Current Challenges and Achievements in Maternal Immunization Research

Muñoz, Flor M.

doi:10.3389/fimmu.2018.00436

Cited by 34 publications

(35 citation statements)

References 37 publications

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“…Maternal vaccination aims to reduce maternal and neonatal morbidity and mortality caused by infection [1]. The World Health Organisation (WHO) recommends the inactivated influenza, tetanus-toxoid-containing vaccine (TTCV), and combined tetanus, diphtheria, and acellular pertussis (Tdap) vaccines for pregnant women in settings where the disease burden is known [2]. Historically, maternal tetanus vaccination was limited to areas of significant transmission.…”

Section: Introductionmentioning

confidence: 99%

“…In areas where there is ongoing maternal to neonatal transmission of tetanus, two doses of TTCV (preferably Tetanus-diphtheria) are recommended in pregnancy in addition to Tdap or DTaP (for pertussis) and seasonal influenza vaccines. [2] Pertussis vaccination was limited to childhood, however the resurgence of pertussis during outbreaks that disproportionately affected younger infants led to national policy changes between 2011 and 2015 in countries such as the United Kingdom and the United States, that introduced routine maternal pertussis vaccination. [2,3] Similarly, the widespread influenza immunisation programs during the 2009 H1N1 pandemic resulted in public health bodies particularly in Europe, the United States and Australia introducing guidance to implement recommendations for routine antenatal seasonal influenza vaccination during the subsequent decade.…”

Section: Introductionmentioning

confidence: 99%

“…[2] Pertussis vaccination was limited to childhood, however the resurgence of pertussis during outbreaks that disproportionately affected younger infants led to national policy changes between 2011 and 2015 in countries such as the United Kingdom and the United States, that introduced routine maternal pertussis vaccination. [2,3] Similarly, the widespread influenza immunisation programs during the 2009 H1N1 pandemic resulted in public health bodies particularly in Europe, the United States and Australia introducing guidance to implement recommendations for routine antenatal seasonal influenza vaccination during the subsequent decade. The United States Healthy People 2020 campaign sets a target to achieve influenza vaccination coverage of 80% among pregnant women [4].…”

Section: Introductionmentioning

confidence: 99%

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Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis

et al. 2020

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Background The most important factor influencing maternal vaccination uptake is healthcare professional (HCP) recommendation. However, where data are available, one-third of pregnant women remain unvaccinated despite receiving a recommendation. Therefore, it is essential to understand the significance of other factors and distinguish between vaccines administered routinely and during outbreaks. This is the first systematic review and meta-analysis (PROSPERO: CRD 42019118299) to examine the strength of the relationships between identified factors and maternal vaccination uptake. Methods We searched MEDLINE, Embase Classic & Embase, PsycINFO, CINAHL Plus, Web of Science, IBSS, LILACS, AfricaWideInfo, IMEMR, and Global Health databases for studies reporting factors that influence maternal vaccination. We used random-effects models to calculate pooled odds ratios (OR) of being vaccinated by vaccine type. Findings We screened 17,236 articles and identified 120 studies from 30 countries for inclusion. Of these, 49 studies were eligible for meta-analysis. The odds of receiving a pertussis or influenza vaccination were ten to twelve-times higher among pregnant women who received a recommendation from HCPs. During the 2009 influenza pandemic an HCP recommendation increased the odds of antenatal H1N1 vaccine uptake six times (OR 6.76, 95% CI 3.12-14.64, I 2 = 92.00%). Believing there was potential for vaccine-induced harm had a negative influence on seasonal (OR 0.22, 95% CI 0.11-0.44 I 2 = 84.00%) and pandemic influenza vaccine uptake (OR 0.16, 95% CI 0.09-0.29, I 2 = 89.48%), reducing the odds of being

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis

et al. 2020

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“…The strategy to overcome this is to boost antibody levels by vaccination during pregnancy. At present, the World Health Organization (WHO) recommends maternal vaccination for tetanus, pertussis, and influenza [171]. It is crucial that women be vaccinated at a time that allows generation of a peak antibody response and thus optimal transfer of antibody to the infant.…”

Section: Maternal Vaccinationmentioning

confidence: 99%

Challenges for the Newborn Immune Response to Respiratory Virus Infection and Vaccination

Crofts

Alexander-Miller

2020

Vaccines

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The initial months of life reflect an extremely challenging time for newborns as a naïve immune system is bombarded with a large array of pathogens, commensals, and other foreign entities. In many instances, the immune response of young infants is dampened or altered, resulting in increased susceptibility and disease following infection. This is the result of both qualitative and quantitative changes in the response of multiple cell types across the immune system. Here we provide a review of the challenges associated with the newborn response to respiratory viral pathogens as well as the hurdles and advances for vaccine-mediated protection.

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“…Vaccination of pregnant women (maternal vaccination) can protect both the mother and her offspring from infection 1 . Pregnancy is associated with dynamic adaptions of the immune system throughout gestation to allow immunological tolerance of the developing foetus 2 .…”

Section: Introductionmentioning

confidence: 99%

Pregnancy has a minimal impact on the acute transcriptional signature to vaccination

et al. 2020

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Vaccination in pregnancy is an effective tool to protect both the mother and infant; vaccines against influenza, pertussis and tetanus are currently recommended. A number of vaccines with a specific indication for use in pregnancy are in development, with the specific aim of providing passive humoral immunity to the newborn child against pathogens responsible for morbidity and mortality in young infants. However, the current understanding about the immune response to vaccination in pregnancy is incomplete. We analysed the effect of pregnancy on early transcriptional responses to vaccination. This type of systems vaccinology approach identifies genes and pathways that are altered in response to vaccination and can be used to understand both the acute inflammation in response to the vaccine and to predict immunogenicity. Pregnant women and mice were immunised with Boostrix-IPV, a multivalent vaccine, which contains three pertussis antigens. Blood was collected from women before and after vaccination and RNA extracted for analysis by microarray. While there were baseline differences between pregnant and nonpregnant women, vaccination induced characteristic patterns of gene expression, with upregulation in interferon response and innate immunity gene modules, independent of pregnancy. We saw similar patterns of responses in both women and mice, supporting the use of mice for preclinical screening of novel maternal vaccines. Using a systems vaccinology approach in pregnancy demonstrated that pregnancy does not affect the initial response to vaccination and that studies in non-pregnant women can provide information about vaccine immunogenicity and potentially safety.npj Vaccines (2020) 5:29 ; https://doi.

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Current Challenges and Achievements in Maternal Immunization Research

Cited by 34 publications

References 37 publications

Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis

Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis

Challenges for the Newborn Immune Response to Respiratory Virus Infection and Vaccination

Pregnancy has a minimal impact on the acute transcriptional signature to vaccination

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