Röbl-Mathieu M, Terhardt M
Connollystr. 4, 80809 München, Deutschland.
Berlin, Deutschland.
Monatsschr Kinderheilkd. 2021;169(11):1043-1050. doi: 10.1007/s00112-021-01321-7. Epub 2021 Oct 20.
Due to characteristics of the immune system, pregnant women, fetuses and infants show an increased infection-related morbidity and mortality, which can be reduced by vaccinations during pregnancy.
This article elucidates the mechanisms, the evidence of expected effects, contraindications and possible adverse effects of vaccinations in pregnancy.
A selective literature search was carried out with particular attention to the recommendations of the Standing Committee on Vaccinations of the Robert Koch Institute (STIKO) and the pertinent guidelines.
Vaccinations during pregnancy protect expectant mothers from a severe course of a number of different infectious diseases and therefore the associated pregnancy complications. Moreover, neonates are given passive immune protection against life-threatening infections by the vertical transmission of maternal antibodies. The efficacy and safety of vaccination in pregnancy is well-established for inactivated vaccines against tetanus, influenza and pertussis; vaccinations with live-attenuated vaccines are contraindicated due to a theoretical risk for the fetus. Currently available data on the deployment of vaccines against coronavirus disease 2019 (COVID 19) are still limited.
The goals of vaccination during pregnancy are to directly protect pregnant women by active immunization and/or the child by natural passive immunization. Pregnant women should not be excluded from an indicated vaccination for their own protection and that of the child. Additional reasonable measures to protect the health of mother and child include the vaccination of other persons in close contact as well as the closure of relevant vaccination gaps among young adults, particularly for women of childbearing age.
由于免疫系统的特点,孕妇、胎儿和婴儿感染相关的发病率和死亡率会增加,而孕期接种疫苗可降低这种情况。
本文阐明孕期接种疫苗的机制、预期效果的证据、禁忌证和可能的不良反应。
进行了选择性文献检索,特别关注罗伯特·科赫研究所疫苗接种常设委员会(STIKO)的建议和相关指南。
孕期接种疫苗可保护准妈妈免受多种不同传染病的严重病程影响,从而预防相关的妊娠并发症。此外,通过母体抗体的垂直传播,新生儿可获得针对危及生命感染的被动免疫保护。孕期接种灭活破伤风、流感和百日咳疫苗的有效性和安全性已得到充分证实;由于对胎儿存在理论风险,禁忌接种减毒活疫苗。目前关于2019冠状病毒病(COVID-19)疫苗接种的可用数据仍然有限。
孕期接种疫苗的目标是通过主动免疫直接保护孕妇和/或通过自然被动免疫保护胎儿。不应因孕妇自身及胎儿的保护而将其排除在有指征的疫苗接种之外。保护母婴健康的其他合理措施包括对密切接触的其他人进行疫苗接种,以及填补年轻人尤其是育龄妇女中相关的疫苗接种空白。