Vaccine-Preventable Diseases in Pregnancy

Abstract

In 2011, the Centers for Disease Control and Prevention identified the reduction in vaccine-preventable diseases (VPDs) as one of the greatest achievements of the previous decade. During that time, several new pediatric and adult vaccines were introduced including rotavirus, quadrivalent meningococcal conjugate, herpes zoster, human papillomavirus, pneumococcal conjugate, and adult tetanus, diphtheria, acellular pertussis. Despite the impact of immunization and its public health priority, vaccine coverage among adults in the United States remains suboptimal. Incorporation of adult immunization into routine obstetric and gynecologic care may be one innovative approach to vaccinate women. Pregnancy is a particularly vulnerable period for VPD-associated complications for both mother and baby, as demonstrated by the influenza pandemic of 2009. In addition to preventing maternal and congenital disease, maternal immunization can also provide direct fetal/infant protection via passive immunity. This article summarizes vaccine classification, specific vaccines recommended during pregnancy/postpartum, and barriers to maternal immunization.

Keywords

maternal immunization - vaccine - passive immunity

• References

• 1 Bunker JP, Frazier HS, Mosteller F. Improving health: measuring effects of medical care. Milbank Q 1994; 72: 225-258
• 2 Roush SW, Murphy TV. Vaccine-Preventable Disease Table Working Group. Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. JAMA 2007; 298: 2155-2163
• 3 CDC. Facts about adult immunization. Fact sheets 2009. Available at: http://www.nfid.org/publications/factsheets/adultfact.pdf . Accessed June 4, 2012
• 4 Centers for Disease Control and Prevention (CDC). Ten great public health achievements—United States, 2001–2010. MMWR Morb Mortal Wkly Rep 2011; 60: 619-623
• 5 HealthyPeople.Gov. 2020 Topics & objectives: immunization and infectious diseases 2012. Available at: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=23 . Accessed July 25, 2012
• 6 National Foundation for Infectious Diseases. Facts about influenza for adults. 2012. Available at: http://www.adultvaccination.com/vpd/influenza/facts.html . Accessed June 4, 2012
• 7 National Foundation for Infectious Diseases. Pneumococcal disease. 2012. Available at: http://www.adultvaccination.com/vpd/pneumococcal . Accessed June 4, 2012
• 8 Howlader N, Noone AM, Krapcho M , et al. SEER cancer statistics review, 1975–2008. Available at: http://seer.cancer.gov/csr/1975_2008/ . Accessed July 25, 2012
• 9 Stratton KRDJ, Lawrence S. Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: National Academy Press; 2000
• 10 Schaffer SJ, Fontanesi J, Rickert D , et al; Working Group on Complementary Settings. How effectively can health care settings beyond the traditional medical home provide vaccines to adolescents?. Pediatrics 2008; 121 (Suppl. 01) S35-S45
• 11 Gonik B, Jones T, Contreras D, Fasano N, Roberts C. The obstetrician-gynecologist's role in vaccine-preventable diseases and immunization. Obstet Gynecol 2000; 96: 81-84
• 12 Leader S, Perales PJ. Provision of primary-preventive health care services by obstetrician-gynecologists. Obstet Gynecol 1995; 85: 391-395
• 13 Jamieson DJ, Honein MA, Rasmussen SA , et al; Novel Influenza A (H1N1) Pregnancy Working Group. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374: 451-458
• 14 Siston AM, Rasmussen SA, Honein MA , et al; Pandemic H1N1 Influenza in Pregnancy Working Group. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA 2010; 303: 1517-1525
• 15 Louie JK, Acosta M, Jamieson DJ, Honein MA. California Pandemic (H1N1) Working Group. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N Engl J Med 2010; 362: 27-35
• 16 Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol 1998; 148: 1094-1102
• 17 Pierce M, Kurinczuk JJ, Spark P, Brocklehurst P, Knight M. UKOSS. Perinatal outcomes after maternal 2009/H1N1 infection: national cohort study. BMJ 2011; 342: d3214
• 18 Zaman K, Roy E, Arifeen SE , et al. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med 2008; 359: 1555-1564
• 19 Englund JA, Mbawuike IN, Hammill H, Holleman MC, Baxter BD, Glezen WP. Maternal immunization with influenza or tetanus toxoid vaccine for passive antibody protection in young infants. J Infect Dis 1993; 168: 647-656
• 20 Centers for Disease Control and Prevention (CDC). Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep 2011; 60: 1128-1132
• 21 Tanaka MVC, Vitek CR, Pascual FB, Bisgard KM, Tate JE, Murphy TV. Trends in pertussis among infants in the United States, 1980–1999. JAMA 2003; 290: 2968-2975
• 22 Edwards KM. Overview of pertussis: focus on epidemiology, sources of infection, and long term protection after infant vaccination. Pediatr Infect Dis J 2005; 24 (6, Suppl) S104-S108
• 23 National Foundation for Infectious Diseases. Rubella (German measles). 2012. Available at: http://www.adultvaccination.com/vpd/rubella . Accessed June 4, 2012
• 24 Goldfarb I, Panda B, Wylie B, Riley L. Uptake of influenza vaccine in pregnant women during the 2009 H1N1 influenza pandemic. Am J Obstet Gynecol 2011; 204 (6) (Suppl. 01) S112-S115
• 25 Centers for Disease Control and Prevention. Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep 2012; 61: 1-7
• 26 Immunology of Vaccine-Preventable Diseases; Principles of Vaccination: Epidemiology and Prevention of Vaccine-Preventable Diseases. Atlanta, GA: Centers for Disease Control and Prevention; 2012
• 27 Murphy TV, Slade BA, Broder KR , et al; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2008; 57 (RR-4) 1-51
• 28 Centers for Disease Control and Prevention (CDC). Pertussis—United States, 1997–2000. MMWR Morb Mortal Wkly Rep 2002; 51: 73-76
• 29 Wendelboe AM, Van Rie A, Salmaso S, Englund JA. Duration of immunity against pertussis after natural infection or vaccination. Pediatr Infect Dis J 2005; 24 (5, Suppl) S58-S61
• 30 Healy CM, Rench MA, Baker CJ. Implementation of cocooning against pertussis in a high-risk population. Clin Infect Dis 2011; 52: 157-162
• 31 Centers for Disease Control. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep 2011; 60: 1424-1426
• 32 Gall SA, Myers J, Pichichero M. Maternal immunization with tetanus-diphtheria-pertussis vaccine: effect on maternal and neonatal serum antibody levels. Am J Obstet Gynecol 2011; 204: 334 , e1–e5
• 33 Pertussis maternal immunization study. ClinicalTrials.gov Identifier: NCT00553228. Available at: http://clinicaltrials.gov/ct2/show/NCT00553228?term=NCT00553228&rank=1 . Accessed July 11, 2012
• 34 Vaccine Information Statement. Td or Tdap Centers for Disease Control and Prevention 2012; . Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-td-tdap.pdf
• 35 Fiore AE, Wasley A, Bell BP. Advisory Committee on Immunization Practices (ACIP). Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006; 55 (RR-7) 1-23
• 36 Mast EE, Weinbaum CM, Fiore AE , et al; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep 2006; 55 (RR-16) 1-33 ; quiz CE1–CE4
• 37 Gambarin-Gelwan M. Hepatitis B in pregnancy. Clin Liver Dis 2007; 11: 945-963
• 38 Levy M, Koren G. Hepatitis B vaccine in pregnancy: maternal and fetal safety. Am J Perinatol 1991; 8: 227-232
• 39 Makris MC, Polyzos KA, Mavros MN, Athanasiou S, Rafailidis PI, Falagas ME. Safety of hepatitis B, pneumococcal polysaccharide and meningococcal polysaccharide vaccines in pregnancy: a systematic review. Drug Saf 2012; 35: 1-14
• 40 State Information. Hepatitis B prevention mandates for daycare and K–12. 2011. Available at: http://www.immunize.org/laws/hepb.asp . Accessed July 20, 2012
• 41 Grijalva CG, Griffin MR. Population-based impact of routine infant immunization with pneumococcal conjugate vaccine in the USA. Expert Rev Vaccines 2008; 7: 83-95
• 42 CDC. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep 2010; 59: 1102-1106
• 43 CDC. Guidelines for vaccinating pregnant women. 2012. Available at: http://www.cdc.gov/vaccines/pubs/preg-guide.htm . Accessed June 4, 2012
• 44 Munoz FM, Englund JA, Cheesman CC , et al. Maternal immunization with pneumococcal polysaccharide vaccine in the third trimester of gestation. Vaccine 2001; 20: 826-837
• 45 Shahid NS, Steinhoff MC, Hoque SS, Begum T, Thompson C, Siber GR. Serum, breast milk, and infant antibody after maternal immunisation with pneumococcal vaccine. Lancet 1995; 346: 1252-1257
• 46 O'Dempsey TJ, McArdle T, Ceesay SJ , et al. Immunization with a pneumococcal capsular polysaccharide vaccine during pregnancy. Vaccine 1996; 14: 963-970
• 47 Schlaudecker EP, Steinhoff MC, Omer SB , et al. Antibody persistence in mothers one year after pneumococcal immunization in pregnancy. Vaccine 2012; 30: 5063-5066
• 48 Bilukha OO, Rosenstein N.. Prevention CDC; National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC). Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2005; 54 (RR-7) 1-21
• 49 O'Dempsey TJ, McArdle T, Ceesay SJ , et al. Meningococcal antibody titres in infants of women immunised with meningococcal polysaccharide vaccine during pregnancy. Arch Dis Child Fetal Neonatal Ed 1996; 74: F43-F46
• 50 Maternal flu vaccine trial in Bamako, Mali. ClinicalTrials.gov Identifier: NCT01430689. Available at: http://clinicaltrials.gov/ct2/show/NCT01430689?term=NCT01430689&rank=1 . Accessed July 11, 2012
• 51 Siegel M, Fuerst HT. Low birth weight and maternal virus diseases. A prospective study of rubella, measles, mumps, chickenpox, and hepatitis. JAMA 1966; 197: 680-684
• 52 Atmar RL, Englund JA, Hammill H. Complications of measles during pregnancy. Clin Infect Dis 1992; 14: 217-226
• 53 Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L. Measles, mumps, and rubella—vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 1998; 47 (RR-8) 1-57
• 54 Centers for Disease Control and Prevention (CDC). Revised ACIP recommendation for avoiding pregnancy after receiving a rubella-containing vaccine. MMWR Morb Mortal Wkly Rep 2001; 50: 1117
• 55 Buimovici-Klein E, Hite RL, Byrne T, Cooper LZ. Isolation of rubella virus in milk after postpartum immunization. J Pediatr 1977; 91: 939-941
• 56 Klein EB, Byrne T, Cooper LZ. Neonatal rubella in a breast-fed infant after postpartum maternal infection. J Pediatr 1980; 97: 774-775
• 57 Marin M, Güris D, Chaves SS, Schmid S, Seward JF. Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2007; 56 (RR-4) 1-40
• 58 Registries MP. Varicella zoster virus-containing vaccines. 2006. Available at: http://www.merckpregnancyregistries.com/varivax.html . Accessed September 13, 2012
• 59 Shrim A, Koren G, Yudin MH, Farine D. Maternal Fetal Medicine Committee. Management of varicella infection (chickenpox) in pregnancy. J Obstet Gynaecol Can 2012; 34: 287-292
• 60 Manning SE, Rupprecht CE, Fishbein D , et al; Advisory Committee on Immunization Practices Centers for Disease Control and Prevention (CDC). Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2008; 57 (RR-3) 1-28
• 61 Rupprecht CE, Briggs D, Brown CM , et al; Centers for Disease Control and Prevention (CDC). Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the advisory committee on immunization practices. MMWR Recomm Rep 2010; 59 (RR-2) 1-9
• 62 Chutivongse S, Wilde H, Benjavongkulchai M, Chomchey P, Punthawong S. Postexposure rabies vaccination during pregnancy: effect on 202 women and their infants. Clin Infect Dis 1995; 20: 818-820
• 63 Varner MW, McGuinness GA, Galask RP. Rabies vaccination in pregnancy. Am J Obstet Gynecol 1982; 143: 717-718
• 64 Sudarshan MK, Madhusudana SN, Mahendra BJ, Ashwathnarayana DH, Jayakumary M , Gangaboriah. Post exposure rabies prophylaxis with Purified Verocell Rabies Vaccine: a study of immunoresponse in pregnant women and their matched controls. Indian J Public Health 1999; 43: 76-78
• 65 Wright JG, Quinn CP, Shadomy S, Messonnier N. Centers for Disease Control and Prevention (CDC). Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep 2010; 59 (RR-6) 1-30
• 66 CDC. Travelers' health. Available at: http://wwwnc.cdc.gov/travel/ . Accessed July 23, 2012
• 67 Staples JE, Gershman M, Fischer M. Centers for Disease Control and Prevention (CDC). Yellow fever vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010; 59 (RR-7) 1-27
• 68 Suzano CE, Amaral E, Sato HK, Papaiordanou PM. Campinas Group on Yellow Fever Immunization during Pregnancy. The effects of yellow fever immunization (17DD) inadvertently used in early pregnancy during a mass campaign in Brazil. Vaccine 2006; 24: 1421-1426
• 69 CDC; CDC Health Information for International Travel 2012. New York, NY: Oxford University Press; 2012
• 70 Lu P, Bridges CB, Euler GL, Singleton JA. Influenza vaccination of recommended adult populations, U.S., 1989–2005. Vaccine 2008; 26: 1786-1793
• 71 Meharry PM, Colson ER, Grizas AP, Stiller R, Vázquez M. Reasons why women accept or reject the Trivalent Inactivated Influenza Vaccine (TIV) during pregnancy. Matern Child Health J 2012; ; February 25 (Epub ahead of print)
• 72 Panda B, Stiller R, Panda A. Influenza vaccination during pregnancy and factors for lacking compliance with current CDC guidelines. J Matern Fetal Neonatal Med 2011; 24: 402-406
• 73 Leddy MA, Anderson BL, Power ML, Gall S, Gonik B, Schulkin J. Changes in and current status of obstetrician-gynecologists' knowledge, attitudes, and practice regarding immunization. Obstet Gynecol Surv 2009; 64: 823-829
• 74 Kuehn BM. Mothers take physicians' advice on vaccines. JAMA 2010; 304: 2577-2578
• 75 Yudin MH, Salaripour M, Sgro MD. Pregnant women's knowledge of influenza and the use and safety of the influenza vaccine during pregnancy. J Obstet Gynaecol Can 2009; 31: 120-125
• 76 American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee Opinion No. 468: Influenza vaccination during pregnancy. Obstet Gynecol 2010; 116: 1006-1007
• 77 Committee on Obstetric Practice. ACOG Committee Opinion No. 521: Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Obstet Gynecol 2012; 119: 690-691
• 78 Committee on Adolescent Health Care; ACOG Working Group on Immunization. 344: Human papillomavirus vaccination. Obstet Gynecol 2006; 108 (3 Pt 1) 699-705
• 79 ACOG. Immunization for women. Available at: http://www.immunizationforwomen.org/ . Accessed July 25, 2012
• 80 Centers for Disease Control and Prevention (CDC). Influenza vaccination coverage among health-care personnel—United States, 2010–11 influenza season. MMWR Morb Mortal Wkly Rep 2011; 60: 1073-1077
• 81 Silverman NS, Greif A. Influenza vaccination during pregnancy. Patients' and physicians' attitudes. J Reprod Med 2001; 46: 989-994
• 82 Pertussis vaccine in healthy pregnant women. ClinicalTrials.gov Identifier: NCT00707148. Available at: http://clinicaltrials.gov/ct2/show/NCT00707148?term=NCT00707148&rank=1 . Accessed July 11, 2012