Ensuring the Safety of Maternal Immunization

* Abbreviation: Tdap — : tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed Over the past decade, the acceptance and implementation of maternal vaccination strategies has bourgeoned.1 There are several reasons that immunizing pregnant women is an attractive vaccination strategy. First, by immunizing the pregnant woman, there is the potential to prevent the targeted infection in the woman and her infant. Second, there is a window of susceptibility in infants before the initiation of the primary infant immunization series. Maternal immunization can help bridge this window of susceptibility. Finally, pregnant women are often more adherent to medical care during their pregnancies than at other times in their lives, thus making vaccine administration more efficient. However, although we have made significant progress in the implementation of maternal-immunization programs, the uptake of maternal immunization in the United States for influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed (Tdap) vaccine hovers between 50% and 70%.2,3 When pregnant women are asked why they do not receive a vaccine, one of the more commonly reported reasons is concern about safety for the fetus and the long-term adverse risks to the infant.2 … Address correspondence to Kathryn M. Edwards, MD, Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, D-7221 Medical Center North, Nashville, TN 37232. E-mail: kathryn.edwards{at}vumc.org