Abstract

As early as the 19th century vaccination in pregnancy has been observed to protect both mothers and infants against smallpox, pertussis and tetanus. More recently the pace and focus of maternal vaccination has accelerated, most significantly since the influenza pandemic of 2009. Vaccination in pregnancy boosts the concentration of vaccine-specific antibody in the mother to increase antibody concentration in the infant at birth, providing protection until the period of maximum susceptibility or risk has passed or until the infant has completed the routine infant immunizations. There are now 3 vaccines, which have specific recommendations for routine use in pregnancy in an increasing number of countries, and other vaccines are progressing through clinical trials. Here we review the mechanisms of protection, the current recommendations and future prospects, and evaluation of safety of vaccines in pregnancy.