Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Bahaa Abu-Raya¹, Kirsten Maertens², Kathryn M Edwards³, Saad B Omer⁴, Janet A Englund⁵, Katie L Flanagan^{6

7

8}, Matthew D Snape⁹, Gayatri Amirthalingam¹⁰, Elke Leuridan², Pierre Van Damme², Vana Papaevangelou¹¹, Odile Launay¹², Ron Dagan¹³, Magda Campins¹⁴, Anna Franca Cavaliere¹⁵, Tiziana Frusca¹⁶, Sofia Guidi¹⁵, Miguel O'Ryan¹⁷, Ulrich Heininger¹⁸, Tina Tan¹⁹, Ahmed R Alsuwaidi²⁰, Marco A Safadi²¹, Luz M Vilca²², Nasamon Wanlapakorn²³, Shabir A Madhi^{24

25}, Michelle L Giles²⁶, Roman Prymula²⁷, Shamez Ladhani¹⁰, Federico Martinón-Torres²⁸, Litjen Tan²⁹, Lessandra Michelin³⁰, Giovanni Scambia¹⁵, Nicola Principi³¹, Susanna Esposito³²

Affiliations

¹ Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
² Faculty of Medicine and Health Sciences, Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
³ Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, United States.
⁴ Department of Internal Medicine (Infectious Diseases), Department of Epidemiology of Microbial Diseases, Yale School of Medicine, Yale School of Public Health, New Haven, CT, United States.
⁵ Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA, United States.
⁶ Faculty of Health Sciences, School of Medicine, University of Tasmania, Launceston, TAS, Australia.
⁷ School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia.
⁸ Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia.
⁹ Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
¹⁰ Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom.
¹¹ Third Department of Pediatrics, University Hospital ATTIKON, National and Kapodistrian University of Athens, Athens, Greece.
¹² Université de Paris, Inserm, CIC 1417, F-CRIN I REIVAC, Assistance Publique-Hôpitaux de Paris, Paris, France.
¹³ The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
¹⁴ Preventive Medicine and Epidemiology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
¹⁵ Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
¹⁶ Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
¹⁷ Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences and Associate Researcher, Millennium Institute of Immunology and Immunotherapy, University of Chile, Santiago, Chile.
¹⁸ Pediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland.
¹⁹ Division of Pediatric Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
²⁰ Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
²¹ Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
²² Unit of Obstetrics and Gynecology, Buzzi Hospital - ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy.
²³ Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
²⁴ Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
²⁵ Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
²⁶ Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia.
²⁷ School of Medicine Hradec Kralove, Institute of Social Medicine, Charles University Prague, Prague, Czechia.
²⁸ Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, University of Santiago, Santiago de Compostela, Spain.
²⁹ Immunization Action Coalition, St. Paul, MN, United States.
³⁰ Infectious Diseases and Vaccinology Division, Health Sciences Post Graduation Program, University of Caxias Do Sul, Caxias Do Sul, Brazil.
³¹ Università degli Studi di Milano, Milan, Italy.
³² Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy.

PMID: 32670282
PMCID: PMC7326941
DOI: 10.3389/fimmu.2020.01282

Review

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Bahaa Abu-Raya et al. Front Immunol. 2020.

. 2020 Jun 24:11:1282.

doi: 10.3389/fimmu.2020.01282. eCollection 2020.

Authors

Affiliations

¹ Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
² Faculty of Medicine and Health Sciences, Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
³ Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, United States.
⁴ Department of Internal Medicine (Infectious Diseases), Department of Epidemiology of Microbial Diseases, Yale School of Medicine, Yale School of Public Health, New Haven, CT, United States.
⁵ Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA, United States.
⁶ Faculty of Health Sciences, School of Medicine, University of Tasmania, Launceston, TAS, Australia.
⁷ School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia.
⁸ Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia.
⁹ Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
¹⁰ Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, United Kingdom.
¹¹ Third Department of Pediatrics, University Hospital ATTIKON, National and Kapodistrian University of Athens, Athens, Greece.
¹² Université de Paris, Inserm, CIC 1417, F-CRIN I REIVAC, Assistance Publique-Hôpitaux de Paris, Paris, France.
¹³ The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
¹⁴ Preventive Medicine and Epidemiology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
¹⁵ Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
¹⁶ Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy.
¹⁷ Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences and Associate Researcher, Millennium Institute of Immunology and Immunotherapy, University of Chile, Santiago, Chile.
¹⁸ Pediatric Infectious Diseases, University of Basel Children's Hospital, Basel, Switzerland.
¹⁹ Division of Pediatric Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.
²⁰ Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
²¹ Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
²² Unit of Obstetrics and Gynecology, Buzzi Hospital - ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy.
²³ Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
²⁴ Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
²⁵ Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
²⁶ Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia.
²⁷ School of Medicine Hradec Kralove, Institute of Social Medicine, Charles University Prague, Prague, Czechia.
²⁸ Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, University of Santiago, Santiago de Compostela, Spain.
²⁹ Immunization Action Coalition, St. Paul, MN, United States.
³⁰ Infectious Diseases and Vaccinology Division, Health Sciences Post Graduation Program, University of Caxias Do Sul, Caxias Do Sul, Brazil.
³¹ Università degli Studi di Milano, Milan, Italy.
³² Department of Medicine and Surgery, Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy.

PMID: 32670282
PMCID: PMC7326941
DOI: 10.3389/fimmu.2020.01282

Abstract

Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant.

Keywords: group B Streptococcus vaccines; influenza; maternal immunization; pertussis; pregnant women; respiratory syncytial virus; tetanus.

Copyright © 2020 Abu-Raya, Maertens, Edwards, Omer, Englund, Flanagan, Snape, Amirthalingam, Leuridan, Damme, Papaevangelou, Launay, Dagan, Campins, Cavaliere, Frusca, Guidi, O'Ryan, Heininger, Tan, Alsuwaidi, Safadi, Vilca, Wanlapakorn, Madhi, Giles, Prymula, Ladhani, Martinón-Torres, Tan, Michelin, Scambia, Principi and Esposito.

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Figures

**Figure 1**
Countries with recommendations for immunization against pertussis in pregnancy by official authorities (for South America, pertussis immunization during pregnancy is recommended by The Pan American Health Organization). This figure was inspired by G. Amirthalingham and K. Maertens and created by K. Maertens.

**Figure 2**
A summary of the major factors affecting vaccination in pregnancy. Created by Claudio Rosa.

See this image and copyright information in PMC

References

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Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Affiliations

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical