Maternal Vaccination and Vaccines

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Vaccines and Public Health".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 11258

Special Issue Editor


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Guest Editor
Division of Perinatal Medicine, Abano Terme, Italy
Interests: COVID-19 and pregnancy; pregnant women; public health
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Special Issue Information

Dear Colleagues,

Maternal vaccination may protect pregnant women, their fetuses, and infants from vaccine-preventable infections. No adverse fetal impacts have been identified with inactivated viruses, toxoids, or bacterial vaccines, while live-attenuated vaccines should be reserved for the postpartum period. Despite sufficient safety data to support the use of vaccines during pregnancy, maternal immunization is still not widely used for disease prevention due to concerns about vaccine safety from pregnant women. In this Special Issue, articles and reviews presenting data which support the use of maternal vaccines in pregnancy and providing updates on the status of vaccines currently under development for use in pregnant women are welcomed.

Dr. Gianluca Straface
Guest Editor

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Keywords

  • prenatal care
  • vaccination
  • vaccination hesitancy
  • Tdap vaccine
  • influenza vaccine
  • COVID-19 vaccine

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Published Papers (4 papers)

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Research

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13 pages, 1552 KiB  
Article
The Tdap Vaccination in Pregnancy: Results of a Healthy Equity Audit on Coverage Trends and Their Determinants in the Reggio Emilia Province (Italy)
by Laura Bonvicini, Filomena Giulia Sileo, Benedetta Riboldi, Eufemia Bisaccia, Marco Tamelli, Daniela Bertani, Silvia Cilloni, Luca Ghirotto and Paolo Giorgi Rossi
Vaccines 2025, 13(3), 251; https://doi.org/10.3390/vaccines13030251 - 27 Feb 2025
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Abstract
Background/Objectives: The Italian National Plan for Vaccine Prevention 2017–2019 recommended tetanus, diphtheria, and acellular pertussis vaccines (Tdap) for pregnant women, irrespectively of their immunization history. This study aims to describe the coverage rate trends for Tdap vaccination in pregnancy and evaluate the differences [...] Read more.
Background/Objectives: The Italian National Plan for Vaccine Prevention 2017–2019 recommended tetanus, diphtheria, and acellular pertussis vaccines (Tdap) for pregnant women, irrespectively of their immunization history. This study aims to describe the coverage rate trends for Tdap vaccination in pregnancy and evaluate the differences by socioeconomic status. Methods: This is a retrospective analysis within a health equity audit of the Local Health Authority of Reggio Emilia on vaccination in pregnancy from 2018 (a local vaccination campaign) to 2023. All women residents in our area who gave birth during that period were included and linked to the electronic Registry of Immunization Service. The vaccination coverage in pregnant women was analyzed over time and stratified by pregnant women’s sociodemographic and obstetric characteristics. Results: The coverage of Tdap in pregnant women of the Province of Reggio Emilia increased from 15.9% in 2018 to 53.9% in 2023. The coverage was higher among Italians, women with higher educational levels (aPR 1.49 (CI95%1.41–1.57)), within 31–35 years of age (aPR 1.37 (CI95% 1.28–1.46)), occupied, nulliparous (aPR multiparous vs nulliparous: 0.76 (0.74; 0.78)), and followed in the private sector (aPR 1.07 (1.03–1.11)). Inequalities in coverage increased during the study period for women assisted in the private sector, while decreased or remained stable for women assisted in the context of public services. Conclusions: The vaccination promotion campaign in Reggio Emilia helped increase Tdap coverage in pregnancy from 16 to 53%. Nevertheless, the coverage rates of the most disadvantaged women are still several points lower than the average. Full article
(This article belongs to the Special Issue Maternal Vaccination and Vaccines)
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Review

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26 pages, 2914 KiB  
Review
Pertussis in Early Infancy: Diagnostic Challenges, Disease Burden, and Public Health Implications Amidst the 2024 Resurgence, with Emphasis on Maternal Vaccination Strategies
by Konstantina Leontari, Alexandra Lianou, Andreas G. Tsantes, Filippos Filippatos, Zoi Iliodromiti, Theodora Boutsikou, Styliani Paliatsou, Anastasios E. Chaldoupis, Petros Ioannou, Alexandra Mpakosi, Nicoletta Iacovidou and Rozeta Sokou
Vaccines 2025, 13(3), 276; https://doi.org/10.3390/vaccines13030276 - 5 Mar 2025
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Abstract
Bordetella pertussis is the causative agent of pertussis or whooping cough, an acute and highly contagious respiratory infection that can have serious and fatal complications such as pneumonia, encephalopathy, and seizures, especially for newborns. The disease is endemic not only in the European [...] Read more.
Bordetella pertussis is the causative agent of pertussis or whooping cough, an acute and highly contagious respiratory infection that can have serious and fatal complications such as pneumonia, encephalopathy, and seizures, especially for newborns. The disease is endemic not only in the European Union (EU)/European Economic Area (EEA) but also globally. Larger outbreaks are anticipated every three to five years, even in countries where vaccination rates are high. Despite the high pertussis vaccination coverage in developed countries and a low rate of pertussis incidence for many years, especially during the COVID-19 pandemic, the incidence of pertussis has been on the rise again, with outbreaks in some places, which is referred to as “re-emergence of pertussis”. The aim of this review is to underscore the critical importance of achieving high vaccination coverage, particularly among pregnant women, to safeguard vulnerable neonates from pertussis during their early months, before they are eligible for vaccination. This aligns with the need to address diagnostic challenges, mitigate disease severity, and strengthen public health strategies in light of the ongoing 2024 Bordetella pertussis resurgence. Full article
(This article belongs to the Special Issue Maternal Vaccination and Vaccines)
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12 pages, 666 KiB  
Review
Pertussis Epidemiology in Children: The Role of Maternal Immunization
by Nicola Principi, Sonia Bianchini and Susanna Esposito
Vaccines 2024, 12(9), 1030; https://doi.org/10.3390/vaccines12091030 - 9 Sep 2024
Cited by 4 | Viewed by 3237
Abstract
In the last twelve months, a significant global increase in pertussis cases has been observed, particularly among infants under three months of age. This age group is at the highest risk for severe disease, hospitalization, and death. Maternal immunization with the Tdap vaccine [...] Read more.
In the last twelve months, a significant global increase in pertussis cases has been observed, particularly among infants under three months of age. This age group is at the highest risk for severe disease, hospitalization, and death. Maternal immunization with the Tdap vaccine during pregnancy has been recommended to protect newborns by transferring maternal antibodies transplacentally. This review examines the current epidemiology of pertussis, the importance of preventing it in young children, and the effectiveness of maternal immunization. Despite the proven benefits of maternal vaccination, which has been found effective in pertussis prevention in up to 90% of cases, coverage remains suboptimal in many countries. Factors contributing to low vaccination rates include vaccine hesitancy due to low trust in health authority assessments, safety concerns, practical barriers to vaccine access, and the impact of the COVID-19 pandemic, which disrupted routine vaccination services. The recent increase in pertussis cases may also be influenced by the natural cyclic nature of the disease, increased Bordetella pertussis (Bp) activity in older children and adults, and the genetic divergence of circulating Bp strains from vaccine antigens. Given the high efficacy of maternal vaccination in preventing pertussis in infants, increasing coverage rates is crucial. Efforts to improve vaccine uptake should address barriers to access and vaccine hesitancy, ensuring consistent immune protection for the youngest and most vulnerable populations. Enhanced maternal vaccination could significantly reduce the incidence of whooping cough in infants, decreasing related hospitalizations and deaths. Full article
(This article belongs to the Special Issue Maternal Vaccination and Vaccines)
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37 pages, 1689 KiB  
Review
Safety and Efficacy of Antiviral Drugs and Vaccines in Pregnant Women: Insights from Physiologically Based Pharmacokinetic Modeling and Integration of Viral Infection Dynamics
by Bárbara Costa, Maria João Gouveia and Nuno Vale
Vaccines 2024, 12(7), 782; https://doi.org/10.3390/vaccines12070782 - 16 Jul 2024
Cited by 2 | Viewed by 5312
Abstract
Addressing the complexities of managing viral infections during pregnancy is essential for informed medical decision-making. This comprehensive review delves into the management of key viral infections impacting pregnant women, namely Human Immunodeficiency Virus (HIV), Hepatitis B Virus/Hepatitis C Virus (HBV/HCV), Influenza, Cytomegalovirus (CMV), [...] Read more.
Addressing the complexities of managing viral infections during pregnancy is essential for informed medical decision-making. This comprehensive review delves into the management of key viral infections impacting pregnant women, namely Human Immunodeficiency Virus (HIV), Hepatitis B Virus/Hepatitis C Virus (HBV/HCV), Influenza, Cytomegalovirus (CMV), and SARS-CoV-2 (COVID-19). We evaluate the safety and efficacy profiles of antiviral treatments for each infection, while also exploring innovative avenues such as gene vaccines and their potential in mitigating viral threats during pregnancy. Additionally, the review examines strategies to overcome challenges, encompassing prophylactic and therapeutic vaccine research, regulatory considerations, and safety protocols. Utilizing advanced methodologies, including PBPK modeling, machine learning, artificial intelligence, and causal inference, we can amplify our comprehension and decision-making capabilities in this intricate domain. This narrative review aims to shed light on diverse approaches and ongoing advancements, this review aims to foster progress in antiviral therapy for pregnant women, improving maternal and fetal health outcomes. Full article
(This article belongs to the Special Issue Maternal Vaccination and Vaccines)
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