Maternal Immunization

Omer, Saad B.; Jamieson, Denise J.

doi:10.1016/b978-0-323-35761-6.00036-5

Cited by 15 publications

(24 citation statements)

References 152 publications

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“…However, pregnant women are able to induce immune responses and immune memory similarly to non-pregnant women after natural infection and vaccination, suggesting that this concept was too simplistic [1,13]. Instead, the immune system appears to be modulated during pregnancy rather than actively suppressed, with the consequence that the risk increases only for some infections [6,10].…”

Section: The Immune System During Pregnancy and The Effect Of Maternamentioning

confidence: 99%

“…multiple sclerosis, rheumatoid arthritis) is often reduced during the third trimester of pregnancy, whereas the severity of diseases that are controlled by inflammatory responses (e.g. influenza, malaria, lupus) is increased [6]. The transition is associated with an alteration of the balance between type 1 (Th1) and type 2 (Th2) T helper cells, with a shift from Th1 (i.e.…”

Section: The Immune System During Pregnancy and The Effect Of Maternamentioning

confidence: 99%

“…Recommendations for maternal immunization have existed for decades, notably for preventing influenza in industrialized countries and tetanus in developing countries [4], but interest in maternal immunization has been recently raised worldwide, notably after the 2009-2010 H1N1 influenza pandemic and outbreaks of pertussis with associated infant deaths in several countries despite high vaccination coverage. Although wider acceptance of maternal immunization has been hampered by the perception that limited safety and efficacy data are available [5], a growing body of evidence suggests that maternal immunization against tetanus, pertussis and influenza has an acceptable safety profile, is effective, and confers significant benefits on pregnant women and their infants [6]. More proactive communication of these points to the healthcare community and the public could help support the acceptance of maternal immunization as a routine immunization practice [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Maternal immunization: where are we now and how to move forward?

et al. 2018

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Pregnancy and the postpartum period are associated with elevated risks to both mother and infant from infectious disease. Vaccination of pregnant women, also called maternal immunization, has the potential to protect pregnant women, foetuses and infants from several vaccinepreventable diseases. Maternal immunoglobulin G antibodies are actively transferred through the placenta to provide passive immunity to new-borns during the first months of life, until the time for infant vaccinations or until the period of greatest susceptibility has passed. Currently, inactivated influenza, tetanus, and pertussis vaccines are recommended during pregnancy in many countries, but other vaccines may also be administered to pregnant women when risk factors are present. Several new vaccines with a specific indication for use during pregnancy are under development (e.g. respiratory syncytial virus and group B streptococcus vaccines). Years of experience suggest that maternal immunization against influenza, tetanus or pertussis has an acceptable safety profile, is well tolerated, effective and confers significant benefits to pregnant women and their infants. This review describes the principles of maternal immunization and provides an update of the recent evidence regarding the use and timing of maternal immunization. Finally, the barriers preventing wider vaccination coverage and the current limitations in addressing these are also described (Supplementary Material). KEY MESSAGESMaternal immunization gives pregnant women greater protection against infectious diseases; induces high levels of maternal antibodies that can be transferred to the foetus; and helps protect new-borns during their first months of life, until they are old enough to be vaccinated. Pregnant women and new-borns are more vulnerable to infectious diseases than the overall population; nevertheless, vaccination rates are often low in pregnant women. This review provides an update of the recent evidence regarding the use and timing of maternal immunization and describes the barriers preventing wider vaccination uptake and the current limitations in addressing these. ARTICLE HISTORY

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Section: The Immune System During Pregnancy and The Effect Of Maternamentioning

confidence: 99%

Section: The Immune System During Pregnancy and The Effect Of Maternamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternal immunization: where are we now and how to move forward?

et al. 2018

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“…3,18,21,25 However, it is important to note what has been defined in terms of security. Kharbanda, in a cohort study, noted that the MV was not associated with preterm birth RR; .…”

Section: Security and Cost/effectivenessmentioning

confidence: 99%

“…8 The absence of vaccination under that age makes the infant vulnerable to pertussis, it is for that reason that maternal vaccination (MV) is an interesting strategy to overcome this situation. 21,[24][25][26] Tdap (acellular vaccine of purified extracts of adhesion molecules BP combined with tetanus toxoid and reduced diphtheria toxoid) can protect adolescents and adults, it is administrated with just one dose. 1,4,5,15,19,23 The objective of this revision was to identify the benefits of MV to prevent infant pertussis.…”

Section: Introductionmentioning

confidence: 99%

Benefits of maternal vaccination to prevent pertussis in infants

Monterrosa-Castro

Ramirez-García

Beltrán-Barrios

2017

Int J Reprod Contracept Obstet Gynecol

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Pertussis, also called whooping cough, is an infectious and preventable pathology that generates important child morbidity and mortality worldwide. There are different biological preparations for its use in infants, while for adolescents and adults is Tdap, (acellular vaccine of purified extracts of Bordetella pertussis (BP), combined with tetanus and diphtheria toxoid) that has been proposed as maternal vaccination (MV). The objective was to identify the benefits of MV in the prevention of childhood pertussis, a review was made in PubMed, Science Direct, EBSCOhosT, OvidSP and Embase databases (years 2008-2016) and an electronic alert system (January-April 2017). 1083 titles were identified and 44 articles were selected. After the MV (administered between 27 and 36 weeks of gestation) the passage of IgG-BP to the fetus is sufficient to generate adequate infant protection, generating two benefits: reducing infant morbidity (number of cases and hospital admissions) and decreasing mortality by pertussis. The MV offers 93% of effectiveness [95%CI: 81-97] and OR: 0.09 [95%CI: 0,03-0,25]. The MV is more favorable in each pregnancy than cocoon strategy, vaccination before pregnancy, before 26 weeks of gestation or in the postpartum. The use of MV is a safe and cost-effectiveness tool to prevent childhood pertussis.

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Association of COVID-19 Vaccination in Pregnancy With Adverse Peripartum Outcomes

Fell

Dhinsa

Alton

et al. 2022

JAMA

115

124

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IMPORTANCEThere is limited comparative epidemiological evidence on outcomes associated with COVID-19 vaccination during pregnancy; monitoring pregnancy outcomes in large populations is required.OBJECTIVE To evaluate peripartum outcomes following COVID-19 vaccination during pregnancy. DESIGN, SETTING, AND PARTICIPANTSPopulation-based retrospective cohort study in Ontario, Canada, using a birth registry linked with the provincial COVID-19 immunization database. All births between December 14, 2020, and September 30, 2021, were included.EXPOSURES COVID-19 vaccination during pregnancy, COVID-19 vaccination after pregnancy, and no vaccination.MAIN OUTCOMES AND MEASURES Postpartum hemorrhage, chorioamnionitis, cesarean delivery (overall and emergency cesarean delivery), admission to neonatal intensive care unit (NICU), and low newborn 5-minute Apgar score (<7). Linear and robust Poisson regression was used to generate adjusted risk differences (aRDs) and risk ratios (aRRs), respectively, comparing cumulative incidence of outcomes in those who received COVID-19 vaccination during pregnancy with those vaccinated after pregnancy and those with no record of COVID-19 vaccination at any point. Inverse probability of treatment weights were used to adjust for confounding. RESULTS Among 97 590 individuals (mean [SD] age, 31.9 [4.9] years), 22 660 (23%) received at least 1 dose of COVID-19 vaccine during pregnancy (63.6% received dose 1 in the third trimester; 99.8% received an mRNA vaccine). Comparing those vaccinated during vs after pregnancy (n = 44 815), there were no significantly increased risks of postpartum hemorrhage (incidence: 3.0% vs 3.0%; aRD, −0.28 per 100 individuals [95% CI, −0.59 to 0.03]; aRR, 0.91 [95% CI, 0.82-1.02]), chorioamnionitis (0.5% vs 0.5%; aRD, −0.04 per 100 individuals [95% CI, −0.17 to 0.09]; aRR, 0.92 [95% CI, 0.70-1.21]), cesarean delivery (30.8% vs 32.2%; aRD, −2.73 per 100 individuals [95% CI, −3.59 to −1.88]; aRR, 0.92 [95% CI, 0.89-0.95]), NICU admission (11.0% vs 13.3%; aRD, −1.89 per 100 newborns [95% CI, −2.49 to −1.30]; aRR, 0.85 [95% CI, 0.80-0.90]), or low Apgar score (1.8% vs 2.0%; aRD, −0.31 per 100 newborns [95% CI, −0.56 to −0.06]; aRR, 0.84 [95% CI, 0.73-0.97]). Findings were qualitatively similar when compared with individuals who did not receive COVID-19 vaccination at any point (n = 30 115). CONCLUSIONS AND RELEVANCEIn this population-based cohort study in Ontario, Canada, COVID-19 vaccination during pregnancy, compared with vaccination after pregnancy and with no vaccination, was not significantly associated with increased risk of adverse peripartum outcomes. Study interpretation should consider that the vaccinations received during pregnancy were primarily mRNA vaccines administered in the second and third trimester.

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Maternal Immunization

Cited by 15 publications

References 152 publications

Maternal immunization: where are we now and how to move forward?

Maternal immunization: where are we now and how to move forward?

Benefits of maternal vaccination to prevent pertussis in infants

Association of COVID-19 Vaccination in Pregnancy With Adverse Peripartum Outcomes

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