Maternal Immunization
Core Principles
- Denotes vaccine administration during pregnancy.
- Confers protection to mother, fetus, and infant.
- Relies on passive transplacental immunoglobulin g transfer.
- Facilitates immunoglobulin a transfer through breast milk.
- Prevents neonatal morbidity prior to active childhood immunization.
Recommended Vaccines During Pregnancy
| Vaccine | Timing | Primary Goal |
|---|---|---|
| Tetanus, diphtheria, acellular pertussis | 27-36 weeks | Prevents infant pertussis <2 months. |
| Inactivated influenza | Any trimester | Prevents infant flu <6 months. |
| Respiratory syncytial virus | 32-36 weeks | Prevents infant severe lower respiratory tract disease. |
| Coronavirus disease | Any trimester | Prevents severe maternal disease and preterm birth. |
Tetanus, Diphtheria, And Acellular Pertussis
- Requires one dose during each pregnancy regardless of prior vaccination history.
- Optimal administration timing spans 27 to 36 weeks.
- Unimmunized women require one tetanus, diphtheria, acellular pertussis dose plus one tetanus, reduced diphtheria dose separated by at least one month.
- Protects infants <2 months before primary infant vaccination series begins.
Inactivated Influenza Vaccine
- Forms integral part of routine prenatal care.
- Safe for administration during any trimester.
- Reduces infant influenza infections by 63% during first six months of life.
- Half-life of maternally acquired antibodies lasts 42-50 days.
- Live attenuated influenza vaccine remains absolutely contraindicated.
Respiratory Syncytial Virus Vaccine
- Employs bivalent prefusion f protein-based vaccine.
- Administered strictly between 32 and 36 weeks gestation.
- Provides 82% efficacy against medically attended severe infant lower respiratory illness up to 3 months.
- Postmarketing safety trials demonstrate no increased risk of preterm birth or adverse neonatal outcomes.
- World health organization recommends either maternal vaccine or infant long-acting monoclonal antibodies, avoiding simultaneous use for the same mother-infant pair.
Coronavirus Disease Vaccine
- Pregnancy increases risk for intensive care admission, mechanical ventilation, and stillbirth.
- Messenger ribonucleic acid vaccines generate robust maternal immunity.
- Facilitates effective protective antibody transfer to fetal circulation.
- Demonstrates no significant association with adverse pregnancy outcomes.
Contraindications And Precautions
- Live vaccines generally contraindicated during pregnancy.
- Measles, mumps, rubella, and varicella strictly avoided.
- Pregnancy must be avoided for 4 weeks post-vaccination with live viral vaccines.
- Smallpox vaccine directly harms developing fetus.
- Yellow fever vaccine avoided unless travel to highly endemic zones remains absolutely unavoidable.