The RSV vaccine is the latest in a series of immunizations that could protect pregnant people and their babies from severe disease and death
When the U.S. Food and Drug Administration approved the most recent respiratory syncytial virus vaccine on August 21, it became the first vaccine that had been developed specifically to be given during pregnancy to protect the baby after birth to receive the go-ahead. But it’s not the first vaccine that the Centers for Disease Control and Prevention has recommended during pregnancy.
Many infections happen right around the time of birth, before most vaccines are given, says Kathryn Edwards, a professor of pediatrics and scientific director of Vanderbilt University’s Vaccine Research Program. “But when you immunize the mother, you protect the mother from a disease that she could present to the baby, and you protect the baby against disease. So it’s a twofer—one shot but with the protection of two.
Neonatal tetanus, for example, killed an estimated 787,000 newborns globally in 1988. While improving hygienic practices during delivery can reduce a portion of those deaths, only tetanus vaccination during pregnancy eliminates the risk, so the World Health Organization made tetanus vaccination during pregnancy a top priority in 1989.
Then in late 2019 a new virus arrived that threatens both pregnant people and their fetuses. “With COVID, we saw again that pregnancy was a significant risk and that people who were pregnant were much more likely to end up in the hospital and [die], with increased risk of fetal loss and miscarriage,” Talaat says. Again, though, companies were hesitant to conduct COVID vaccine trials with pregnant volunteers, which left pregnant people vulnerable to infection, she says.
Yet the increased risk of prematurity occurred only in low- and middle-income countries, and the finding was only significant when compared with infants born to mothers who did not receive the flu or COVID vaccines. It’s plausible that the RSV vaccine did not increase the risk of prematurity but rather that the flu and COVID vaccines decreased that risk, Offit says. Those calculations were never done because GSK scrapped the trial, however.
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