Progressing 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. Along with complications related to labor/delivery and premature birth, infections (sepsis, meningitis, pneumonia, and diarrhea) are among the top causes of newborn deaths.
Even in the first year of life, deaths remain unacceptably high. More than 4.5 million infants die during this period each year—many due to infectious diseases that could be prevented. 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/infancy period is maternal immunization—vaccinating the mother during pregnancy to enhance immunity for mother, baby, or both.
Maternal immunization—a promising approach
When a pregnant woman is vaccinated, her protective antibodies can pass to her child. This protects the baby from certain diseases for the first few months after birth by bridging the gap when infants immune systems are immature and need time or multiple doses to respond to direct vaccination. The approach has had demonstrated success in combating maternal and newborn tetanus (MNT), influenza, and pertussis around the world. For example, it has helped more than 40 low- and middle-income countries (LMICs) eliminate MNT since 2000.
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 programs serving mothers and infants to deliver vaccines.
Recognizing these needs, we are advancing maternal immunization strategies against several illnesses that disproportionately threaten newborns, infants, and/or pregnant women, including respiratory syncytial virus (RSV), Group B Streptococcus, influenza, and pertussis (whooping cough.) Our work centers on supporting vaccine development, identifying and filling research and information gaps (such as assessing the investment case for maternal vaccines), and facilitating cross-sector collaboration to advance availability, access, and uptake of affordable maternal vaccine solutions.
PATH IN ACTION
The Advancing Maternal Immunization (AMI) collaboration
Many infant deaths due to infectious diseases could be prevented through maternal immunization, but the intervention is not used to its full potential in many places, especially in LMICs where it is not widely available beyond MNT. Accelerating access is key for protecting infants when direct vaccination is not an option for them. To drive uptake, viable pathways to enable informed decision-making and achieve rapid launch must be determined.
The AMI collaboration is bringing together diverse stakeholders to identify such pathways and to provide tools to help decision-makers, implementers, researchers, and others navigate them successfully. With a goal of improving infant health and survival, AMI’s current focus is on an important cause of infant respiratory deaths and illness—RSV. Maternal vaccines are currently being developed for RSV and could be available in a few years, underscoring a need to establish an environment poised for vaccine decision-making and introduction now. Toward this end, AMI is developing a roadmap to facilitate informed global, regional, and country decisions around RSV maternal vaccines, and to identify a strategy for meeting introduction and uptake requirements in LMICs. [Photo: PATH/Evelyn Hockstein]