Peer-reviewed article
Maternal Immunization: Nature Meets Nurture
Anja Saso, Beate Kampmann ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a scientific review of maternal immunization, where pregnant women are vaccinated to protect their newborns. The strategy works by passing antibodies from mother to baby either across the placenta during pregnancy or through breast milk after birth, giving infants protection during their most vulnerable early months. The review examines how these antibodies are transferred, the biological mechanisms involved, and factors that affect how well this protection works across different populations and settings.
Key points
- Maternal immunization provides passive, antigen-specific protection to infants in their first months of life when they are most vulnerable to infections
- Antibodies are transferred from mother to infant through two main routes: transplacentally during pregnancy and postnatally through breast milk
- High maternal antibody titres may influence neonatal immune development and subsequent infant vaccine responses
- Multiple vaccine and host-related factors influence the effectiveness of maternal-infant antibody transfer across different environments
- There are important gaps in knowledge about optimal testing, delivery and implementation of maternal vaccination programs worldwide
Limitations
This is a review article that synthesizes existing knowledge rather than presenting new empirical data or evaluation results. It does not assess the effectiveness of specific maternal immunization programs or provide comparative outcome data from implementation studies.
Abstract
Vaccinating women in pregnancy (i.e., maternal immunization) has emerged as a promising tool to tackle infant morbidity and mortality worldwide. This approach nurtures a 'gift of nature,' whereby antibody is transferred from mother to fetus transplacentally during pregnancy, or postnatally in breast milk, thereby providing passive, antigen-specific protection against infections in the first few months of life, a period of increased immune vulnerability for the infant. In this review, we briefly summarize the rationale for maternal immunization programs and the landscape of vaccines currently in use or in the pipeline. We then direct the focus to the underlying biological phenomena, including the main mechanisms by which maternally derived antibody is transferred efficiently to the infant, at the placental interface or in breast milk; important research models and methodological approaches to interrogate these processes, particularly in the context of recent advances in systems vaccinology; the potential biological and clinical impact of high maternal antibody titres on neonatal ontogeny and subsequent infant vaccine responses; and key vaccine- and host-related factors influencing the maternal-infant dyad across different environments. Finally, we outline important gaps in knowledge and suggest future avenues of research on this topic, proposing potential strategies to ensure optimal testing, delivery and implementation of maternal vaccination programs worldwide.