Maternal vaccination
Maternal vaccination to protect the newborn via transplacental antibody transfer. Per CDC ACIP 2023, ACOG 2023, and SEGO 2023, routine schedule: Tdap (preferably 27–36 weeks) – pertussis protection in first 3 months; influenza vaccine – any trimester; COVID vaccine – as recommended; RSV vaccine (Abrysvo) at 32–36 weeks – RSV bronchiolitis protection in first 6 months. All inactivated and safe.
ICD-10 Z234 drugs
Also known as: Vaccination in pregnancy for infant protection
Drugs used for this condition
- ACOVID-19 vaccine, mRNA (Pfizer-BioNTech)First line · mRNA SARS-CoV-2 vaccineActive maternal immunization against COVID-19. CDC ACIP 2024 and SEGO 2023 recommend any trimester. No increased risk of miscarriage, preterm birth, or birth defects (Lancet 2022 meta-analysis, n>250,000).
- AInactivated influenza vaccineFirst line · Inactivated subunit or split influenza vaccineActive maternal immunization against influenza. Per CDC ACIP 2024 and SEGO 2023, recommended in any trimester (preferably before seasonal peak). Reduces severe maternal disease and protects the infant for the first 6 months via transplacental antibodies.
- ARSV vaccine, recombinant (maternal)First line · Recombinant protein vaccine, stabilized prefusion F proteinMaternal RSV immunization. Per CDC ACIP 2024 and SEGO 2024, at 32–36 weeks during RSV season (September-January in Northern Hemisphere). Alternative – nirsevimab (Beyfortus) monoclonal antibody to the infant at birth.
- ATdap – tetanus, diphtheria, acellular pertussis vaccineFirst line · Combined inactivated bacterial vaccine (Td + acellular pertussis)Active maternal immunization against pertussis. Per CDC ACIP 2023, ACOG 2023, SEGO 2023 – every pregnancy at 27–36 weeks, optimally 27-30. Reduces pertussis in infants <3 months by 78–91% (Baxter, Pediatrics 2017; Skoff, CID 2017). Tetanus/diphtheria booster every 10 years.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit