Influenza epidemiology and immunization during pregnancy: Final report of a World Health Organization working group |
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Affiliation: | 1. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa and Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Canada;2. Influenza Division, Centers for Disease Control and Prevention, USA;3. Department of Public Health, University of Otago, New Zealand;4. Department of Pediatrics-Neonatology, University of Washington School of Medicine, USA;5. European Centre for Disease Prevention and Control (ECDC), Sweden;6. Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Belgium;7. Center for Vaccine Innovation and Access, PATH, USA;8. Centre for Global Child Health, Hospital for Sick Children, Canada;9. Center of Excellence in Women & Child Health, The Aga Khan University, Pakistan;10. National Institute for Communicable Diseases, National Health Laboratory Service, South Africa;11. School of Public Health, University of the Witwatersrand, South Africa;12. Latin American Center for Perinatology, Women and Reproductive Health, Panamerican Health Organization, Uruguay;13. Agence de Médecine Préventive, France;14. Department of Obstetrics and Gynecology, University of Washington, USA;15. Medical School for International Health and Department of Health Systems Management, Ben Gurion University of the Negev, Israel;p. School of Public Health, University of Michigan, USA;q. National Perinatal Epidemiology Unit, University of Oxford, UK;r. Saw Swee Hock School of Public Health, National University of Singapore, Singapore;s. Institute for Infectious Disease Research, McMaster University, Canada;t. Queen Mary, University of London, UK;u. Robinson Research Institute and Adelaide Medical School, University of Adelaide and Women''s and Children''s Health Network, Australia;v. Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, UK;w. Department of Family Medicine, University of Ottawa, Canada;x. South Australian Health and Medical Research Institute, University of Adelaide, Australia;y. Division of Women and Child Health, Aga Khan University, Pakistan;z. Departments of Epidemiology and Obstetrics and Gynecology, Brown University, USA;11. Independent Information Specialist, Canada;12. Initiative for Vaccine Research, World Health Organization, Switzerland |
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Abstract: | From 2014 to 2017, the World Health Organization convened a working group to evaluate influenza disease burden and vaccine efficacy to inform estimates of maternal influenza immunization program impact. The group evaluated existing systematic reviews and relevant primary studies, and conducted four new systematic reviews. There was strong evidence that maternal influenza immunization prevented influenza illness in pregnant women and their infants, although data on severe illness prevention were lacking. The limited number of studies reporting influenza incidence in pregnant women and infants under six months had highly variable estimates and underrepresented low- and middle-income countries. The evidence that maternal influenza immunization reduces the risk of adverse birth outcomes was conflicting, and many observational studies were subject to substantial bias. The lack of scientific clarity regarding disease burden or magnitude of vaccine efficacy against severe illness poses challenges for robust estimation of the potential impact of maternal influenza immunization programs. |
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Keywords: | Influenza Immunization Pregnancy Infants |
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