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Protecting pregnancy during pandemics: What recent outbreaks teach us
Annette K Regan1,2, Flor M Muñoz3
1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Human Vaccines & Immunotherapeutics
|December 10, 2025
Summary
Recent public health emergencies, like the H1N1 pandemic and mpox outbreaks, highlight the need for better vaccine and therapeutic safety evaluation in pregnant individuals. Improving vaccination rates during pregnancy is crucial for protecting maternal and infant health.
Area of Science:
- Public Health
- Epidemiology
- Perinatal Medicine
Background:
- Public health emergencies disproportionately affect pregnant individuals, increasing their risk of severe illness.
- Past emergencies, including the 2009 influenza A/H1N1 pandemic and recent mpox outbreaks, have generated valuable perinatal pharmacovigilance data.
- Historically, pregnant populations were excluded from clinical trials for vaccines and therapeutics, limiting safety data.
Purpose of the Study:
- To review insights from recent public health emergencies regarding pregnant individuals.
- To assess the evolving landscape of including pregnant people in clinical trials for medical countermeasures.
- To identify challenges and opportunities for improving vaccination and care during health crises.
Main Methods:
- The authors provide a commentary based on experiences from recent public health emergencies.
- Analysis of trends in clinical trial inclusion for pregnant populations.
- Review of pharmacovigilance data and vaccination strategies during epidemics.
Main Results:
- Perinatal pharmacovigilance capacity has improved, enhancing post-authorization safety evaluations for pregnant individuals.
- There is a growing trend towards including pregnant people in clinical trials.
- Healthcare system strain during emergencies can disrupt essential prenatal, birthing, and postnatal care.
Conclusions:
- Vaccination during pregnancy is feasible but often has suboptimal uptake.
- Further research is needed to understand and address vaccine hesitancy in pregnant populations.
- Integrating maternal health considerations into pandemic preparedness is essential for protecting pregnant individuals and newborns.
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