Maternal Immunization as a Strategy to Decrease Susceptibility to Infection in Newborn Infants

Benjamin Lindsey; Beate Kampmann; Christine Jones


Curr Opin Infect Dis. 2013;26(3):248-253. 

In This Article

Safety of Maternal Vaccination

Another prominent concern is safety of maternal vaccination. Live-attenuated vaccines are contraindicated for use just before, or during pregnancy, because of potential complications if the attenuated virus was to be passed on to the fetus.[14] This potential risk has however been studied in women who were inadvertently vaccinated during pregnancy with live-attenuated rubella, influenza and yellow fever vaccines with no reported adverse outcomes.[15,16,17] Tetanus vaccination has been safely administered to several millions of pregnant women without documented serious adverse outcomes.

Studies of maternal pertussis vaccination dating from the1930s to the present time have not identified any adverse events in the neonate, however many of these studies were relatively small and unlikely to show any rare complications. A recent analysis of articles of the Vaccine Adverse Events Reporting System of pregnant women who received tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnancy also failed to identify any concerning patterns of adverse fetal or maternal events.[18]

The 2009 influenza pandemic focused renewed attention on the safety of influenza vaccination in pregnancy. Studies to date have not revealed harmful effects of maternal influenza vaccination. A review of 11 studies, including 10 428 pregnant women, concluded no harmful effects to either the mother or the infant.[19] Recent studies have added to the existing body of evidence that have shown no association between A(H1N1)v2009 influenza vaccination or trivalent inactivated influenza vaccination and adverse events including spontaneous abortion, major malformations, preeclampsia, prematurity, birth weight, or neonatal death, including when administered in the first trimester of pregnancy.[20,21,22]

In summary, the risks of maternal vaccines to the infant are mainly theoretical as to date there is no evidence of increased risk of serious adverse events. Postmarketing surveillance and prospective epidemiological studies such as the Vaccines and Medications in Pregnancy Surveillance System are important.[23]