Lulu C Bravo
University of The Philippines, Manila
Although a significant improvement in childhood and infant mortality rate in the last 2 decades has been achieved, neonatal mortality on the other hand has been quite slow. Almost half of neonatal deaths has been attributed to infections and prematurity which remain a challenge in preventive health care and a major objective for maternal immunization or vaccination during pregnancy. Other objectives for maternal immunization are to protect the mother , the fetus and even the young child. Both mother and baby are vulnerable to infectious diseases due to altered and underdeveloped immune responses and would thus need the protection from maternal antibodies that could be transferred transplacentally. The tetanus toxoid given to pregnant women has been proven to reduce by as much as 94% the incidence of both maternal and neonatal tetanus.
Other vaccines that are now currently recommended are Tdap to prevent pertussis and influenza vaccine. Newer vaccines in the development stages for maternal immunization include Group B Streptococcus and Respiratory Syncitial Virus or RSV . Vaccines that are commonly given to adults such as Hepatitis B, Hepatitis A, HPV, Meningococcal, Rabies and others may or may not be given depending on the risk involved and the benefits that will be provided. Certain precautions and contraindications especially with live vaccines will have to be considered during pregnancy. Women of reproductive age should be screened for their immunization status and given recommended adult immunization even prior to pregnancy for better protection and delivery. WHO has launched a maternal Immunization and Antenatal Care Situation Analysis (MIACSA ) since 2016 particularly in low and middle income countries to determine barriers and enablers as well as technical support needed to effectively manage and deliver maternal immunization.
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