Global perspectives on maternal immunisation

Although considerable progress has been made globally to reduce under-5 mortality, advances in the reduction of neonatal deaths in the first year of life have been slower. The annual deaths of almost 700 000 infants younger than 1 month are attributed to infectious diseases such as pneumonia and sepsis, and these account for about 28% of neonatal deaths under the age of 1 month.1 Additionally, many more newborn babies, with immature immune systems, have long-term morbidity from infections early in life.2 Sustainable Development Goal 3·2 calls for the end of preventable deaths of newborn babies and children younger than 5 years by 2030, with all countries aiming to reduce neonatal mortality to at least 12 per 1000 livebirths.3 To reach these goals, effective strategies to protect infants in the first weeks of life will be essential. Maternal immunisation during pregnancy is one such strategy, with the untapped potential of providing protection to the infant through the transfer of maternal antibodies across the placenta.4 These antibodies persist in the circulation after birth and can protect the infant against infectious diseases during the first months of life. This strategy could potentially provide additional benefit by preventing infectious causes of preterm births and stillbirths, and by protecting pregnant women.