Vaccination during pregnancy: present and future
- Authors: Shipitsyna E.V.1, Shirshova N.Y.2, Kogan I.Y.1
-
Affiliations:
- D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology
- City Polyclinic No. 32, Saint Petersburg
- Issue: No 11 (2021)
- Pages: 9-16
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249331
- DOI: https://doi.org/10.18565/aig.2021.11.9-16
- ID: 249331
Cite item
Abstract
Vaccination during pregnancy, which is finding increasing use worldwide, is one of the most effective and promising strategies for preventing morbidity and mortality from infectious diseases among pregnant women and newborn babies. Vaccination for pregnant women has been shown to be highly effective and safe in a number of important infections, such as influenza, pertussis, and tetanus. As there is more evidence that vaccination during pregnancy against the novel coronavirus infection is effective and safe, an increasing number of countries include it in priority vaccination programs. In recent years, progress has been made to design new vaccines against Group B streptococcus, respiratory syncytial virus, and cytomegalovirus, which are designed mainly for pregnant women. According to many studies, an obstetrician/gynecologist’s vaccination recommendation with sufficient information on the need and safety of vaccination for a woman and a newborn baby is a key factor for a pregnant woman’s decision to get vaccinated. Conclusion: This review analyzes the literature on the main aspects of vaccination during pregnancy: the efficacy and safety of currently recommended vaccines and the factors influencing the attitude of pregnant women to vaccination. It discusses the issues of pregnant women’s vaccination against the novel coronavirus infection and the promising areas and developments in vaccination during pregnancy.
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About the authors
Elena V. Shipitsyna
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology
Email: shipitsyna@inbox.ru
Dr. Bio. Sci., Leading Researcher of the International Department
Natalia Yu. Shirshova
City Polyclinic No. 32, Saint Petersburg
Email: p32@zdrav.spb.ru
PhD, Head Physician
Igor Yu. Kogan
D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology
Email: ovrt@ott.ru
Corresponding Member of RAS, Dr. Med. Sci., Professor, Director
References
- United Nations. The global strategy for women’s, children’s and adolescent’s health (2016-2030). New York; 2015. Available: https://www.who.int/life-course/partners/global-strategy/globalstrategyreport2016-2030-lowres.pdf
- Kollmann T.R., Marchant A., Way S.S. Vaccination strategies to enhance immunity in neonates. Science. 2020; 368(6491): 612-5. https://dx.doi.org/10.1126/science.aaz9447.
- World Health Organisation. Global accine action plan 2011-2020. Geneva: WHO; 2013.
- Abu-Raya B., Maertens K., Edwards K.M., Omer S.B., Englund J.A., Flanagan K.L. et al. Global perspectives on immunization during pregnancy and priorities for future research and development: An international consensus statement. Front. Immunol. 2020; 11: 1282. https://dx.doi.org/10.3389/ FIMMU.2020.01282.
- Kachikis A., Eckert L.O., Englund J. Who’s the target: mother or baby? Viral Immunol. 2018; 31(2): 184-94. https://dx.doi.org/10.1089/vim.2017.0135.
- Calvert A., Jones C.E. Placental transfer of antibody and its relationship to vaccination in pregnancy. Curr. Opin. Infect. Dis. 2017; 30(3): 268-73. https://dx.doi.org/10.1097/QCO.0000000000000372.
- Maertens K., De Schutter S., Braeckman T., Baerts L., Van Damme P., De Meester I. et al. Breastfeeding after maternal immunisation during pregnancy: Providing immunological protection to the newborn: A review. Vaccine. 2014; 32(16): 1786-92. https://dx.doi.org/10.1016/j.vaccine.2014.01.083.
- Macias Saint-Gerons D., Sola Arnau I., De Mucio B., Arevalo-Rodriguez I., Aleman A., Castro J.L. et al. Adverse events associated with the use of recommended vaccines during pregnancy: An overview of systematic reviews. Vaccine. 2021; 39(Suppl. 2): B12-26. https://dx.doi.org/10.1016/J.VACCINE.2020.07.048.
- World Health Organisation. Global advisory committee on vaccine safety. Safety of immunization during pregnancy. A review of the evidence. 2014. Available: https: //www.who.int/vaccine_safety/publications/safety_pregnancy_nov2014.pdf
- Fell D., Azziz-Baumgartner E., Baker M., Batra M., Beaute J.P.B., Beutels P. et al. Influenza epidemiology and immunization during pregnancy: Final report of a World Health Organization working group. Vaccine. 2017; 35(43): 5738-50. https://dx.doi.org/10.1016/J.VACCINE.2017.08.037.
- Louie J.K., Acosta M., Jamieson D.J., Honein M.A. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N. Engl. J. Med. 2010; 362(1): 27-35. https://dx.doi.org/10.1056/NEJMOA0910444.
- Fell D., Savitz D., Kramer M., Gessner B., Katz M., Knight M. et al. Maternal influenza and birth outcomes: systematic review of comparative studies. BJOG. 2017; 124(1): 48-59. https://dx.doi.org/10.1111/1471-0528.14143.
- Manske J. Efficacy and effectiveness of maternal influenza vaccination during pregnancy: a review of the evidence. Matern. Child Health J. 2014; 18(7): 1599609. https://dx.doi.org/10.1007/S10995-013-1399-2.
- Thompson M.G., Kwong J.C., Regan A.K., Katz M.A., Drews S.J., Azziz-Baumgartner E. et al. Influenza vaccine effectiveness in preventing influenza-associated hospitalizations during pregnancy: a multi-country retrospective test negative design study, 2010-2016. Clin. Infect. Dis. 2018; 68(9): 1444-53. https://dx.doi.org/10.1093/cid/ciy737.
- Madhi S.A., Cutland C.L., Kuwanda L., Weinberg A., Hugo A., Jones S. et al. Influenza vaccination of pregnant women and protection of their infants. N. Engl. J. Med. 2014; 371(10): 918-31. https://dx.doi.org/10.1056/ NEJMoa1401480.
- Министерство здравоохранения Российской Федерации. Приказ №125н от 21.03.2014 "Об утверждении национального календаря профилактических прививок и календаря профилактических прививок по эпидемическим показаниям". Available: https://www.rospotrebnadzor.ru/deyatelnost/epidemiological-surveillance/?ELEMENT_ID=5575
- World Health Organisation. WHO Global Health Observatory (GHO) data. Diphtheria-tetanus-pertussis (DTP3) immunization coverage. 2020. Available: https://www.who.int/data/gho/data/themes/immunization
- Masseria C., Martin C., Krishnarajah G., Becker L., Buikema A., Tan T. Incidence and burden of pertussis among infants less than 1 year of age. Pediatr. Infect. Dis. J. 2017; 36(3): e54-61. https://dx.doi.org/10.1097/INF.0000000000001440.
- Sawyer M., Liang J.L., Messonnier N., Clark T.A. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women - Advisory Committee on Immunization Practices (ACIP), 2012. MMWR Morb. Mortal. Wkly Rep. 2013; 62(7): 131-5.
- Munoz F., Bond N., Maccato M., Pin ell P., Hammill H., Swamy G. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial. JAMA. 2014; 311(17): 1760-9. https://dx.doi.org/10.1001/ JAMA.2014.3633.
- Huygen K., Cabore R., Maertens K., Van Damme P., Leuridan E. Humoral and cell mediated immune responses to a pertussis containing vaccine in pregnant and nonpregnant women. Vaccine. 2015; 33(33): 4117-23. https://dx.doi.org/10.1016/J.VACCINE.2015.06.108.
- Amirthalingam G., Andrews N., Campbell H., Ribeiro S., Kara E., Donegan K. et al. Effectiveness of maternal pertussis vaccination in England: An observational study. Lancet. 2014; 384(9953): 1521-8. https://dx.doi.org/10.1016/S0140-6736(14)60686-3.
- Eberhardt C., Blanchard-Rohner G., Lemaitre B., Boukrid M., Combescure C., Othenin-Girard V. et al. Maternal immunization earlier in pregnancy maximizes antibody transfer and expected infant seropositivity against pertussis. Clin. Infect. Dis. 2016; 62(7): 829-36. https://dx.doi.org/10.1093/CID/CIW027.
- Thwaites S., Beeching N., Newton C. Maternal and neonatal tetanus. Lancet. 2015; 385(9965): 362-70. https://dx.doi.org/10.1016/S0140-6736(14)60236-1.
- United Nations Children’s Fund, World Health Organization, UNPF. Maternal and neonatal tetanus elimination by 2005: strategies for achieving and maintaining elimination. Available: https://apps.who.int/iris/handle/10665/69618
- Njuguna H.N., Yusuf N., Raza A.A., Ahmed B., Tohme R.A. Progress toward maternal and neonatal tetanus elimination - worldwide, 2000-2018. MMWR Morb. Mortal. Wkly Rep. 2020; 69(17): 515-20. https://dx.doi.org/10.15585/ MMWR.MM6917A2.
- Припутневич Т.В., Гордеев А.Б., Любасовская Л.А., Шабанова Н.Е. Новый коронавирус SARS-COV-2 и беременность: обзор литературы. Акушерство и гинекология. 2020; 5: 6-12. [Priputnevich T.V., Gordeev A.B., Ljubasovskaja L.A., Shabanova N.E. New coronavirus SARS-COV-2 and pregnancy: literature review. Akusherstvo i ginekologija/ Obstetrics and Gynecology. 2020; 5: 6-12 (in Russian)]. https://dx.doi.org/10.18565/aig.2020.5.6-12.
- Chmielewska B., Barratt I., Townsend R., Kalafat E., van der Meulen J., Gurol-Urganci I. et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob. Health. 2021; 9(6): e759-72. https://dx.doi.org/10.1016/S2214-109X(21)00079-6.
- Villar J., Ariff S., Gunier R.B., Thiruvengadam R., Rauch S., Kholin A. et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021; 175(8): 817-26. https://dx.doi.org/10.1001/jamapediatrics.2021.1050.
- Беженарь В.Ф., Зазерская И.Е., Кучерявенко А.Н., Мещанинова С.Г., Мазурок В.А., Ржеутская Р.Е., Годзоева А.О. Случай стремительного течения новой коронавирусной инфекции COVID-19 у беременной. Акушерство и гинекология. 2021; 1: 186-93. https://dx.doi.org/10.18565/aig.2021.1.186-193.
- Savasi V.M., Parisi F., Patane L., Ferrazzi E., Frigerio L., Pellegrino A. et al. Clinical findings and disease severity in hospitalized pregnant women with coronavirus disease 2019 (COVID-19). Obstet. Gynecol. 2020; 136(2): 252-8. https://dx.doi.org/10.1097/AOG.0000000000003979.
- World Health Organisation. Global vaccine safety: meningococcal A conjugate vaccine during pregnancy. Available: https://www.who.int/groups/global-advisory-committee-on-vaccine-safety/topics/meningococcal-a-conjugate-vaccine/pregnancy
- Krubiner C.B., Faden R.R., Karron R.A., Little M.O., Lyerly A.D., Abramson J.S. et al. Pregnant women & vaccines against emerging epidemic threats: Ethicsguidance for preparedness, research, and response. Vaccine. 2021; 39: 85-120. https://dx.doi.org/10.1016/J.VACCINE.2019.01.011.
- Wang E.W, Parchem J.G., Atmar R.L., Clark E.H. SARS-CoV-2 vaccination during pregnancy: A complex decision. Open Forum Infect. Dis. 2021; 8(5): ofab180. https://dx.doi.org/10.1093/ofid/ofab180.
- Shimabukuro T.T., Kim S.Y., Myers T.R., Moro P.L., Oduyebo T., Panagiotakopoulos L. et al. Preliminary findings of mRNA Covid-19 vaccine safety in pregnant persons. N. Engl. J. Med. 2021; 384(24): 2273-82. https://dx.doi.org/10.1056/NEJMOA2104983.
- Goldshtein I., Nevo D., Steinberg D., Rotem R., Gorfine M., Chodick G., Segal Y. Association between BNT162b2 vaccination and incidence of SARS-CoV-2 infection in pregnant women. JAMA. 2021; 326(8): 728-35. https://dx.doi.org/10.1001/JAMA.2021.11035.
- Gray K.J., Bordt E.A., Atyeo C., Deriso E., Akinwunmi B., Young N. et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. Am. J. Obstet. Gynecol. 2021; 225(3): 303.e1-303.e17. https://dx.doi.org/10.1016/j.ajog.2021.03.023
- Министерство здравоохранения Российской Федерации. Методические рекомендации «Организация оказания медицинской помощи беременным, роженицам, родильницам и новорожденным при новой коронавирусной инфекции COVID-19». 2021: 130-1. https://minzdrav.gov.ru/poleznye-resursy/rekomendatsii-po-vaktsinatsii-beremennyh-zhenschin
- Министерство здравоохранения Российской Федерации. Временные методические рекомендации «Порядок проведения вакцинации взрослого населения против COVID-19». 2021. [Health Ministry of the Russian Federation. Clinical recommendations «Vaccination of the adult population against COVID-19». 2021 (in Russian)]. Available: https://minzdrav.gov.ru/news/2021/07/02/16927-utverzhdeny-vremennye-metodicheskie-rekomendatsii-poryadok-provedeniya-vaktsinatsii-vzroslogo-naseleniya-protiv-covid-19
- Lawn J.E., Bianchi-Jassir F., Russell N.J., Kohli-Lynch M., Tann C.J., Hall J. et al. Group B streptococcal disease worldwide for pregnant women, stillbirths, and children: why, what, and how to undertake estimates? Clin. Infect. Dis. 2017; 65(Suppl. 2): S89-99. https://dx.doi.org/10.1093/cid/cix653.
- Madhi S.A., Cutland C.L., Jose L., Koen A., Govender N., Wittke F. et al. Safety and immunogenicity of an investigational maternal trivalent group B streptococcus vaccine in healthy women and their infants: a randomised phase 1b/2 trial. Lancet Infect. Dis. 2016; 16(8): 923-34. https://dx.doi.org/10.1016/S1473-3099(16)00152-3.
- Heyderman R.S., Madhi S.A, French N., Cutland C., Ngwira B., Kayambo D. et al. Group B streptococcus vaccination in pregnant women with or without HIV in Africa: a non-randomised phase 2, open-label, multicentre trial. Lancet Infect. Dis. 2016; 16(5): 546-55. https://dx.doi.org/10.1016/S1473-3099(15)00484-3.
- Coultas J.A., Smyth R., Openshaw P.J. Respiratory syncytial virus (RSV): a scourge from infancy to old age. Thorax. 2019; 74(10): 986-93. https://dx.doi.org/10.1136/THORAXJNL-2018-212212
- Madhi S.A., Polack F.P., Piedra P.A., Munoz F.M., Trenholme A.A., Simoes E.A.F. et al. Respiratory syncytial virus vaccination during pregnancy and efects in infants. N. Engl. J. Med. 2020; 383(5): 426-39. https://dx.doi.org/10.1056/nejmoa1908380.
- Schleiss M.R., Permar S.R., Plotkin S.A. Progress toward development of a vaccine against congenital cytomegalovirus infection. Clin. Vaccine Immunol. 2017; 24(12): e00268-17. https://dx.doi.org/10.1128/CVI.00268-17.
- Permar S., Schleiss M., Plotkin S. Advancing our understanding of protective maternal immunity as a guide for development of vaccines to reduce congenital cytomegalovirus infections. J. Virol. 2018; 92(7): e00030-18. https://dx.doi.org/10.1128/JVI.00030-18.
- Healy C.M., Rench M.A., Montesinos D.P., Ng N., Swaim L.S. Knowledge and attitiudes of pregnant women and their providers towards recommendations for immunization during pregnancy. Vaccine. 2015; 33(41): 5445-51. https://dx.doi.org/10.1016/j.vaccine.2015.08.028.
- Chervenak FA., McCullough L.B., Bornstein E., Johnson L., Katz A., McLeod-Sordjan R. et al. Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. Am. J. Obstet. Gynecol. 2021; 224(5): 470-8. https://dx.doi.org/10.1016/j.ajog.2021.01.027.
- Kilich E., Dada S., Francis M.R., Tazare J., Chico R.M., Paterson P. et al. Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis. PLoS One. 2020; 15(7): e0234827. https://dx.doi.org/10.1371/journal.pone.0234827
- Ceulemans M., Foulon V., Panchaud A., Winterfeld U., Pomar L., Lambelet V. et al. Vaccine willingness and impact of the covid-19 pandemic on women’s perinatal experiences and practices - a multinational, cross-sectional study covering the first wave of the pandemic. Int. J. Environ. Res. Public Health. 2021; 18(7): 3367. https://dx.doi.org/10.3390/ijerph18073367
- Stuckelberger S., Favre G., Ceulemans M., Nordeng H., Gerbier E., Lambelet V. et al. SARS-CoV-2 vaccine willingness among pregnant and breastfeeding women during the first pandemic wave: A cross-sectional study in Switzerland. Viruses. 2021; 13(7): 1199. https://dx.doi.org/10.3390/V13071199
- Skjefte M., Ngirbabul M., Akeju O., Escudero D., Hernandez-Diaz S., Wyszynski D.F. et al. COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries. Eur. J. Epidemiol. 2021; 36(2): 197-211. https://dx.doi.org/10.1007/S10654-021-00728-6
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