08.08.2023 – 11:03
Pfizer Pharma GmbH
Berlin (ots)
Babies are very susceptible to pathogens in the first few weeks and months because their immature immune system is not yet able to fight them adequately.[1] By immunizing expectant mothers, however, there is the possibility of passing on the vaccination protection to the unborn child and thus protecting babies from infectious diseases from birth. During pregnancy, antibodies are transferred from the expectant mother to the unborn child via the placenta. The principle of maternal immunization is an uncomplicated and safe procedure that is currently being used to protect newborns from whooping cough and is being tested in clinical studies for other pathogens.[2]
Maternal vaccination against respiratory syncytial virus (RSV) could make an important contribution to reducing the burden of disease in newborns, since almost every child is infected with RSV by the age of two.[3] The RS virus is the most common respiratory pathogen in infants and young children and can cause infections that can lead to serious complications such as acute respiratory failure. Severe RSV disease can affect any infant, most of those affected do not have a previous illness and are not born prematurely.[3] The first six months are particularly critical because the newborn’s immune system is not yet fully developed.[4] Worldwide, approximately 1 in 28 deaths in infants aged 28 days to 6 months can be attributed to RSV infection.[5] After recovering from an RSV infection, the risk of asthma may be increased.[6]
Need for information on maternal immunization: Antibodies from the mother provide “nest protection” for the newborn
Infectious diseases such as RSV, influenza and whooping cough pose a particular risk to newborns. They are therefore dependent on the so-called nest protection provided by maternal antibodies. The antibodies can be caused by a vaccination of the pregnant woman or by a naturally occurring infection and pass through the placenta into the blood of the unborn child. As a result, the infant receives nest protection for a certain period of time from birth, i.e. it is protected against certain pathogens for a while.[7]
Various vaccinations during pregnancy are already widespread throughout Europe. The Standing Committee on Vaccination (STIKO) recommends healthy pregnant women z. B. the vaccination against flu and whooping cough, with the aim of protecting the expectant mother and the unborn child.[8] The principle of so-called maternal immunization has been established for many years and has proven to be safe.[9,10] Nevertheless, maternal vaccination has so far been used too rarely: In 2021, not even every second pregnant woman (39.7%) had been vaccinated against whooping cough.[11] It is therefore important that gynaecologists inform their pregnant patients about vaccinations during pregnancy and their benefits. Because the personal recommendation of the attending gynecologist is often the most important reason for deciding to have a vaccination.[12]
Babies in the first few months of life are particularly affected by RSV
Compared to influenza, RSV infection in children under the age of five is associated with a 16 times higher rate of hospital admissions.[3] The severe RSV wave in autumn and winter 2022/2023 brought many children’s hospitals to the edge of their limits. About 70 percent of all RSV-related hospitalizations were in infants younger than 12 months.[13] Almost 80 percent of the children treated for RSV in intensive care were younger than one year.[13] Newborns up to the age of three months were the most affected group at 59 percent.[11] RSV infections cannot be cured with medication. You can only alleviate the symptoms, for example by taking antipyretic measures.[14] Depending on the severity, invasive ventilation may also be necessary.[14,15] There is currently no vaccination against RSV that pregnant women can use to protect their newborns. However, several pharmaceutical companies are researching vaccine candidates, including for pregnant women – the first approvals are expected in 2023.
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Sources:
Faucette AN, Pawlitz MD, Pei B, et al. Immunization of pregnant women: Future of early infant protection. Hum Vaccines Immunother 2015;11(11):2549-55. Ciobanu AM, Dumitru AE, Gica N, Botezatu R, Peltecu G, Panaitescu AM. Benefits and risks of IgG transplacental transfer. Diagnostics 2020;10(8):583. Hartmann K et al. Clinical burden of respiratory syncytial virus in hospitalized children aged Health 2018;15(5):847. Li Y et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022;399(10340):2047-2064. Rosas-Salazar, Christian, et al. “Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study.” The Lancet 401.10389 (2023): 1669-1680. Pfizer.de. Impfungen für Schwangere: Schutz für das Neugeborene vom ersten Atemzug an. https://www.pfizer.de/newsroom/news-stories/impfungen-f%C3%BCr-schwangere. Abrufdatum: 19.07.2023. Robert Koch-Institut. Ständige Impfkommission: Empfehlungen der Ständigen Impfkommission (STIKO) beim Robert Koch-Institut 2023. Epid Bull 2023;4:3-68. Zöllkau J et al. Impfen in der Schwangerschaft. Gynäkol Geburtshilfe 2022;27(2):46-53. Simionescu AA et al. Comprehensive overview of vaccination during pregnancy in Europe. J Pers Med 2021;11(11):1196. Rieck T, Steffen A, Feig M, et al. Impfquoten bei Erwachsenen in Deutschland – Aktuelles aus der KV-Impfsurveillance. Epid Bull 2022;49:3-23. Zöllkau J, Hagenbeck C, Schleußner E. Impfen in der Schwangerschaft. Gynäkol Geburtshilfe 2022;27(2):46-53. Deutsche Gesellschaft für Pädiatrische Infektiologie, e. V. Ergebnisse der Atemwegsinfektions-Erfassung. https://dgpi.de/awi-erfassung-update/. Abrufdatum: 19.07.2023. Robert Koch-Institut. Respiratorische Synzytial-Virus-Infektionen (RSV). RKI-Ratgeber. https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_RSV.html. Abrufdatum: 19.07.2023. Robert Koch-Institut. Häufig gestellte Fragen und Antworten zu RSV-Infektionen (Respiratorische Synzytial-Viren). Stand: 12.12.2022. https://www.rki.de/SharedDocs/FAQ/RSV/FAQ_Liste.html. Abrufdatum: 19.07.2023.
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