Report of the WHO technical consultation on the effect of maternal influenza and influenza vaccination on the developing fetus: Montreal, Canada, September 30-October 1, 2015.
In 2012, the World Health Organization (WHO) released a position paper on influenza vaccination recommending that pregnant women have the highest priority for seasonal vaccination in countries where the initiation or expansion of influenza immunization programs is under consideration. Although the primary goal of the WHO recommendation is to prevent influenza illness in pregnant women, the potential benefits of maternal immunization in protecting young infants are also recognized. The extent to which maternal influenza vaccination may prevent adverse birth outcomes such as preterm birth or small-for-gestational-age birth, however, is unclear as available studies are in disagreement. To inform WHO about the empirical evidence relating to possible benefits of influenza vaccination on birth outcomes, a consultation of experts was held in Montreal, Canada, September 30-October 1, 2015. Presentations and discussions covered a broad range of issues, including influenza virus infection during pregnancy and its effect on the health of the mother and the fetus, possible biological mechanisms for adverse birth outcomes following maternal influenza illness, evidence on birth outcomes following influenza illness during pregnancy, evidence from both observational studies and randomized controlled trials on birth outcomes following influenza vaccination of pregnant women, and methodological issues. This report provides an overview of the presentations, discussions and conclusions.
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada. Electronic address: dfell@cheo.on.ca.
Deshayne B
DB
Fell
Centre for Global Child Health, Hospital for Sick Children, 525 University Avenue, Suite 702, Toronto, ON M5G 2L3, Canada. Electronic address: zulfiqar.bhutta@sickkids.ca.
Zulfiqar A
ZA
Bhutta
Department of Obstetrics & Gynaecology, University of British Columbia, Shaughnessy Building C408A, 4500 Oak Street, Vancouver, BC V6N 3N1, Canada. Electronic address: jhutcheon@cfri.ca.
Jennifer A
JA
Hutcheon
Center for Immunization Research, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address: rkarron@jhu.edu.
Ruth A
RA
Karron
National Perinatal Epidemiology Unit, University of Oxford, Old Road Campus, Oxford OX3 7LF, United Kingdom. Electronic address: marian.knight@npeu.ox.ac.uk.
Marian
M
Knight
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 4018 Ste-Catherine St W, Room K-116, Westmount, QC H3Z 1P2, Canada. Electronic address: michael.kramer@mcgill.ca.
Michael S
MS
Kramer
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI 48109-2029, USA. Electronic address: asmonto@umich.edu.
Arnold S
AS
Monto
Department of Obstetrics and Gynecology, Duke University, 2608 Erwin Rd, Suite 210, Durham, NC 27710, USA. Electronic address: geeta.swamy@duke.edu.
Geeta K
GK
Swamy
Initiative for Vaccine Research, World Health Organization, 20, Avenue Appia, CH-1211 Geneva 27, Switzerland. Electronic address: ortizj@who.int.
Justin R
JR
Ortiz
Departments of Epidemiology and Obstetrics and Gynecology, Brown University, 47 George Street, Providence, RI 02912, USA. Electronic address: david_savitz@brown.edu.
David A
DA
Savitz
D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000473:pathology*; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000473:pathology*; D011256:Pregnancy Outcome; D014944:World Health Organization
D007252:Influenza Vaccines
Fetal growth; Influenza vaccination; Pregnancy; Preterm birth; Stillbirth