MIRNA – Maternal Immunisation Readiness Network in Africa & Asia
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Vaccination in Pregnancy: An Update for a Changing Time

Introduction Vaccinations in pregnancy have been proven to reduce maternal, fetal, and neonatal morbidity and mortality from infectious diseases.1, 2 It is estimated that 154 million deaths worldwide have been avoided since the introduction of routine vaccinations. Despite the wealth of research and literature to support the safety and efficacy of vaccines in pregnancy, immunization […]

Original researchMaternal ImmunisationVaccination2026DOI: https://doi.org/10.1002/ijgo.71273
Abstract

Maternal immunization is one of the most effective public health interventions to reduce infectious morbidity and mortality in pregnant women, fetuses, and newborns. Despite robust evidence supporting vaccine safety and effectiveness in pregnancy, global uptake has declined following the COVID-19 pandemic, contributing to resurgent outbreaks of vaccine-preventable diseases. While national immunization schedules vary, there is broad international consensus recommending influenza and tetanus-diphtheria-acellular pertussis (Tdap) vaccination during pregnancy, with increasing adoption of maternal respiratory syncytial virus (RSV) immunization. This review provides an updated, globally relevant summary of recommended vaccines before, during, and after pregnancy, highlights vaccines under development, and discusses implementation challenges. Strengthening maternal immunization requires coordinated action across governments, healthcare systems, industry, and media to improve access, trust, and equity in vaccine delivery.

Introduction

Vaccinations in pregnancy have been proven to reduce maternal, fetal, and neonatal morbidity and mortality from infectious diseases.1, 2 It is estimated that 154 million deaths worldwide have been avoided since the introduction of routine vaccinations. Despite the wealth of research and literature to support the safety and efficacy of vaccines in pregnancy, immunization rates have continued to fall since the COVID-19 pandemic, leading to outbreaks of infectious diseases that can have negative impacts on pregnancy outcomes.3, 4 The reduction in vaccination rates is multifactorial, including changes to immunization schedules and global funding, media misinformation, lack of access to appropriate vaccines, and public mistrust—all leading to vaccine hesitancy.4 These factors combined create a challenge for governments and healthcare providers to protect pregnant women and their babies. To improve vaccination rates, it is necessary for governments, industry, the media, healthcare workers, and community-based organizations to work together to educate and optimize access to and uptake of recommended vaccines to maximize the benefits of vaccinations. To assist healthcare providers, it is important that they have access to up-to-date and easy-to-use recommendations. It is also important to understand the rationale for each vaccine; in some cases it is to protect the mother from disease, in other cases it is a strategy of maternal vaccination for infant protection. This review aims to provide an update on the evidence and recommendations for vaccination in pregnancy and is designed for ease of use by healthcare providers globally, ensuring patients are provided with up-to-date recommendations for vaccination coverage throughout pregnancy, from planning to the postpartum period. It includes recommendations on the use of new vaccines and an update on vaccine development. Box 1 highlights the importance of immunization during and pre-pregnancy.

Optimization of maternal health and well-being should be viewed as a priority by governments and healthcare providers caring for those considering pregnancy. A discussion about vaccination and prevention of infectious disease should be included whenever patients present for prepregnancy care. The preventative opportunities may be beneficial for mother, fetus, and newborn, or all three. Any health visit with a girl or woman of reproductive age should include a prepregnancy vaccination check in case of a subsequent intended or unintended pregnancy.

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Wendy Hodge, Méabh Bhuinneáin, Gelila Goba, Marisa Labovsky, Eliana Amaral, Asma Khalil, David Lissauer, Hema Divakar, Fionnuala M. McAuliffe, Deborah Money, Dharmintra Pasupathy The FIGO Committee on Infections During Pregnancy
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https://doi.org/10.1002/ijgo.71273
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References

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