NVAC Maternal Immunization Working Group

Pregnant women are at increased risk of complications from some vaccine preventable diseases, like influenza and pertussis. Despite this risk, vaccine coverage remains quite low. The NVAC Maternal Immunization Working Group was created to assess the problem and provide recommendations to correct it.

Specifically, The Assistant Secretary for Health charged the National Vaccine Advisory Committee (NVAC) to review the current state of maternal immunizations and existing best practices. The working group was asked to first identify programmatic barriers to implementation of current recommendations regarding maternal immunization and make recommendations for overcoming these barriers. Efforts to identify barriers to and opportunities for developing vaccines for pregnant women should then be identified as well as ways to overcome these barriers and leverage the opportunities.

The Working Group completed phase one of its work with the presentation of the report: Reducing Patient and Provider Barriers to Maternal Immunizations.

Understanding the Risk to Mother and Infant

There are serious infectious diseases that can impact young infants before they can be actively immunized and for whom maternal vaccination may be protective. For example:

• In 2011, following recent outbreaks of pertussis which resulted in infant deaths, the Advisory Committee on Immunization Practices (ACIP) recommended Tdap for pregnant women during late pregnancy to protect infants through placental transfer of antibodies.¹
• Given during pregnancy, the flu shot protects both mother and baby (up to 6 months old) from the risk from serious illness and complications of the flu.

Improving Rates of Maternal Immunization

There is a need to further bring prenatal care into the culture of immunization and prevention to:

• achieve goals outlined in the NVP and Healthy People 2020,
• reduce socio-economic disparities,
• reduce morbidity and mortality, and
• encourage development of new vaccines, essentially establishing a national platform for maternal immunization.

It is also important to monitor the impact of maternal immunization on prevention of morbidity and mortality in both the mother and her infant. And finally, there is a need to ensure vaccine safety systems are adequate to detect any causally related adverse events in newborns or pregnant women.

Additional Resources

• NVAC Maternal Immunization Working Group Charge
• Funding Opportunity: Vaccine Safety Research
• NVAC Report: Reducing Patient and Provider Barriers to Maternal Immunizations
• NVAC Presentation: Overview of the U.S. Vaccine Surveillance Systems & Ongoing Scientific Activities to Monitor Maternal Vaccine Safety

¹Updated 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. Oct 21 2011;60(41):1424-1426.