ReviewMaternal immunisation in developing countries
Introduction
Maternal immunisation provides a potential means of protecting infants against infection with a number of important pathogens during the first few months of life that has universal application. However, maternal immunisation may be of particular value in poor countries where child mortality, especially during the first few months of life, remains unacceptably high. This review highlights some of the reasons why this is the case.
Section snippets
Characteristics of poor countries that favour a role for maternal immunisation
Reasons why maternal immunisation may have a particularly important role to play in poor countries, summarised in Table 1, include the following.
Constraints on maternal immunisation in developing countries
Although there are many features that suggest that maternal immunisation might be especially useful in developing countries, there are a number of constraints that need to be taken into account.
Conclusions
Despite the potential complications of malaria and of HIV, maternal immunisation offers an attractive approach to the prevention of early infant deaths in developing countries. The problem of malaria can probably be largely overcome by ensuring that women receive intermittent presumptive treatment with antimalarials during pregnancy, now recommended practice, and that vaccination is carried out at this time or shortly afterwards. The issue of HIV is more difficult; initially studies could be
Acknowledgements
The author thanks the many colleagues with whom he has worked on the subject of maternal immunisation in The Gambia over a period of many years, in particular, Steve Obaro, Tim O’Dempsey, Amanda Leach, Rahman Suara and Kim Mulholland.
References (18)
- et al.
Serum, breast milk, and infant antibody after maternal immunisation with pneumococcal vaccine
Lancet
(1995) - et al.
23-Valent pneumococcal polysaccharide vaccine in HIV-1-infected Ugandan adults: double-blind, randomised and placebo controlled trial
Lancet
(2000) - et al.
Reduced transfer of tetanus antibodies with placental malaria
Lancet
(1994) - et al.
Immunization with a pneumococcal capsular polysaccharide vaccine during pregnancy
Vaccine
(1996) - et al.
Changes in the pattern of infant and childhood mortality in Upper River Division, The Gambia from 1989 to 1993
Trop. Med. Int. Health
(1997) - et al.
Neonatal mortality in a rural area of The Gambia
Ann. Trop. Paediatr.
(1999) - Vandelaer J. Tetanus in developing countries. Vaccine...
- WHO Young Infants Study Group. Bacterial etiology of serious infections in young infants in developing countries:...
- et al.
Pneumococcal disease among children in a rural area of West Africa
Pediatr. Infect. Dis. J.
(1996)
Cited by (32)
Knowledge and attitudes towards maternal immunization: perspectives from pregnant and non-pregnant mothers, their partners, mothers, healthcare providers, community and leaders in a selected urban setting in South Africa
2021, HeliyonCitation Excerpt :However, some countries continue to experience challenges regarding the implementation of maternal influenza vaccination programmes. Poor availability of resources and a reluctance of pregnant women to accept vaccination due to fears about adverse impact on foetal development and health have been mentioned as major barriers to the achievement of national and international targets on maternal and child health (Ortiz et al., 2012; Greenwood 2003; Munoz and Patricia 2013). Moreover, research has shown that maternal knowledge, attitudes and beliefs play a substantial role in vaccine hesitancy (Larson Williams et al., 2018).
Vaccinating in Pregnancy: Opportunities and Challenges
2020, Primary Care - Clinics in Office PracticeCitation Excerpt :Maternal immunization may be particularly helpful in developing countries where infant death rates are high often due to infection, attendance at prenatal clinics is high, and breastfeeding is nearly universal. Neonatal tetanus, although still a significant cause of neonatal death, has decreased recently due to immunization with tetanus toxoid during pregnancy.26 There is some evidence that pneumococcal disease contributes to a significant portion of neonatal deaths before the age at which infants can be vaccinated.
Immunogenicity and efficacy of influenza immunization during pregnancy: Recent and ongoing studies
2012, American Journal of Obstetrics and GynecologyUnderstanding current practice of clinical medicine in the tropics (II). Bacterial and viral diseases. Malnutrition
2012, Revista Clinica Espanola