Pneumococcal Vaccination During Pregnancy: Can It Prevent Infant Infections?
Vaccinations could significantly reduce the impact of pneumococcal disease in infants, but pneumococcal vaccines are not indicated for newborns under six weeks of age. Pneumococcal vaccinations during pregnancy may help to prevent pneumococcal disease in newborns prior to vaccine administration.
A review in the Cochrane Library located six randomized controlled trials of 919 participants evaluating the effectiveness of pneumococcal vaccination during pregnancy in reducing neonatal infection risk. Primary outcomes included neonatal pneumococcal infection (pneumonia, meningitis, bacteremia/sepsis, neonatal death due to pneumococcal infection), otitis media, and neonatal pneumococcal colonization at two to three months of age and by six to seven months of age.
There was no evidence that pneumococcal vaccination during pregnancy reduced the risk of neonatal infection, although the data suggested an effect in reducing pneumococcal colonization in infants by 16 months of age. None of the trials reported neonatal death as a result of pneumococcal infection. The overall quality of evidence was low for primary outcomes and most outcomes had wide confidence intervals crossing the line of no effect. Small sample sizes and few events also contributed to low quality of evidence.
While pneumococcal vaccine is recommended to pregnant women with underlying medical conditions for preventing maternal infections, there is insufficient evidence to support their use during pregnancy for preventing infant infections. Two recent trials have shown promising results in neonatal vaccinations for minimizing invasive pneumococcal disease, but no clinical outcomes have been reported.