Uptake of vaccination in pregnancy

Abstract Maternal immunisation is a public health strategy which aims to provide protection against certain infections to both mother and her fetus or newborn child. Vaccination of pregnant women induces vaccine-specific antibodies leading to subsequent transfer of these antibodies across the placenta or via breastfeeding to the offspring. Currently, vaccinations in pregnancy are limited to Pertussis, Tetanus, Diphtheria and Polio as well as the seasonal Influenza vaccine. Some countries have in recent years incorporated routine antenatal vaccinations in their national immunisation programmes. Future vaccines targeted at pregnant women such as Respiratory syncytial virus (RSV) and Group B streptococcus (GBS) are under development. The recently approved Covid-19 vaccines have no safety data for use in pregnancy currently but have been considered in the UK in extremely vulnerable pregnant women or pregnant frontline health and social care workers. In this article we review the evidence supporting maternal immunisation and discuss uptake of vaccines in pregnant women, challenges of recording data on vaccine coverage, as well as consider reasons behind current levels of uptake and strategies for future improvements.