Table 3.
Consensus on priorities for future research related to factors that influence the immunogenicity and efficacy/effectiveness of immunization during pregnancy.
| Immune responses of pregnant women to vaccination |
|---|
| 1. Immune response (quantity and quality of cellular and antibody immune responses) of pregnant women to vaccines with potential use in pregnancy in comparison with non-pregnant women |
| 2. Immune response (quantity and quality of cellular and antibody immune responses) of pregnant women to vaccines with potential use in pregnancy at various stages of pregnancy in comparison with non-pregnant women |
| Trans-placental transfer of maternal antibodies to fetus |
| 1. Create a better understanding of the molecular and cellular basis of maternal antibody transfer across the placenta, based on currently available vaccines for use in pregnancy, which would help the design of future vaccines that induce antibodies with optimal characteristics for transfer to the fetus |
| 2. The induction of different vaccine-induced IgG subclasses should be evaluated early in the development of new vaccines designed for pregnant women |
| 3. The effect of maternal health conditions on the transfer of vaccine-induced IgG subclasses should be assessed early in the development of new vaccines designed for pregnant women. This is especially important for some health conditions more prevalent in low-middle income countries such as poor nutrition, human immunodeficiency infection, malaria infection and hypergammaglobulinemia |
| Timing of immunization during pregnancy |
| 1. The main target for protection in pregnancy (i.e., pregnant women and/or infant) and the time in gestation and/or infancy this maximal protection is desired have to be clearly defined for individual pathogens targeted for immunization |
| 2. The safety of vaccination when administered in different stages during gestation |
| 3. Time-dependent efficiency of transplacental transfer of vaccine-induced antibodies (quantity and quality) |
| 4. Time-dependent clinical efficacy/effectiveness (for both term and preterm infants) |