Annals of Medicine
ISSN: 0785-3890 (Print) 1365-2060 (Online) Journal homepage: http://www.tandfonline.com/loi/iann20
Maternal immunization: Where are we now and how to move forward? Ivo Vojtek, Ilse Dieussaert, T. Mark Doherty, Valentine Franck, Linda Hanssens, Jacqueline Miller, Rafik Bekkat-Berkani, Walid Kandeil, David Prado-Cohrs & Andrew Vyse To cite this article: Ivo Vojtek, Ilse Dieussaert, T. Mark Doherty, Valentine Franck, Linda Hanssens, Jacqueline Miller, Rafik Bekkat-Berkani, Walid Kandeil, David Prado-Cohrs & Andrew Vyse (2018): Maternal immunization: Where are we now and how to move forward?, Annals of Medicine, DOI: 10.1080/07853890.2017.1421320 To link to this article: https://doi.org/10.1080/07853890.2017.1421320
Accepted author version posted online: 08 Jan 2018.
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Date: 10 January 2018, At: 04:00
TITLE: Maternal immunization: Where are we now and how to move forward? Ivo Vojtek1, Ilse Dieussaert2, T. Mark Doherty1, Valentine Franck1, Linda Hanssens1a, Jacqueline Miller2, Rafik Bekkat-Berkani3, Walid Kandeil1, David Prado-Cohrs4, Andrew Vyse1b
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Affiliations: 1GSK, R&D department, Wavre, Belgium; 2GSK, R&D department, Rockville,
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R&D department, Guatemala City, Guatemala.
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Corresponding author: Dr. Ivo Vojtek, GSK, Building W23-F0, 20 Avenue Fleming - 1300
Running title: Maternal immunization
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Wavre - Belgium. Phone: +32 2 656 67 08. Email:
[email protected].
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Target journal: Annals of Medicine Manuscript type: Review
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Word count: Manuscript: 6415 (33 pages including disclosures and references); Abstract: 203. Footnote: Boostrix and Boostrix-IPV are trademarks owned by or licensed to the GSK group of companies. a
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MD, United States; 3GSK, R&D department, Philadelphia Navy Yard, PA, United States; 4GSK,
Current affiliation: Independent Researcher; b Current affiliation: Pfizer Ltd.
ABSTRACT Pregnancy and the post-partum period are associated with elevated risks to both mother and infant from infectious disease. Vaccination of pregnant women, also called maternal immunization, has the potential to protect pregnant women, fetuses, and infants from several vaccine-preventable diseases. Maternal immunoglobulin G antibodies are actively transferred
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through the placenta to provide passive immunity to newborns during the first months of life,
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Currently, inactivated influenza, tetanus, and pertussis vaccines are recommended during
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pregnancy in many countries, but other vaccines may also be administered to pregnant women
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when risk factors are present. Several new vaccines with a specific indication for use during pregnancy are under development (e.g., respiratory syncytial virus and group B streptococcus
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vaccines). Years of experience suggest that maternal immunization against influenza, tetanus, or pertussis has an acceptable safety profile, is well tolerated, effective, and confers significant
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benefits to pregnant women and their infants. This review describes the principles of maternal immunization and provides an update of the recent evidence regarding the use and timing of
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maternal immunization. Finally, the barriers preventing wider vaccination coverage and the current limitations in addressing these are also described. (Supplementary Material) Keywords: maternal immunization, immunity; patient safety, quality of care; pregnancy;
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until the time for infant vaccinations or until the period of greatest susceptibility has passed.
vaccine
KEY MESSAGES
Maternal immunization gives pregnant women greater protection against infectious diseases; induces high levels of maternal antibodies that can be transferred to the fetus; and helps protect newborns during their first months of life, until they are old enough to be vaccinated.
Pregnant women and newborns are more vulnerable to infectious diseases than the overall
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This review provides an update of the recent evidence regarding the use and timing of
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maternal immunization and describes the barriers preventing wider vaccination uptake and
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the current limitations in addressing these.
INTRODUCTION
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Pregnant women and newborns are more vulnerable to some infections, associated with elevated
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morbidity and mortality, as illustrated during the 1918 and 2009–2010 influenza A (H1N1)
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pandemics (1, 2). In addition, although mortality has been greatly reduced in children aged
