Advancing maternal immunization
Protecting mother and baby from infectious diseases
The first 28 days of life (the newborn period), are a child’s most vulnerable. In fact, newborns account for nearly half of all child deaths before five years of age—about 2.9 million deaths each year. Maternal deaths also remain unacceptably high. In 2013 alone, more than 289,000 mothers died during pregnancy, childbirth, or the days following delivery.
Along with complications related to labor/delivery and premature birth, infections (sepsis, meningitis, pneumonia, and diarrhea) are among the top causes of newborn deaths. Pregnant women are also at especially high risk for certain diseases, including tetanus and influenza. For these reasons, disease prevention is an important part of a broader suite of interventions to help mothers and babies survive and thrive.
A promising way to prevent disease in pregnancy and/or the newborn period is maternal immunization—vaccinating the mother during pregnancy to enhance immunity for both mother and baby.
Maternal immunization—a promising approach
During the newborn period, babies have immature immune systems that are not yet able to adequately respond either to some of the more dangerous germs encountered shortly after birth or to most childhood vaccines. By vaccinating a woman during pregnancy, it is possible to boost her immunity and naturally transfer antibodies through the placenta to her developing fetus. These antibodies provide protection during the baby’s first, most vulnerable, months of life, until its own immune system matures and direct vaccination can be effective. The approach has had demonstrated success in combating maternal and newborn tetanus, influenza, and pertussis around the world.
Our work in maternal immunization
To maximize maternal immunization’s lifesaving potential against priority diseases, coordination is needed to determine how the approach fits within the broader toolkit of maternal and newborn health interventions and systems. Overcoming remaining scientific, policy, regulatory, and implementation
challenges is critical, as is leveraging existing maternal care programs to deliver vaccines.
Recognizing these needs, we are advancing maternal immunization strategies against several illnesses that disproportionately threaten newborns and/or pregnant women, including respiratory syncytial virus (RSV), Group B Streptococcus, influenza, and pertussis (whooping cough.) Our work centers on filling research and information gaps (such as assessing vaccine acceptability and feasibility of this intervention in low-resource settings) and facilitating cross-sector collaboration to advance affordable maternal vaccine solutions.
PATH IN ACTION
RSV prevention in early life
RSV is a leading cause of newborn and infant respiratory infections and hospitalizations worldwide, and a significant cause of death, mostly between birth and five months of age. Almost all RSV deaths are in low-resource settings. The virus is so pervasive in large part because of the lack of a vaccine, which leaves a critical gap in the newborn survival toolkit. Fortunately, RSV maternal vaccines are in development and could be ready for introduction in a few years. We are collaborating across vaccine and maternal/newborn health spheres to create an enabling environment for incoming RSV vaccines so that, when they are available, the global health community is poised to use them and make them accessible for low- and middle-income countries.