Introduction of new vaccines for immunization in pregnancy – Programmatic, regulatory, safety and ethical considerations

• Published in: Vaccine Vol. 37; no. 25; pp. 3267 - 3277
• Main Authors: Kochhar, Sonali, Edwards, Kathryn M., Ropero Alvarez, Alba Maria, Moro, Pedro L., Ortiz, Justin R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 31.05.2019; Elsevier Limited
• Subjects: Antenatal care; Babies; Communicable Diseases; Communication; Congenital diseases; Country-level policy making; Cytomegalovirus; Decision making; Developing Countries; Drug delivery systems; Female; Fetuses; Global policies; Health care; Health care facilities; Health facilities; Health Personnel; Health policies; Healthcare providers; Humans; Immunisation; Immunization; Immunization Programs; Infants; Infections; Infectious diseases; Influenza; Introduction; Maternal & child health; Maternal Immunization; Maternal-Child Health Services; Medical ethics; Medical personnel; Morbidity; Neonates; Pharmacology; Pharmacovigilance; Policies; Pregnancy; Pregnant Women; Prenatal care; Program; Regulatory; Safety; Tetanus; Vaccination - adverse effects; Vaccination - ethics; Vaccination - legislation & jurisprudence; Vaccination coverage; Vaccine hesitancy; Vaccines; Vaccines - administration & dosage; Whooping cough; Womens health; Workers; Program; Vaccine hesitancy; Immunisation; Maternal Immunization; Regulatory; Vaccines; Global policies; Pharmacovigilance; Pregnancy; Vaccination coverage; Country-level policy making; Introduction; Antenatal care; Safety; Healthcare providers; Health policies
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2019.04.075

Immunizing pregnant women is a promising strategy to reduce infectious disease-related morbidity and mortality in pregnant women and their infants. Important pre-requisites for the successful introduction of new vaccines for immunization in pregnancy include political commitment and adequate financial resources: trained, committed and sufficient numbers of healthcare workers to deliver the vaccines; close integration of immunization programs with antenatal care and Maternal and Child Health services; adequate access to antenatal care by pregnant women in the country (especially in low and middle-income countries (LMIC)); and a high proportion of births occurring in health facilities (to ensure maternal and neonatal follow-up can be done). The framework needed to advance a vaccine program from product licensure to successful country-level implementation includes establishing and organizing evidence for anticipated vaccine program impact, developing supportive policies, and translating policies into local action. International and national coordination efforts, proactive planning from conception to implementation of the programs (including country-level policy making, planning, and implementation, regulatory guidance, pharmacovigilance) and country-specific and cultural factors must be taken into account during the vaccines introduction.