose of IHNV at 13 days post hatch (dph) and 32 dph or challenged with F. psychrophilum at 13 dph. Mortality following a low-dose IHNV challenge at 13 dph was significantly lower in progeny from vaccinated broodstock vs. unvaccinated broodstock, but no significant differences were observed at 32 dph. Mortality due to BCWD was also significantly reduced in 13 dph fry that originated from broodstock immunized with the Fp B.17-ILM vaccine. After vaccination broodstock developed specific or neutralizing antibodies respectively to F. psychrophilum and IHNV; however, antibody titers in eggs and fry were undetectable. In the eggs and fry mRNA transcripts of the complement components C3 and C5 were detected at much higher levels in progeny from vaccinated broodstock and showed a significantly increased and rapid response post-challenge compared with unvaccinated broodstock. After challenges pro-inflammatory cytokine expression was immediately and considerably elevated in the fry from vaccinated broodstock vs. unvaccinated broodstock, whereas adaptive immune genes were elevated to a lesser degree. Results suggest that maternal transfer of innate and adaptive factors at the transcript level occurred because development of lymphomyeloid organs is not complete in such young fry. In addition to documenting maternally derived immunity in teleosts, this study demonstrates that broodstock vaccination can confer some degree of protection to progeny against viral and bacterial pathogens.

Maternal tributyrin supplementation in late pregnancy and lactation improves offspring immunity, gut microbiota, and diarrhea rate in a sow model.

Several studies have evaluated the effects of tributyrin on sow reproductive performance; however, none of these studies have investigated the effects of tributyrin on sow gut microbiota and its potential interactions with immune systems and milk composition. Therefore, we speculated that tributyrin, the combination of butyrate and mono-butyrin without odor, would reach the hindgut and affect the intestinal microbiota composition and play a better role in regulating sow reproductive performance, gut flora, and health. Thirty sows (Landrace × Yorkshire) were randomly divided into two groups: the control group (CON) and the tributyrin group (TB), which received basal diet supplemented with 0.05% tributyrin. The experimental period lasted for 35 days from late pregnancy to lactation. The results showed that TB supplementation significantly shortened the total parturition time and reduced the diarrhea rate in suckling piglets. On day 20 of lactation, the milk fat and protein levels increased by 9 and 4%, respectively. TB supplementation significantly improved the digestibility of dry material, gross energy, and crude fat in the sow diet, but had no significant effect on crude protein digestibility. Furthermore, TB supplementation increased the levels of IL-10, IL-6, and IgA in the blood of weaned piglets, but had no effect on maternal immunity. Analysis of the fecal microbial composition revealed that the addition of TB during late gestation and lactation increased the microbiota diversity in sows and piglets. At the phylum level, sows in the TB group had a slight increase in the relative abundance of Bacteroidota and Spirochaetota and a decrease in Firmicutes. At the order level, the relative abundance of Lactobacillales was increased in piglets and sows, and the TB group showed increased relative abundance of Enterobacterales and significantly decreased relative abundance of Oscillospirales in piglets. At family level, the relative abundance of Lactobacillaceae, Oscillospiraceae, and Christensenellaceae increased in sows, and the relative abundance of Enterobacteriaceae and Lactobacillaceae increased in piglets. At genus level, the relative abundance of Lactobacillus increased in sows and piglets, but the relative abundance of Subdoligranulum and Eubacterium_fissicatena_group decreased in piglets in the TB group. In conclusion, tributyrin supplementation shortened the farrowing duration and reduced the diarrhea rate of piglets by improving the inflammatory response and composition of gut microbiota in piglets and sows.

Protective effect of maternal immunization on birth outcomes: A data linkage study.

To explore the impact of maternal immunization on adverse pregnancy outcomes including preterm birth (PTB) and stillbirth. The authors performed a data linkage study for women who delivered a singleton baby between January 2017 and May 2021. They used Poisson models to estimate incidence rates of adverse pregnancy outcomes and Cox proportional hazards models to estimate hazard ratios (HRs) with 95% confidence intervals (CIs), accounting for the time-dependent nature of the exposure and adjusting for confounders. This study included 10 938 women who received at least one vaccine, and 4029 unvaccinated women. Influenza vaccine was associated with a significant reduction in stillbirth (adjusted HR [aHR], 0.55 [95% CI, 0.33-0.94]), but not in PTB (aHR, 0.92 [95% CI, 0.77-1.10]). Pertussis vaccine was associated with a significant reduction in PTB (aHR, 0.78 [95% CI, 0.64-0.94]) and a similar point estimate for reduction in stillbirth (aHR, 0.59 [95% CI, 0.31-1.10]), although not significant. Reductions in PTB and stillbirth associated with maternal immunization suggest possible protective effects beyond pathogen-specific protection. These findings may strengthen justification for scaling up maternal immunization in low-income settings where there remains a high burden of these adverse pregnancy outcomes.

Protective efficacy of a recombinant enterotoxin antigen in a maternal immunization model and the inhibition of specific maternal antibodies to neonatal oral vaccination

ETEC (enterotoxigenic Escherichia coli) infection is the leading cause of profuse watery diarrhea in mammals, especially among pre-weaning and post-weaning piglets in swine industry. Maternal immunization is a current rational strategy for providing protection to susceptive piglets and reducing the incidence of ETEC-associated diarrhea. Here we evaluated the protective efficiency of a recombinant antigen (MBP-SLS) fused by major enterotoxin subunits (STa-LTB-STb) via a maternal immunization model, and the impacts of maternal antibodies to neonatal oral vaccination were also investigated in the neonates. The high titers of specific IgG and sIgA in pups shown that the maternal antibodies could be transferred passively. Furthermore, the increases of IL-6 and IL-10 cytokines in breast milk and pup serum indicated that immunization on mother could effectively boost the immune system of neonates. Newborn rats from immunized mothers showed a 70% survival rate after ETEC infection. However, the mucosal immune responses of neonates were inhibited by the high level of maternal specific antibodies. Among the oral-vaccinated neonates, born from mock-immunized rats reached the highest survival after ETEC challenge. Collectively, the fusion MBP-SLS antigen could effectively induce strong immune responses in rats during pregnancy and the pups could receive passive protection through specific antibodies transferred via milk and placenta. However, the specific maternal antibodies exhibited an inhibition effect on the mucosal immune responses in offspring.

Preclinical development of a novel Group B Streptococcus (GBS) vaccine candidate for maternal immunization based upon the alpha-like protein family of GBS surface proteins (Alp).

A novel Group B Streptococcus (GBS) vaccine, based upon the GBS alpha-like surface proteins, is being developed by MinervaX for administration to pregnant women. The vaccine is intended to generate antibodies (IgG) capable of crossing the placenta, in order to passively immunize the baby and provide protection in utero and up to 3 months after birth. An initial vaccine candidate, GBS-NN (based on the N-terminal domains of Rib and AlphaC surface proteins) was replaced, due to insufficient cross-reactivity with the two other N-terminal proteins (Alp1 and Alp2/3), by a modified vaccine candidate designated GBS-NN/NN2 that included all four AlpNs. Preclinical studies raised no safety concerns and the subsequent Phase I clinical trial demonstrated that the vaccine was well tolerated and strongly immunogenic. As the vaccine is intended for use during pregnancy for maternal immunization, an embryofetal study in rats and a fertility and embryofetal study in rabbits were performed, in both cases using GBS-NN/NN2. Vaccination of female rats or rabbits did not adversely affect embryofetal development or survival in either species, or mating or fertility in rabbits. In both studies, the pregnant animals developed immune responses to GBS-NN and GBS-NN2 proteins and concentrations of antibodies to both fusion proteins were detected in the fetuses and in the amniotic fluid. Data generated during these reproductive studies indicated a suitable safety margin (approximately 40-fold clinical dose) considered appropriate to support a subsequent human trial of GBS-NN/NN2 administered in the second and third trimesters of pregnancy.

RESPIRATORY SYNCYTIAL VIRUS PATHOLOGY, TREATMENT AND POSSIBILITY OF PROPHYLAXIS BY VACCINATION

Background: Respiratory Syncytial Virus (RSV) is one of the main causes of morbidity and mortality among children under one year old, in the context of lower respiratory tract infections (LRTIs) of viral etiology. RSV belongs to the family Pneumoviridae, order Mononegavirales and is a filamentous enveloped virus in the genus Orthopneumovirus. Methods: We screened PubMed, PubMed Central (PMC), ScienceDirect and Google Scholar clinical trials in different phases and several national and international guidelines on the subject of treatment and prevention of RSV infections, using specific keywords. Results: Several methods have been tried over time to achieve primary prophylaxis in the case of RSV. Longacting monoclonal antibodies (mAbs), active immunization of children and passive immunization of newborns through maternal immunization were among the tested methods. For the geriatric and immunocompromised patients, three approaches were used in the search for a vaccine: nucleic acids, subunits of the nucleic acids and other vectors to create a safe and efficient product. For the groups at risk, RSV immunization would be the most efficient form of prevention. As a result, understanding the viral structure and its interaction at the cellular level is critical. The virus can connect to a variety of receptors, demonstrating the complexity of the pathogenic process by which it expresses itself, CX3 chemokine receptor 1 (CX3CR1), annexin II and Toll-like receptors being among the most well-known. Conclusions: Although multiple vaccines are being tested in clinical trials for neonates, geriatric patients and patients with comorbidities, none is currently licensed. Palivizumab, a monoclonal antibody authorized in 1998, is now used for prophylaxis.

Impact Laying Times of Broiler Breeder Supplement with Aromatic Oils (Miarom) in drinking water on Hatchability, Maternal immunity and serum antioxidant and antioxidant Statues hatched chicks

Adding aromatic oils (Miarom) in drinking water of broiler breeder was evaluated experimentally of its effect on hatchability percentage, immunity, Lipid profile, and biochemical traits at different laying times (10:00 AM and 02:00 PM). A total of 3600 eggs of broiler breeder (Ross-308) at age 60 weeks, were collected and divided into 5 treatments of different times of egg collection and laying times as follows: (T1: General Control, T2: Control 10:00 AM, T3: Control 02:00 PM, T4: Miarom 10:00 AM and T5: Miarom 02:00 PM). Results indicated the used Miarom from Miavit company - Germany (this extract contains: 200 grams essential oils mixture such as eucalyptus oil, anise oil, thyme oil, and peppermint oil) per litter it added in drinking water 1ml/10L for 7 days. The results of this study showed (p≤0.01) increased in hatching traits percentage, chick’s antibody titer against Newcastle Disease (ND) and Infectious Bronchitis Virus (IBV) by ELISA, high-density lipoprotein HDL, total protein and glutathione GSH-Px antioxidant enzyme. Also, significantly (p≤0.01) reduced infertile eggs, triglycerides TG, total cholesterol TCH, low-density lipoprotein LDL, corticosterone hormone, and malondialdehyde antioxidant enzyme. In conclusion, results showed that aromatic oils supplementation in broiler breeders leads to improve hatchability and immune status at different laying times, noticed that both Miarom treatments had a positive effect on studied parameters and T4 10:00 AM laying time was most effective in all parameters of the study.&#x0D; &#x0D;

Faktor Determinan Kejadian Stunting pada Balita Usia 24-59 Bulan

Background: Stunting is still one of the most common and unresolved nutritional problems, in Margasari District stunting cases increased in August 2020. The purpose of this study was to analyze the factors associated with stunting in toddlers aged 24-59 months in the working area of the Margasari Health Center. Methods: This study uses an observational analytic quantitative research type with a case control design. Sampling using non-random sampling technique with purposive sampling method and a sample of 98 toddlers consisting of 49 children in the case and control groups. Data analysis consisted of chi-square test and Odds Ratio. This study uses secondary data from the mother's KIA book and primary data through interviews. Results: The results of the analysis showed that the factors that had a significant relationship with the incidence of stunting in toddlers were family income (P = 0.026; OR = 2.729), mother's educational status (p = 0.037; OR = 2.658), exclusive breastfeeding (p = 0.043; OR = 2.510 ), complementary foods (p=0.002; OR=4,240), and energy intake (p=0.004; OR=5,110). While the factors that were not significantly related were maternal employment status (p = 0.492; OR = 1.524), diarrhea (p = 0.074; OR 3.932), immunization status (p = 1000; OR = 0.652), and low birth weight (p = 0.678; OR = 0.479). Conclusion: This study suggests to the government to create an effective stunting prevention program, besides that the community is expected to increase knowledge about nutrition before deciding to have children.

Inequalities in Immunization against Maternal and Neonatal Tetanus: A Cross-Sectional Analysis of Protection at Birth Coverage Using Household Health Survey Data from 76 Countries.

Substantial progress in maternal and neonatal tetanus elimination has been made in the past 40 years, with dramatic reductions in neonatal tetanus incidence and mortality. However, twelve countries have still not achieved maternal and neonatal tetanus elimination, and many countries that have achieved elimination do not meet key sustainability thresholds to ensure long-lasting elimination. As maternal and neonatal tetanus is a vaccine-preventable disease (with coverage of the infant conferred by maternal immunization during and prior to pregnancy), maternal tetanus immunization coverage is a key metric for monitoring progress towards, equity in, and sustainability of tetanus elimination. In this study, we examine inequalities in tetanus protection at birth, a measure of maternal immunization coverage, across 76 countries and four dimensions of inequality via disaggregated data and summary measures of inequality. We find that substantial inequalities in coverage exist for wealth (with lower coverage among poorer wealth quintiles), maternal age (with lower coverage among younger mothers), maternal education (with lower coverage among less educated mothers), and place of residence (with lower coverage in rural areas). Inequalities existed for all dimensions across low- and lower-middle-income countries, and across maternal education and place of residence across upper-middle-income countries. Though global coverage changed little over the time period 2001-2020, this obscured substantial heterogeneity across countries. Notably, several countries had substantial increases in coverage accompanied by decreases in inequality, highlighting the need for equity considerations in maternal and neonatal tetanus elimination and sustainability efforts.

Knowledge, Attitudes, and Practices Concerning Maternal Immunization Among Pregnant/Postpartum Women and Health Care Professionals in Peru.

For pregnant women, vaccination with inactivated influenza vaccine (IIV) and tetanus, diphtheria, acellular pertussis vaccine (Tdap) is recommended. In Peru, uptake is nonetheless low. A study was conducted to identify factors affecting maternal vaccination coverage. The study's primary objectives were to describe the knowledge, attitudes, and practices regarding maternal immunization among pregnant/postpartum women and health care professionals (HCPs). The secondary objective was to determine the vaccination coverage and the impact of Ministry of Health (MOH) recommendations. An observational multicenter, cross-sectional survey study was conducted from February1, 2021 to June30, 2021 in five cities in Peru. Two surveys were conducted to assess knowledge, attitudes, and practices concerning maternal immunization: one among pregnant/postpartum women and one among HCPs. Participants were 668 pregnant/postpartum women with a mean age of 29.6years and 219 HCPs-mostly midwives (46.6%) and obstetricians/gynecologists (44.7%). Of the pregnant/postpartum women, 66.9% knew that, in general, vaccinations are given for prevention, and 98.5% believed vaccines are important. Nonetheless, 69.6% of pregnant/postpartum women had poor or moderate knowledge of maternal vaccination. Disease knowledge of influenza (89.1%) and tetanus (87.0%) was high, while knowledge of pertussis (37.7%) was low. Women agreed/strongly agreed that they would get vaccinated with Tdap if a doctor (96.3%), midwife (88.9%), or nurse (72.0%) recommended it. Of the HCPs, 81.3% routinely recommended Tdap vaccination for pregnant women. To enhance vaccine acceptance in pregnant women in Peru, we must improve knowledge of the diseases, MOH recommendations, and benefits of the offered vaccinations. HCPs could provide this vaccination knowledge and information along with their vaccination recommendation as the pregnant/postpartum women indicated they would take the vaccines if recommended by their HCPs. Our findings are important for the successful implementation of maternal immunization programs in Peru.

Safety of COVID-19 vaccines in pregnancy: a VAERS based analysis

PurposeSince vaccination against COVID-19 is recommended in pregnant people, we aimed to provide further evidence on the safety profile of COVID-19 vaccines in pregnancy.MethodsData on COVID-19 vaccines adverse events following immunizations (AEFIs) in pregnant people were retrieved from the open-access Vaccine Adverse Event Reporting System (VAERS) from December 2020 to April 2022.ResultsFrom December 2020 to April 1, 2022, a total of 4,869 reports involving pregnant women at COVID-19 vaccination were reported to VAERS. Among vaccines recipients, most belonged to the age group between 30 and 39 years old (3,029; 62.21%) and nearly half experienced an adverse event within 48 h of immunization (2,344; 48.14%). Overall, 21,816 suspected adverse reactions associated with COVID-19 vaccines were reported, and for as many as 80.43% of patients, they were described as non-serious. Most reactions occurred after administration of the mRNA-1273 (53.34%) and the BNT162b2 (40.68%) vaccines, while only a small proportion were related to the Johnson & Johnson’s vaccine (5.69%). The most common non-pregnancy specific adverse events were headache (482; 2.21%), fatigue (472; 2.16%), and pyrexia (436; 2.00%), while adverse pregnancy outcomes with the highest reporting rate were abortions spontaneous (762; 3.49%), and vaginal haemorrhage (229; 1.05%).ConclusionThis post-marketing survey on VAERS data have provided updated evidence on the safety of COVID-19 vaccines during pregnancy, thus supporting clinicians in recommending maternal immunization.

Maternal immunization with pneumococcal surface protein A provides the immune memories of offspring against pneumococcal infection.

Streptococcus pneumoniae (S. pneumoniae) is one of the most widespread pathogens in the world and one of the largest infectious causes of infant mortality. Although current vaccines have various benefits, antibiotic resistance and the inability to vaccinate infants less than one year old demands the development of new protective strategies. One strategy, 'maternal immunization', is to protect infants by passive immunity from an immunized mother, although its mechanism is still not fully understood. The current study aimed to acquire immunity against S. pneumoniae in infants by maternal immunization with pneumococcal common antigen, pneumococcal surface protein A (PspA). Four-week-old female mice were immunized with recombinant PspA intranasally twice a week for three weeks. Females were mated with age-matched males after immunization, and delivered offspring. The week-old offspring derived from and fostered by immunized mothers had more anti-PspA-specific antibody producing cells in the spleen than those derived from sham-immunized mothers. The offspring were raised up to four weeks old and were subcutaneously stimulated with recombinant PspA. The levels of anti-PspA IgG in sera after stimulation were significantly higher in the offspring derived from the immunized mothers and the induced specific antibody to PspA showed protective efficacy against systemic pneumococcal infection. Maternal immunization is suggested to be able to provide a sustained immune memory to offspring. The current study would be a milestone in the field of maternal immunization toward a universal pneumococcal vaccine.

Household Vulnerability Dimensions, Maternal Health Practices and Childhood Immunization Status in Nigeria

Immunisation is considered one of the most cost-effective public health interventions for reducing childhood morbidity, mortality, and disability globally. However, while global achievement of over 70% coverage rates was sustained in the 1990s, wide variations exist between and within countries. In some developing countries, immunisation rates increased substantially, but in sub-Saharan Africa, immunisation rates plummeted, leaving millions of children vulnerable to life-threatening diseases. In Nigeria, coverage rates for routine immunisation of all antigens still fall below 50%. The study examined the overall influence of household vulnerability dimensions, maternal health practices on childhood immunization status in Nigeria. The study used secondary data from the 2013 Nigeria Demographic and Health Surveys (NDHS). The analytical weighted sample size was 5,824 women of reproductive ages (15-49 years) with a live birth in the past three years, whose children were within age 12-23 months at the time of the survey. The data were analyzed using frequency distribution, chi-square test and binary logistic regression. The results showed a decreasing regional variation in the proportion of fully immunized children from a high of 23.6% in the South-West, to a low of 9.1% in the North-East. The overall household vulnerability status showed that children in more and most vulnerable households were 62% (OR = 0.38; p &lt; 0.001; CI: 0.32-0.46) and 89% less likely (OR = 0.11; p &lt; 0.001; CI: 0.08-0.14) to receive full vaccination compared with their counterpart in non-vulnerable households. The study revealed a significant relationship between mothers’: i) Number of antenatal visits (OR = 1.66; p &lt; 0.05; CI: 0.25-23 1.77); ii) Quality of antenatal care (OR = 2.61; p &lt; 0.05; CI: 1.45-4.67); iii) Place of delivery (OR = 0.62; p &lt; 0.05; CI: 0.45-0.86); iv) Assistance during delivery (OR = 0.41; p &lt; 0.001; CI: 0.28-0.57); v) Time of postnatal check (OR = 1.81; p &lt; 0.001; CI: 1.49-2.19) and full childhood immunisation status. The study concluded that different dimensions of household vulnerability and maternal health-seeking behavior are key underlying factors of childhood immunization in Nigeria.

Establish a Pregnant Sow–Neonate Model to Assess Maternal Immunity of a Candidate Influenza Vaccine

While it is well appreciated that maternal immunity can provide neonatal protection, the contribution of maternal vaccination toward generating such immunity is not well characterized. In our previous work, we created a candidate influenza vaccine using our chimeric hemagglutinin (HA) construct, HA-129. The HA-129 was expressed as part of a whole-virus vaccine that was built on the A/swine/Texas/4199-2/98-H3N2 backbone to generate the recombinant virus TX98-129. The TX98-129 candidate vaccine has the ability to induce broadly protective immune responses against genetically diversified influenza viruses in both mice and nursery pigs. In the current study, we established a pregnant sow-neonate model to evaluate the maternal immunity induced by this candidate vaccine to protect pregnant sows and their neonatal piglets against influenza virus infection. In pregnant sows, the results consistently show that TX98-129 induced a robust immune response against the TX98-129 virus and the parental viruses that were used to construct HA-129. After challenge with a field strain of influenza A virus, a significant increase in antibody titers was observed in vaccinated sows at both 5 and 22 days post challenge (dpc). The challenge virus was detected at a low level in the nasal swab of only one vaccinated sow at 5 dpc. Evaluation of cytokine responses in blood and lung tissue showed that levels of IFN-α and IL-1β were increased in the lung of vaccinated sows at 5 dpc, when compared to unvaccinated pigs. Further analysis of the T-cell subpopulation in PBMCs showed a higher ratio of IFN-γ-secreting CD4+CD8+ and CD8+ cytotoxic T cells in vaccinated sows at 22 dpc after stimulation with either challenge virus or vaccine virus. Finally, we used a neonatal challenge model to demonstrate that vaccine-induced maternal immunity can be passively transferred to newborn piglets. This was observed in the form of both increased antibody titers and deceased viral loads in neonates born from immunized sows. In summary, this study provides a swine model system to evaluate the impact of vaccination on maternal immunity and fetal/neonatal development.