A maternal immunization program (MIP): developing a schedule and platform for routine immunization during pregnancy.

Among the factors that have fostered success in childhood mmunization has been the development of the well-child schedule nd platform. This has allowed an evidence-based, standardzed schedule to be developed, implemented, propagated, and tilized across all pediatric care settings throughout the U.S. Furher, development of the childhood immunization platform made rovision of vaccines to children a routine, rather than special, atient care activity. As a result, success has been dramatic, ith high rates of immunization (at least when such vaccines re accepted by parents). Now, interest in adult immunization s awakening in physicians, healthcare providers, public health fficials, manufacturers, and the press [1,2]. New adult vaccines, ew recommendations for using current vaccines, and the increasng awareness that non-immunized persons create a threat to veryone’s public health is creating momentum for a standardized pproach to adult immunization [3]. Immunization prior to, during, or after pregnancy, or so-called maternal immunization,” is a special form of adult immunizaion in that the vaccine protects both mother and baby—and hence ridges both childhood and adult vaccination. This concept is critcal as newborn infants often cannot form protective immune esponses to specific vaccine antigens until some weeks to months ater in life. This creates a “gap” during which the newborn infant s extremely vulnerable to a number of vaccine-preventable disases. Immunizing the mother not only protects the mother against hese diseases, but allows protective antibodies to be passively ransmitted to the fetus, often in higher concentrations than in he mother herself, thus protecting the neonate from disease until ctive immunization of the infant can be accomplished. This is truly “two for one” benefit at no increased cost. What is perplexing is why this concept has not become a priorty among obstetricians, vaccinologists, professional societies and ublic health officials. For example, the influenza vaccine has been ecommended for all pregnant women since 2004 by the Advisory ommittee on Immunization Practices (ACIP) and the American ollege of Obstetricians and Gynecologists (ACOG). Despite this, ix years later (2010) influenza immunization rates of pregnant omen in the U.S. were estimated at 49%, although 62% of pregant women in a recent national survey said their healthcare rovider (HCP) offered them the vaccine [4]. Importantly, 71% of hose offered the vaccine by their HCP received influenza vaccine, ompared to only 14% who were not offered vaccine by their HCP 4]. Why are pregnant patients not being offered the vaccines by CPs? We believe that key reasons include lack of knowledge,