Vaccination during pregnancy: A golden opportunity to embrace

Abstract

Immunization strategies are part of routine pregnancy care to prevent infectious diseases in the mother, the fetus, and the newborn. Maternal immunization recommendations followed the recognition of the consequences of infectious diseases in pregnancy, including vertical transmission and perinatal consequences. The recent COVID‐19 pandemic highlighted the issue of vaccination among pregnant individuals. Recommendations vary globally; however, Tdap, influenza, and, recently, COVID‐19 vaccines are routinely recommended during pregnancy. There are several new maternal immunization products in the pipeline, including those directed against malaria, cytomegalovirus, Group B Streptococcus, herpes simplex virus, and respiratory syncytial virus. Important challenges must be addressed in all countries to guarantee that pregnant individuals and their babies receive the best care possible, including uptake of recommended immunizations by their entire target population groups. These challenges include disseminating appropriate data for vaccine recommendations and many others, such as ensuring stakeholder endorsement, achieving in‐country distribution and administration, adequate vaccine supply, and a well‐organized healthcare system, ideally offering the immunization free of charge. More recently, the hesitancy of pregnant women to receive immunizations highlights the relevance of cultural aspects and other contextual factors affecting vaccine uptake among pregnant individuals.

Safety and Benefits of COVID-19 Vaccination in Pregnancy—Implications for the Maternal Vaccination Platform

“…Similar studies demonstrate the immunogenicity, effectiveness, and infant protection conferred by maternal vaccination . It is, therefore, disappointing that the uptake of COVID-19 vaccination in pregnancy remains suboptimal …”

“…How then do we encourage vaccination in pregnancy, against COVID-19 infection and other pathogens that threaten the health of mothers and infants? Certainly, studies such as those reported here and others reporting the longitudinal surveillance of safety, immunogenicity, and effectiveness are critical . Strong partnerships and visible support from trusted organizations such as the World Health Organization and national and professional organizations such as the Centers for Disease Control and Prevention, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and their international counterparts are important .…”

“…The impact of these robust study results can be applied not only to COVID-19 vaccination but to the benefits of other maternal vaccines currently recommended and those on the horizon . Safe and effective vaccines such as the COVID-19 vaccine should provide confidence in the maternal vaccination program where maternal vaccines provide protection for mothers and neonates against potentially devastating infections.…”

“…Reasons for these poor vaccination rates include safety concerns despite years of safety data, lack of awareness of risk for severe morbidity and mortality associated with influenza in pregnancy, and lack of knowledge that maternal vaccination protects the newborn when the newborn is most vulnerable before vaccination at 6 months of age. Maternal tetanus, diphtheria, and acellular pertussis vaccine also recommended during each pregnancy has robust safety data while demonstrating excellent protection for infants again when they are most vulnerable to death before 2 months of age . Recent data show that maternal vaccination uptake is low for all recommended vaccines, suggesting that greater efforts are needed to provide education about the harmful effect of these diseases on pregnancy specifically as well as to broadly message the safety data that emerges from real-world use .…”

“…Maternal tetanus, diphtheria, and acellular pertussis vaccine also recommended during each pregnancy has robust safety data while demonstrating excellent protection for infants again when they are most vulnerable to death before 2 months of age . Recent data show that maternal vaccination uptake is low for all recommended vaccines, suggesting that greater efforts are needed to provide education about the harmful effect of these diseases on pregnancy specifically as well as to broadly message the safety data that emerges from real-world use . In initial clinical trials, the maternal respiratory syncytial virus (RSV) vaccine effectively prevents severe and life-threatening RSV infection in neonates through the robust transfer of maternally derived antibodies .…”