Maternal flu vaccination during pregnancy reduces illness in infants
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Key takeaways:
- Maternal influenza vaccination was 34% effective against influenza-associated ED visits or hospitalization among infants.
- Vaccination in a mother’s third trimester was more effective than in the first or second.
Maternal influenza vaccination during pregnancy was associated with reduced chances of influenza-associated ED visits or hospitalizations in infants aged younger than 6 months, according to a study published in JAMA Pediatrics.
“Infants younger than 6 months are at high risk of influenza-associated complications but are not eligible for vaccination given the absence of licensed influenza vaccines for this age group,” Leila C. Sahni, PhD, MD, of the department of pediatrics at Baylor College of Medicine and Texas Children’s Hospital, and colleagues wrote.
“Maternal influenza vaccination is safe, immunogenic, and can prevent laboratory-confirmed influenza and its complications in both mothers and infants,” they wrote. “Maternal immune responses to influenza vaccine during pregnancy are comparable to those of nonpregnant adults, and the transfer of influenza antibodies, either naturally acquired or vaccine induced, from mother to fetus is highly efficient.”
The researchers studied a cohort of 3,764 infants aged younger than 6 months who were seen in the ED or hospitalized for an acute respiratory illness within the New Vaccine Surveillance Network from the 2016-2017 through 2019-2020 influenza seasons. They also accessed immunization systems and medical records, and asked parents to self-report on maternal vaccination status.
Among 3,541 infants in a control group and 223 with influenza, 53% were born to mothers who were vaccinated during pregnancy. Among the infants, maternal vaccination was 34% (95% CI, 12%-50%) effective overall, 39% (95% CI, 12%-58%) effective against influenza-associated hospitalizations and 19% (95% CI, 24% to 48%) effective against ED visits.
The authors also noted that among infants aged younger than 3 months, effectiveness was 53% (95% CI, 30%-68%). Effectiveness was 52% (95% CI, 30%-68%) among infants with mothers who were vaccinated during their third trimester, and 17% (95% CI, 15% to 40%) among those with mothers who were vaccinated during the first or second trimesters.
“Despite the well-documented benefits of maternal influenza vaccination for both mothers and infants, influenza vaccine uptake during pregnancy remains suboptimal,” the authors wrote. “While continued efforts are needed to determine optimal timing, clinicians should continue to offer influenza vaccination at any time during pregnancy to protect both the pregnant person and infant.”
A related editorial authored by Matthew J. Zuber, MD, of Wake Forest School of Medicine, and colleagues noted “a huge opportunity to improve vaccine coverage and health outcomes for all pregnant persons and newborns” since only half of pregnant people are receiving the vaccine.
“To optimize health of the pregnancy dyad, it is essential that vaccine registries expand from children to persons of all ages and thereby eliminate record scatter,” they wrote. “A second opportunity is that all clinicians seeing pregnant persons for a pregnancy visit, prenatal visit or a visit of a child strongly recommend influenza vaccination during pregnancy. A third opportunity is that obstetric and pediatric clinicians collaborate to share effective approaches in their communities to enhance access, confidence and coverage of vaccines and preventive care. Our patients need us to advocate for universal vaccine registries and roll up our sleeves and work collaboratively to optimize maternal and infant health for all.”
Reference:
Sahni LC, et al. JAMA Pediatr. 2023;doi:10.1001/jamapediatrics.2023.5639.
Zuber MJ, et al. JAMA Pediatr. 2023;doi:10.1001/jamapediatrics.2023.5630.
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