Antenatal immunization

Abstract

Pregnancy and early infancy are periods of relative immune suppression and increased vulnerability to infection. In these circumstances infections are associated with high morbidity and mortality. In particular, infants have high rates of invasive disease, higher than at any other stage of life with rates of 100 per 100 000 population. The concept of maternal vaccination is that maternal levels of pathogen-specific antibody are boosted and provide protection to the infant until the infant is able to mount an effective immune response to immunization. However, an important concern for women and healthcare providers is the safety of receiving vaccines during pregnancy. There are challenges associated with assessing safety in pregnant women. This review discusses the rationale for maternal vaccination, the concepts and mechanisms used. An assessment is made of the safety of vaccination during pregnancy, and the challenges associated with this are considered. In general terms, it is considered that the risk from disease far outweighs the small risk associated with vaccination during pregnancy and that they offer a new platform for preventing significant and serious infections in mothers and young infants.