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.
Nurturing care starts before birth, when mothers and other caregivers can start talking and singing to the foetus.
After birth, the baby can recognize the mother’s voice. Early bonding is facilitated by skin-to-skin contact, breastfeeding and the presence of a companion to support the baby mother. These also build the foundations for optimal nutrition, quality interactions and care.