Vaccination

According to the evidence available, vaccination against Covid 19 disease during pregnancy is safe for both mother and baby.
It is important to discuss this with the health care professional that cares for that pregnancy to promote an informed decision about immunization.
Unvaccinated pregnant women are at increased risk of becoming seriously ill, needing intensive care, and even dying. When they get Covid, birth may be triggered prematurely.
It is very important to discuss vaccinations with the professional who is monitoring pregnancy.
 

Here are the key issues concerning the vaccination of pregnant women, to be considered from the first antenatal visits:
Education. Conveying quality information can change one of the main barriers against vaccination, i.e., lack of knowledge about susceptibility to vaccine-preventable diseases, the morbidity caused by those diseases, and the risks and benefits of vaccines.

There is evidence about aspects that influence the population's acceptance of vaccines. These should be strategically considered by members of the health team and by those who manage resources for vaccination campaigns.
These aspects include:
Trust: In the efficacy and safety of vaccines and in the delivery system.
Indifference: Some people have a low perception of the risk of vaccine-preventable diseases, leading them to believe immunization is unnecessary. Indifference may be determined by underestimation of their benefit (efficacy or safety) or by knowledge gaps.

Sometimes, several vaccines must be administered simultaneously during pregnancy; such is the case of Tdap (tetanus and diphtheria toxoids with acellular pertussis vaccine) and influenza vaccine, for instance.
In studies that enrolled non-pregnant individuals to assess the safety of concurrent administration of Tdap and influenza vaccines, compared to their separate use, there was no evidence of increased risk of adverse events.

Several vaccines can be safely administered during pregnancy. In 2014, the WHO Global Advisory Committee on Vaccine Safety conducted a comprehensive assessment of the existing scientific data on the safety of vaccines during pregnancy, concluding that:
- Pregnancy should not prevent pregnant women from receiving a vaccine.
- Although live or attenuated microbial vaccines, such as the MMR vaccine, might pose a theoretical risk to the fetus, no major vaccination-associated adverse outcomes have been reported.

INFLUENZA
•Pregnant women are at increased risk of influenza illness and its complications; so are their infants.
•Influenza vaccines are effective in preventing infection and reducing illness severity in the mother and the newborn. Influenza vaccines have been used for decades and their safety has been well documented. Communication strategies that encourage influenza vaccination is of utmost importance in order to promote its application.

Tetanus is a life-threatening noncommunicable disease caused by a potent neurotoxin produced by the bacterium Clostridium tetani.
Neonatal tetanus can be prevented through vaccination of women before or during pregnancy, which protects the mother and the baby through a transfer of tetanus antibodies. Hygienic childbirth practices are also important to prevent neonatal and maternal tetanus (NNT).

Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), is a leading cause of human disease and death, particularly in developing countries.
Worldwide, TB is intimately linked to poverty, making the control of TB a matter of justice and human rights.
In some areas with a high burden of TB, existing strategies for TB control cannot keep pace with the rising number of cases of TB occurring in parallel with the HIV/AIDS pandemic.
Emerging mycobacterial drug resistance further complicates the situation.

If the mother is HIV positive, the newborn should first be tested for HIV: if the child tests negative for HIV at 5 weeks of birth, he/she can get vaccinated with BCG.
In the case of hepatitis B vaccine, whether the mother or the baby are positive for HIV, the newborn can safely receive this vaccine as soon as possible after birth.

Maternal and neonatal immunization refers to immunization prior to pregnancy, during pregnancy, and during the post-partum period that is intended to provide protection to both the mother and her child.
This is a critical concept, as neonates and premature infants are particularly vulnerable to infections with vaccine-preventable diseases. Additionally, their immature immune systems cannot mount protective immune responses to specific vaccine antigens until several weeks or months after birth. This creates a gap during which newborns are extremely vulnerable.