In the United States, eradication and reduction of vaccine-preventable diseases through immunization has directly increased life expectancy by reducing mortality. Although immunization is a public priority, vaccine coverage among adult Americans is inadequate. The Institute of Medicine, the Community Preventive Services Task Force, and other public health entities have called for the development of innovative programs to incorporate adult vaccination into routine clinical practice. Obstetrician–gynecologists are well suited to serve as vaccinators of women in general and more specifically pregnant women. Pregnant women are at risk for vaccine-preventable disease-related morbidity and mortality and adverse pregnancy outcomes, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. In addition to providing direct maternal benefit, vaccination during pregnancy likely provides direct fetal and neonatal benefit through passive immunity (transplacental transfer of maternal vaccine-induced antibodies). This article reviews: 1) types of vaccines; 2) vaccines specifically recommended during pregnancy and postpartum; 3) vaccines recommended during pregnancy and postpartum based on risk factors and special circumstances; 4) vaccines currently under research and development for licensure for maternal–fetal immunization; and 5) barriers to maternal immunization and available patient and health care provider resources.
Vaccination during pregnancy is a vital component of routine obstetric care, reducing morbidity and mortality among mothers, fetuses, and neonates.Supplemental Digital Content is Available in the Text.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University, Durham, North Carolina.
Corresponding author: Geeta K. Swamy, MD, Duke Maternal-Fetal Medicine, 2608 Erwin Road, Suite 200, Durham, NC 27705; e-mail: email@example.com.
Continuing medical education for this article is available at http://links.lww.com/AOG/A579.
Financial Disclosure Dr. Swamy has received past support from GlaxoSmithKline for consultant and speaker activities that ended in March 2012. Dr. Heine has been a consultant and speaker for GlaxoSmithKline and a speaker for Merck, Inc. Both authors have received research funding from the National Institutes of Health, the Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, and GlaxoSmithKline to conduct vaccine-related research.