The Knowledge Hub

What is the Knowledge Hub?

Explore the VoICE Knowledge Hub—a searchable database featuring the latest peer-reviewed research on immunization benefits, especially in low- and middle-income countries. Browse the Knowledge Hub using a variety of different filters to find vaccine evidence based on country, region, topic, or disease. Click on a tag to find more evidence on a specific area, such as the return on investment of vaccines or impacts of infectious disease outbreaks.


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Immunization during pregnancy can increase anti-meningococcal antibodies in breastmilk, providing better protection for infants

The breastmilk of mothers in Bangladesh who received the meningococcal vaccine during pregnancy had anti-meningococcal antibody levels at 3-6 months after delivery of four to five times higher than that of mothers who did not receive the vaccine.

Although this study was published in 2002, the data on this topic are sparse as it is methodologically difficult to conduct studies to evaluate the relationship between anti-meningococcal antibodies in breastmilk and protection.

Shahid NS, Steinhoff MC, Roy E et al.. 2002. Placental and breast transfer of antibodies after maternal immunization with polysaccharide meningococal vaccine: a randomized, controlled evaluation. Vaccine. 20(17-18).

Immunization during pregnancy reduces the risk of stillbirths and preterm delivery caused by influenza

During the 2009 UK influenza A H1N1 pandemic, pregnant women who contracted influenza were five times more likely to have perinatal mortality (stillbirths) and three times more likely to have a preterm delivery, than were pregnant women who did not contract the virus.

Lim BH, Mahmood TA. 2011. Influenza A H1N1 2009 (Swine Flu) and Pregnancy. The Journal of Obstetrics and Gynecology in India. 61(4).

Immunization during pregnancy reduces the risk of miscarriages, stillbirths, low birthweight, and premature deliveries

Studies from multiple Western countries have found that pregnant women infected with influenza during the 2009 A/H1N1 pandemic were at higher risk of miscarriages, stillbirths, low birthweight and premature deliveries. The risk of fetal death was between 2 and 5.5 times higher in pregnant women with influenza than in pregnant women without influenza. In the UK, the rate of stillbirths was 4.5 times higher and the likelihood of preterm delivery was 4 times greater in influenza-infected pregnant women than non-infected women.

Although this article indicated that influenza vaccination is safely used for the mother and the fetus, conflicting data exists on the effect of vaccination in improving preterm birth rates.

Nunes MC, Madhi SA. 2015. Review on the effects of influenza vaccination during pregnancy on preterm births. Human Vaccines & Immunotherapeutics. 11(11).

Adding dTpa vaccination for pregnant women in Australia would prevent thousands of pertussis hospitalizations each year

A study in Australia estimated that adding dTpa vaccination for pregnant women to the current pertussis immunization program for children would prevent an additional 8,800 symptomatic pertussis cases (mostly unreported) and 146 hospitalizations each year in all ages, including infants and their mothers, as well as one death every 22 months. The study found maternal pertussis vaccination to be cost-effective.

Note: The formulation used in this study is abbreviated dTpa.

Saul N, Wang K, Bag S et al.. 2018. Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: the NSW Public Health Network case-control study. Vaccine. 36(14).

Despite the introduction of a vaccine, newborns in New Zealand still have a high rate of pneumococcal disease Maternal vaccination could help protect these infants

Despite the introduction of pneumococcal conjugate vaccine (PCV) in the childhood immunization program in New Zealand, the incidence of invasive pneumococcal disease in neonates (<30 days old) remains relatively high at 6 per 100,000 (versus 2/100,000 in the U.S.). Out of 19 cases in infants <30 days old in this study, 9 (47%) occurred during the first 7 days of life and 6 within the first 48 hours. If proven effective, maternal vaccination would cover 74% to 84% of the serotypes that infected these infants, depending on the vaccine.

Mount V, Burton C, Jackson C et al.. 2017. Neonatal invasive pneumococcal disease: New Zealand experience in the era of pneumococcal vaccination. Australian and New Zealand Journal of Obstetrics and Gynaecology. 57(3).

Immunization during pregnancy protects against serious illnesses and improves pregnancy outcomes

Pregnant women are at particularly high risk of serious illness and death from a variety of bacterial and viral diseases, such as influenza, pneumococcal pneumonia, and Group B strep, for which vaccines exist or are in development. Vaccine-preventable diseases in pregnancy are associated with adverse pregnancy outcomes such as spontaneous abortion, congenital anomalies, preterm birth, and low birth weight.

Swamy GK, Beigi RH. 2015. Maternal benefits of immunization during pregnancy. Vaccine. 33(47).

Immunization against tetanus, pertussis, and influenza can profoundly improve the health of pregnant mothers and their children

Immunization against tetanus, pertussis and influenza during pregnancy has been shown to have a profound effect on the health of the mother and fetus, and increases survival of infants in their first months of life. Maternal immunizations with tetanus toxoid-containing vaccines has been one of the main contributors to the 94% reduction in global deaths due to tetanus since 1988. Between the 1970s to the early 2000s, maternal immunization against pertussis brought disease incidence down to 5,000 cases per year from the earlier 100,000-250,000 cases per year in the United States. Vaccination of mothers for influenza has brought down confirmed cases of the disease by 63%.

Steedman, M.R., Kampmann, B., Schillings, E., et al. 2016. Strategies to boost maternal immunization to achieve further gains in improved maternal and newborn health. Health Affairs. 35(2).