Health Systems and Policy Research

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Mini Review - (2023) Volume 10, Issue 3

The Effectiveness of Influenza Vaccination in Pregnancy In Relation To Child Health Outcomes

Rishika Panday*
Department of Epidemiology, University of KwaZulu Natal, South Africa
*Correspondence: Rishika Panday, Department of Epidemiology, University of KwaZulu Natal, South Africa, Email:

Received: 01-May-2023, Manuscript No. Iphspr-23-13528; Editor assigned: 03-May-2023, Pre QC No. Iphspr-23-13528; Reviewed: 17-May-2023, QC No. Iphspr-23-13528; Revised: 22-May-2023, Manuscript No. Iphspr- 23-13528 (R); Published: 30-May-2023, DOI: 10.36648/2254- 9137.23.10.3-182


Determine the impact of influenza vaccination during pregnancy on the development of the foetus. Systematic analysis and review. From 1 January 1996 to 29 June 2018, data were gathered from Clinical, the Cochrane Library, EMBASE, Medline, and Medline in process, PubMed, and Web of Science. The Medline database was updated. Observational studies and randomised controlled trials reporting on the health of children and infants delivered to mothers who received the inactivated influenza vaccine during pregnancy. Infant laboratoryconfirmed influenza was the main result. Other respiratory infections, primary care, clinic visits or hospitalisations owing to influenza sickness, and long-term respiratory outcomes in children were secondary outcomes. Four primary RCTs and four observational studies were included in the research, with additional articles describing the secondary outcomes of these RCTs


In a meta-analysis using random effects of an overall decrease in LCI in neonates was linked to maternal influenza immunisation [1]. The maternal influenza vaccination, however, had no impact on ILI in 6-month-old infants. The meta-analysis evaluating the outcome of LCI in newborns excluded two RCTs [2]. Both of these studies demonstrated a protective benefit against LCI for newborns, with up to 70% vaccination effectiveness. An overall inverse (protective) link between maternal influenza vaccination and newborn LCI, hospitalisation and clinic visits due to LCI or ILI in infants, and other respiratory illness in infants 6 months old, was found in observational studies [3]. Conclusions: The maternal influenza vaccine is recommended by this systematic review as a method to lower LCI and LCI-related hospitalisations in young newborns [4]. Explicitly stating these advantages to expectant mothers may Increase vaccination rates for pregnant women and encourage their decision to accept the influenza vaccine during pregnancy [5]. Seasonal and pandemic influenza viruses can cause serious sickness in pregnant women and their unborn children [6]. Pregnancy-related physiological alterations and changes in cell-mediated maternal immunity may increase pregnant women's susceptibility to severe influenza [7]. The World Health Organization considers pregnant women to be at high risk for influenza infection and advises that all pregnant women receive an inactivated influenza vaccine, primarily for their protection. In spite of this, not all nations implement maternal influenza vaccination programmes, and even those that do frequently see low vaccination uptake [8]. For instance, during the influenza season in the United Kingdom, just under half of pregnant women received the vaccine [9]. Newborns are especially susceptible to influenza infection, in part because of the physical characteristics and anatomical characteristics of infancy as well as because there hasn't been any prior exposure to the virus or development of immunity [10].


Regrettably, there are no licenced influenza vaccines for infants under one month old [11]. Infection with influenza is linked to greater rates of hospitalisation and mortality in infants. Hence, safeguarding young newborns from influenza disease continues to be a top public health concern. Maternal influenza vaccination is one method of providing the infant with protection [12]. Via the transfer of antibodies from the mother to the foetus during trans-placental transmission, this may offer passive protection against influenza infection. Babies born to moms who are immune may experience a delay in the start of symptoms and shorter disease duration [13]. Maternal influenza vaccination has been demonstrated to have promise as a strategy for protecting newborns against laboratory-confirmed influenza and influenzarelated hospitalisations, according to a prior systematic review and meta-analysis [14]. Through the use of other databases and the inclusion of additional results, our review seeks to update and build upon this [15]. Four significant Randomized Control Trials all conducted in low- and middle-income settings, revealed different decreases in infants' seasonal LCI. Using LCI in the infant as our major goal, we seek to comprehensively analyse the available data on the impact of maternal prenatal pandemic and seasonal influenza vaccination on infant health outcomes. Other outcomes were long-term respiratory children, infant primary care, clinic visits or hospitalisations owing to influenza sickness, infant ILI, other infant respiratory illnesses, and other infants. According to PRISMA guidelines, this systematic review was carried out and its findings were published. You can find the finished PRISMA checklist in supplementary item 1. The research protocol was submitted to PROSPERO, which is accessible at Six internet databases, including, Cochrane Library, EMBASE, Medline, Medline in process, PubMed, and Web of Science, were searched for publications published between 1 January 1996 and 29 June 2018. The original search method was used to conduct an updated search in the Medline database on October 31, 2019, covering the period from June 30, 2018, to October 31, 2019. The extra item contains complete search strategies for each of the six searches. Also, a thorough search of the reference lists of chosen publications was done. The effectiveness of prenatal influenza vaccination on infants served as the primary outcome measure. LCI. A positive outcome on any influenza diagnostic test was considered to be LCI. The impact of prenatal influenza vaccination on baby ILI, infant respiratory infections, primary care, clinic visits or hospital admissions because of LCI or ILI, and any long-term respiratory effects in children were considered secondary outcome measures. Studies that reported ILI, influenza (without laboratory confirmation by diagnostic test), or followed the WHO definition of ILI were included in the secondary outcome of ILI. A reported temperature (as opposed to a recorded temperature) was included in several studies that employed the WHO definition for ILI. Notwithstanding the difficulties in getting recorded temperatures for observational research, these studies were still included in the evaluation. There was frequently variation in outcome definitions between researches. Definitions of every study's outcomes are displayed in the supporting item. The Cochrane risk-of-bias tool was utilised for RCTs. The overall quality was rated as low, uncertain, or high. The National Heart, Lung, and Blood Institute Study Quality Assessment Tool were employed for observational studies. This utilised a bad, fair, or good quality rating system. The NHLBI quality evaluation tool is built on Cochrane collaboration quality assessment methodologies, giving some consistency amongst the instruments. Two blinded independent reviewers assessed the quality of observational studies and RCTs. Upon unbinding, a choice was made based on each quality rating and total ranking that had been provided. In the absence of agreement, a third author arbitrated. In illustrative tables, specific study characteristics were summarised. Information on all metrics for each result was taken from the paper that was provided. The corrected effect estimates for observational studies were presented. Unadjusted estimates for the vaccination in RCTs were reported. When studies were thought to have used comparable populations, treatments, and controls and reported on similar outcomes, meta-analysis of RCTs was conducted.


The RevMan software was used to run the meta-analysis, which required a minimum of two studies with heterogeneous forest plots. The I2 statistic was utilised to determine the degree of study heterogeneity. Due to a lack of power and the small number of papers included in the meta-analysis, funnel plots were not used. Meta-analysis of random effects was employed. This systematic review's reporting adheres to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. 2009 checkbox requirements This evaluation demonstrates that maternal influenza immunisation is protective against laboratory confirmed influenza in infants under 6 months of age, despite the fact that outcomes varied widely between trials. In order to protect against severe influenza disease as measured by a decrease in hospitalisations in infants under a year old, it supports the use of maternal influenza vaccine. In addition, there is some evidence that maternal influenza vaccination during pregnancy protects the smallest newborns most efficiently, with a possible decreasing impact over time. Because those influenza vaccines are only approved for infants 6 months and older, maternal influenza immunisation during pregnancy may be a crucial strategy for safeguarding these vulnerable children. The thorough search method used in this review, which included multiple study designs, the distinct inclusion and exclusion criteria created in cooperation with A variety of health databases were included in the search technique. The search turned up a lot of research, indicating that it was thorough enough to find all pertinent literature. Most clinical outcomes from the various trials were measured objectively, which minimises the possibility of reporting bias on the part of the reviewers. However restrictions include restricting the search to our study adds to the body of evidence already available, which includes a recent systematic analysis by Nunes and Madhi that demonstrates the protective impact of maternal vaccination for infant lower respiratory tract infection (LCI). For RCTs and observational studies, Nunes and a pooled risk reduction were used. However, it appears that observational studies overstated the impact because risk reduction was smaller when RCTs alone were used for analysis. This is consistent with the results of our combined met analysis of the 34% risk reduction. With the use of a broad search approach, the discovery of several papers, and the examination of multiple outcomes, our review builds on this work. Our analysis of RCTs and observational studies revealed fewer clinic visits and hospitalisations for ILI, LCI, and respiratory illnesses in infants fewer than six months of age.



Conflict of Interest



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Citation: Rishika Panday (2023) The Effectiveness of Influenza Vaccination in Pregnancy In Relation To Child Health Outcomes. Health Sys Policy Res Vol. 10 No. Issue 3:176