Maternal immunization: Difference between revisions
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==Overview== | ==Overview== | ||
Immunization prevents illness, disability and death from vaccine-preventable diseases. Vaccines are useful to reduce childhood mortality and morbidity. Vaccination schedule starts at early infancy and it's not complete by age of 6 months. Therefore, most of the children do not have coverage during the early infancy with adequate protection which may predispose them to infections. This gap may result in higher infection related hospitalization and disease complications in early infancy than in older children. Maternal vaccination has became to consideration to cover this gap. However it can protect mother from acquiring infection it is also effective for infant protection. | Immunization prevents illness, disability and death from vaccine-preventable diseases. Vaccines are useful to reduce childhood mortality and morbidity. Vaccination schedule starts at early infancy and it's not complete by age of 6 months. Therefore, most of the children do not have coverage during the early infancy with adequate protection which may predispose them to infections. This gap may result in higher infection related hospitalization and disease complications in early infancy than in older children. Maternal vaccination has became to consideration to cover this gap. However it can protect mother from acquiring infection it is also effective for infant protection. | ||
==Immunology== | |||
Maternal immunity changes during the pregnancy under influence of hormonal changes. Increased level of estrogen and progesterone are the most important factors for these changes. Increased level of estradiol is associated with increased level of T-helper type 2 cell response compared to type 1 T-cells.<ref name="pmid25207785">{{cite journal |vauthors=Lindheimer MD, Cunningham FG |title=Pregnancy and infection |journal=N. Engl. J. Med. |volume=371 |issue=11 |pages=1076–7 |year=2014 |pmid=25207785 |doi=10.1056/NEJMc1408436#SA3 |url=}}</ref><ref name="pmid17640948">{{cite journal |vauthors=Straub RH |title=The complex role of estrogens in inflammation |journal=Endocr. Rev. |volume=28 |issue=5 |pages=521–74 |year=2007 |pmid=17640948 |doi=10.1210/er.2007-0001 |url=}}</ref> However, increased level of progesterone may result in decrease in immune response and alteration in immune system.<ref name="pmid8887124">{{cite journal |vauthors=Szekeres-Bartho J, Wegmann TG |title=A progesterone-dependent immunomodulatory protein alters the Th1/Th2 balance |journal=J. Reprod. Immunol. |volume=31 |issue=1-2 |pages=81–95 |year=1996 |pmid=8887124 |doi= |url=}}</ref><ref name="pmid22406114">{{cite journal |vauthors=Robinson DP, Klein SL |title=Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis |journal=Horm Behav |volume=62 |issue=3 |pages=263–71 |year=2012 |pmid=22406114 |pmc=3376705 |doi=10.1016/j.yhbeh.2012.02.023 |url=}}</ref> Other aspect of immune response such as, phagocytosis and number of neutrophils and monocytes remains unchanged.<ref name="pmid22406114">{{cite journal |vauthors=Robinson DP, Klein SL |title=Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis |journal=Horm Behav |volume=62 |issue=3 |pages=263–71 |year=2012 |pmid=22406114 |pmc=3376705 |doi=10.1016/j.yhbeh.2012.02.023 |url=}}</ref><br> | |||
These changes (alteration in cell mediated immunity) explain sub-optimal immune response to some certain viral infections such as influenza. Furthermore, it justifies the need for immunization against these infections.<ref name="pmid22447351">{{cite journal |vauthors=Pazos M, Sperling RS, Moran TM, Kraus TA |title=The influence of pregnancy on systemic immunity |journal=Immunol. Res. |volume=54 |issue=1-3 |pages=254–61 |year=2012 |pmid=22447351 |doi=10.1007/s12026-012-8303-9 |url=}}</ref> | |||
Revision as of 18:34, 3 April 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Immunization prevents illness, disability and death from vaccine-preventable diseases. Vaccines are useful to reduce childhood mortality and morbidity. Vaccination schedule starts at early infancy and it's not complete by age of 6 months. Therefore, most of the children do not have coverage during the early infancy with adequate protection which may predispose them to infections. This gap may result in higher infection related hospitalization and disease complications in early infancy than in older children. Maternal vaccination has became to consideration to cover this gap. However it can protect mother from acquiring infection it is also effective for infant protection.
Immunology
Maternal immunity changes during the pregnancy under influence of hormonal changes. Increased level of estrogen and progesterone are the most important factors for these changes. Increased level of estradiol is associated with increased level of T-helper type 2 cell response compared to type 1 T-cells.[1][2] However, increased level of progesterone may result in decrease in immune response and alteration in immune system.[3][4] Other aspect of immune response such as, phagocytosis and number of neutrophils and monocytes remains unchanged.[4]
These changes (alteration in cell mediated immunity) explain sub-optimal immune response to some certain viral infections such as influenza. Furthermore, it justifies the need for immunization against these infections.[5]
- ↑ Lindheimer MD, Cunningham FG (2014). "Pregnancy and infection". N. Engl. J. Med. 371 (11): 1076–7. doi:10.1056/NEJMc1408436#SA3. PMID 25207785.
- ↑ Straub RH (2007). "The complex role of estrogens in inflammation". Endocr. Rev. 28 (5): 521–74. doi:10.1210/er.2007-0001. PMID 17640948.
- ↑ Szekeres-Bartho J, Wegmann TG (1996). "A progesterone-dependent immunomodulatory protein alters the Th1/Th2 balance". J. Reprod. Immunol. 31 (1–2): 81–95. PMID 8887124.
- ↑ 4.0 4.1 Robinson DP, Klein SL (2012). "Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis". Horm Behav. 62 (3): 263–71. doi:10.1016/j.yhbeh.2012.02.023. PMC 3376705. PMID 22406114.
- ↑ Pazos M, Sperling RS, Moran TM, Kraus TA (2012). "The influence of pregnancy on systemic immunity". Immunol. Res. 54 (1–3): 254–61. doi:10.1007/s12026-012-8303-9. PMID 22447351.