4.4 Review

Vaccination in Pregnancy

Journal

DEUTSCHES ARZTEBLATT INTERNATIONAL
Volume 118, Issue 15, Pages 262-268

Publisher

DEUTSCHER AERZTE-VERLAG GMBH
DOI: 10.3238/arztebl.m2021.0020

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Vaccination during pregnancy can protect expecting mothers from severe courses of different infectious diseases, including influenza, tetanus, and pertussis. Following STIKO recommendations, all pregnant women should receive a quadrivalent influenza vaccine starting from the second trimester.
Background: Vaccination during pregnancy can protect both the expecting mother and the unborn and newborn child from infectious diseases. Methods: This review is based on publications retrieved by a selective literature search on the immunological particularities of infectious diseases affecting pregnant women, unborn children, and neonates, with particular attention to the guidelines of the German Standing Committee on Vaccinations (Standige Impfkommission, STIKO) and the pertinent guidelines. Results: Vaccination during pregnancy protects the expecting mother from a severe course of a number of different infectious diseases. Vaccination with inactivated vaccines against influenza, tetanus, and pertussis is effective, safe, and well tolerated. Women who are pregnant or of child-bearing age should be immunized against tetanus according to the STIKO recommendations. All pregnant women from the second trimester onward should receive an inactivated quadrivalent influenza vaccine. The immunity acquired after vaccination with an acellular pertussis vaccine is present only for a limited time. In a cohort study involving 72,781 pregnant women, pertussis vaccination during pregnancy was found to yield 91% protection against pertussis for their subsequently born children in the first three months of life. Further types of vaccine can also be given during pregnancy if indicated. Additional reasonable measures to protect the health of mother and child include the vaccination of other persons in close contact as well as the closure of relevant vaccination gaps among young adults, particularly women of child-bearing age. Treating physicians play a crucial role in encouraging vaccine acceptance by their patients. Conclusion: Maternal immunization is a safe and effective strategy for giving neonates passive immune protection against life-threatening infections by the vertical transmission of maternal antibodies until they are able to build up their own adaptive immunity.

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