title: Maternal immunization: Optimizing protection for the mother and infant.
abstract: Immunizing the pregnant woman to protect both the mother and her infant from infection has been utilized increasingly over the last decade. New outbreaks of pandemic influenza and the resurgence of pertussis have resulted in policy changes and shifts in health authority recommendations for a number of vaccines aimed to protect both pregnant women and their infants in the first months of life. The ability of maternal immunoglobulin IgG antibodies to be transported readily across the healthy intact placenta depends on many different factors including gestational age in the pregnancy, nature and timing of the immunization and presence of maternal HIV or malaria infections. In this paper, the history of maternal immunization is described, and specifically the studies that prompted the recommendations for tetanus, influenza, pertussis, and, when needed, meningococcus vaccines in pregnant women are reviewed. Ongoing research may result in new maternal vaccines against other pathogens including respiratory syncytial virus and group B streptococcus. Both scientific and regulatory considerations remain challenging in licensure of vaccines specifically for maternal immunization.
authors.affiliation: University of Washington Department of Obstetrics and Gynecology, Seattle, WA, USA. Electronic address: alisa.kachikis@gmail.com.
authors.forename: Alisa
authors.initials: A
authors.lastname: Kachikis
authors.affiliation: University of Washington Department of Pediatrics, Pediatric Infectious Diseases, Seattle Children's Hospital, Seattle, WA, USA. Electronic address: janet.englund@seattlechildrens.org.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Englund
mesh_terms: D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007114:Immunization; D007074:Immunoglobulin G / Q000276:immunology; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage; D000068097:Maternal Health; D009035:Mothers; D011247:Pregnancy; D037841:Pregnant People; D013745:Tetanus Toxoid / Q000008:administration & dosage / Q000276:immunology; D014612:Vaccines / Q000008:administration & dosage* / Q000276:immunology
chemical_list: D007074:Immunoglobulin G; D007252:Influenza Vaccines; D013745:Tetanus Toxoid; D014612:Vaccines
keywords: Influenza vaccine; Maternal immunization; Respiratory syncytial virus; Tetanus vaccine; Vaccines