Vaccinating for Two: Increasing Maternal Vaccine Uptake


During pregnancy, there are many preparations that expectant mothers may make before welcoming a newborn: purchasing a stroller, preparing a nursery, buying clothes, diapers, wipes and many other items. Another way expectant mothers can prepare, according to the Centers for Disease Control and Prevention (CDC), is vaccinating themselves against diseases, namely influenza and pertussis.  

As the body changes externally during pregnancy, there are also internal changes that impact the immune system, heart, and lung function, leaving expectant mothers susceptible to some diseases. Not only is the mother at increased risk, but so too is the growing fetus. Because of the increased susceptibility to vaccine-preventable disease, the CDC has guidelines for vaccines that those planning families should receive before, during, and after pregnancy. 

The importance of vaccines like Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) and the flu are twofold; they help to maintain not only a healthy pregnancy, but also a healthy baby in the first few months of life. Those pregnant or planning to be pregnant are encouraged to be vaccinated against influenza before or during pregnancy, as it can prevent severe illness. The vaccination protects the expectant mother from flu complications, which can lead to premature delivery, low birth weight, miscarriage and other birthing difficulties. Fortunately, much like an expectant mother shares the nutrients she eats, she also shares immunization with her baby. Influenza vaccination protects babies from illness until they reach two months of age, when the CDC recommends childhood immunizations begin. 

Research published in the American Academy of Pediatrics found that both Tdap and flu vaccines were effective in the prevention of disease during pregnancy. Newborns whose mothers received seasonal flu shots during pregnancy were 70% less likely to contract an influenza virus than babies born to mothers that were not immunized, according to a study cited in the 2018 State of the Immunion. Similarly, when mothers receive the Tdap vaccine during pregnancy, they reduce infants’ risk of pertussis (whooping cough) by 91%.

Despite the effectiveness of these vaccines in preventing disease, there is still a lag in uptake. As reported by the CDC, about half of pregnant women currently follow the guidelines to receive either the influenza or Tdap vaccines. 

According to a 2016 study featured in Human Vaccines & Immunotherapies, pregnant women cited various reasons for low vaccine uptake, including misperceptions about the severity of risk, mistrust of vaccines, concerns about vaccine efficacy, societal and familial influence, as well as general lack of knowledge. Yet, the study also revealed that patient education interventions proved to increase uptake in maternal vaccinations. 

Clinicians have an opportunity when interacting with patients planning families to address their concerns and rely on best practice strategies for emphasizing vaccine importance. These include providing a clear-cut recommendation and building trust by acknowledging and honoring patient concerns.  

Ultimately, the responsibility to keep expectant mothers and babies healthy lies chiefly on the individual, but when clinicians educate patients, they can help increase vaccine uptake and the likelihood for a healthy mother and baby.