Safety and Efficacy of Vaccines During Pregnancy: A Systematic Review.

Maternal immunization is a safe and effective strategy for protecting mothers and infants from vaccine-preventable diseases. This systematic review evaluated the safety and efficacy of various vaccines administered during pregnancy, focusing on maternal and infant outcomes. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science to identify relevant studies. The search used terms and combinations such as ("maternal vaccination" OR "vaccination during pregnancy") AND ("safety" OR "efficacy" OR "immunogenicity") AND ("influenza" OR "DTaP" OR "respiratory syncytial virus" OR "group B streptococcus" OR "COVID-19"). Boolean operators "AND" and "OR" enhanced precision and filtered the limited results to studies published from 2018 to 2024. Eight studies were included in the review after applying inclusion and exclusion criteria. Influenza, diphtheria-tetanus-pertussis, respiratory syncytial virus, group B streptococcus, and COVID-19 vaccines are safe and effective when administered during pregnancy. These vaccines elicit robust immune responses in pregnant women, with efficient transplacental antibody transfer providing passive immunity to newborns. Adverse effects were mostly mild to moderate and similar to those observed in nonpregnant individuals. No significant increase in adverse pregnancy or neonatal outcomes was associated with maternal vaccination. Most of the included randomized controlled trials (had a low risk of bias, thus supporting the reliability of the findings. However, vaccine hesitancy remains a challenge, highlighting the need for transparent communication between healthcare providers and pregnant women. Future research should focus on long-term infant health outcomes, vaccine safety, immunogenicity in diverse populations, and strategies to optimize maternal immunization timing and enhance neonatal antibody persistence. This review supports the implementation of routine maternal vaccination programs and emphasizes the importance of addressing knowledge gaps and ensuring equitable access to immunization during pregnancy.