Maternal immunization: trends in South and Southeast Asian countries

Maternal immunization has the potential to reduce neonatal deaths caused by vaccine-preventable infectious diseases. Elimination of maternal and neonatal tetanus from many countries illustrates the potential benefits of maternal immunization as a strategy to decrease neonatal mortality caused by vaccine-preventable infections. Many countries in South and Southeast Asia have high cases of neonatal deaths, which were historically attributed to vaccine-preventable infections. Still, these countries vary in recommendations regarding immunization of pregnant women. We reviewed the current recommendations for the use of tetanus toxoid, tetanus-diphtheria, or tetanus-diphtheria-acellular pertussis (Tdap) vaccines for immunization of pregnant women. In addition to protection against tetanus and diphtheria, administration of the Tdap vaccine to pregnant women could help protect neonates against pertussis until they can receive the first two vaccine doses of their primary course. Vaccination against seasonal influenza is also recommended in many countries worldwide for pregnant women as influenza can pose health risks for the mother-fetus unit and the infant. Despite the recognized benefit of influenza vaccination for pregnant women, only some South and Southeast Asian countries have implemented its recommendation. The success of maternal tetanus vaccination has kindled the interest in vaccines that can be safely administered during pregnancy. Future availability of vaccines against respiratory syncytial virus and group B streptococcus, for use in pregnant women, could help prevent neonatal infections, especially in regions where diseases are less controlled. Communicating the body of evidence that supports maternal immunization to obstetricians is key for achieving optimal vaccination coverage to ensure protection of neonates. The current review aims to create awareness about the existing and potential benefits of maternal immunization in South and Southeast Asia.