The historical aspects of vaccination in pregnancy

After all those tough ships through the history-making pandemic of coronavirus disease 2019 (COVID-19), it is time to consider the historical lessons about the vaccine-preventable disease in pregnancy. Throughout many decades, public health crises have driven vaccine development and uptake. The pandemics of the past have necessitated future vaccine development and uptake. 

The relationship between Pandemics and Vaccinations is as follows-

• Pregnant women are targeted for vaccination each flu season due to their disproportionate morbidity and mortality during influenza pandemics. 
• A vaccine developed to combat the teratogenic effects of rubella epidemics was developed in response to these epidemics' devastation. 
• Following vaccination for pertussis and tetanus, immunity is passed from mother to baby, reducing preventable deaths in the early weeks of life. 

Clinicians caring for pregnant women must remember that-

• In recent decades, vaccination during pregnancy has proven to be one of the most effective public health interventions for the primary prevention of communicable diseases and for reducing maternal and perinatal morbidity and mortality.
• The influenza pandemics have explained the importance of international surveillance systems for critical illness in pregnant women, the significance of including pregnant women in vaccine efficacy clinical trials, and the need for community engagement to optimize vaccine uptake.
• The rubella epidemics have highlighted the need for birth defect surveillance systems to recognize teratogenic links with viral pathogens, and the significance of understanding disease epidemiology to optimize vaccination uptake and efficacy.
• The benefits of passive immunity for tetanus and pertussis have caused a significant reduction in infant mortality and morbidity due to optimal timing and dosing during pregnancy.

Thus, Vaccinations are crucial in pregnancy care to prevent infectious diseases in the mother, fetus, and newborn. Its evolution and application must continue to improve maternal and perinatal outcomes, like

• recognizing the unique pathogenic consequences of diseases in pregnancy, 
• improving knowledge about the maternal immune system and its interplay with the fetus, 
• optimizing safe vaccine development, 
• ensuring the participation of pregnant women in appropriately designed trials of efficacy, 
• public health engagement to optimize uptake. 

Mackin DW, Walker SP. The historical aspects of vaccination in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology.2021;76:13-22. https://doi.org/10.1016/j.bpobgyn.2020.09.005.