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Cited by 1,227Influenza Virus Research StudiesRespiratory viral infections researchVaccine Coverage and Hesitancy

Effectiveness of maternal influenza immunization in mothers and infants

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Zaman, K., Roy, Eliza, Arifeen, Shams E., Rahman, Mahbubur, Raqib, Rubhana, Wilson, Emily, Omer, Saad B., Shahid, Nigar S. +2 more·2008·New England Journal of Medicine
DOI 10.1056/nejmoa0708630
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Abstract

BACKGROUND: Young infants and pregnant women are at increased risk for serious consequences of influenza infection. Inactivated influenza vaccine is recommended for pregnant women but is not licensed for infants younger than 6 months of age. We assessed the clinical effectiveness of inactivated influenza vaccine administered during pregnancy in Bangladesh. METHODS: In this randomized study, we assigned 340 mothers to receive either inactivated influenza vaccine (influenza-vaccine group) or the 23-valent pneumococcal polysaccharide vaccine (control group). Mothers were interviewed weekly to assess illnesses until 24 weeks after birth. Subjects with febrile respiratory illness were assessed clinically, and ill infants were tested for influenza antigens. We estimated the incidence of illness, incidence rate ratios, and vaccine effectiveness. RESULTS: Mothers and infants were observed from August 2004 through December 2005. Among infants of mothers who received influenza vaccine, there were fewer cases of laboratory-confirmed influenza than among infants in the control group (6 cases and 16 cases, respectively), with a vaccine effectiveness of 63% (95% confidence interval [CI], 5 to 85). Respiratory illness with fever occurred in 110 infants in the influenza-vaccine group and 153 infants in the control group, with a vaccine effectiveness of 29% (95% CI, 7 to 46). Among the mothers, there was a reduction in the rate of respiratory illness with fever of 36% (95% CI, 4 to 57). CONCLUSIONS: Inactivated influenza vaccine reduced proven influenza illness by 63% in infants up to 6 months of age and averted approximately a third of all febrile respiratory illnesses in mothers and young infants. Maternal influenza immunization is a strategy with substantial benefits for both mothers and infants. (ClinicalTrials.gov number, NCT00142389.)

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  • Infants of influenza-vaccinated mothers were 45-63% less likely to have episodes of proven influenza illness in early infancy (4-6 months of age).

    “infants of influenza vaccinated mothers were 45–63% less likely to have episodes of proven influenza illness in early infancy (4–6 months of age).”

    From Factors Affecting the FcRn-Mediated Transplacental Transfer of Antibodies and Implications for Vaccination in Pregnancy (2017) · cites this paper as [15]

    The Effectiveness section (page not available in our copy) reports 63% effectiveness against laboratory-confirmed influenza in infants followed for up to 24 weeks. It does not report a 45% reduction in proven influenza illness or an estimate specifically for infants aged 4–6 months; the reported 63% applies to infants up to 6 months old. (LLM, conf=0.87)

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  • Maternal vaccination is a highly effective approach to protect infants from infection.

    “Maternal vaccination is a highly effective approach to protect infants from infection.”

    From Factors Affecting the FcRn-Mediated Transplacental Transfer of Antibodies and Implications for Vaccination in Pregnancy (2017) · cites this paper as [15]

    The Abstract reports that maternal influenza vaccination reduced laboratory-proven influenza illness by 63% in infants up to 6 months old. This supports protection against influenza in young infants, but the claim's unqualified reference to infant infection is broader than the infections studied. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In two RCTs, influenza vaccination reduced the incidence of maternal respiratory illness by 36% and 50.4%.

    “two of these RCTs showed that influenza vaccination reduced the incidence of maternal respiratory illness by 36 and 50.4% (15, 16).”

    From Factors Affecting the FcRn-Mediated Transplacental Transfer of Antibodies and Implications for Vaccination in Pregnancy (2017) · cites this paper as [15]

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Research works printed but not linked: 4

  1. [16]16. N Engl J Med 2005;353:2559-67.
  2. [24]24. Heinonen OP, Shapiro S, Monson RR, 22. Hartz SC, Rosenberg I, Slone D. Immuni- zation during pregnancy against poliomy- elitis and influenza in relation to child- hood malignancy. Int J Epidemiol 1973;2: 229-35.
  3. [26]26. Groothuis JR, Levin MJ, Rabalais GP, 24. The New England Journal of Medicine Downloaded from nejm.org on August 29, 2023. For personal use only. No other uses without permission. Copyright © 2008 Massachusetts Medical Society. All rights reserved. n engl j med 359;
  4. [27]27. www.nejm.org october 9, 2008 1564 Effectiveness of Maternal Influenza Vaccine in Mothers and Infants

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Authors
Zaman, K., Roy, E., Arifeen, S. E., Rahman, M., Raqib, R., Wilson, E., Omer, S. B., Shahid, N. S., Breiman, R. F., & Steinhoff, M. C.
Affiliations
  • International Centre for Diarrhoeal Disease Research (BD)
  • Johns Hopkins University (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2008-10-09
Volume
359
Issue
15
Pages
1555-1564
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa0708630
OpenAlex
W2058312037
Cited by
1,227
References
40
Citations by year
2026: 20 · 2025: 32 · 2024: 39 · 2023: 51 · 2022: 43 · 2021: 59 · 2020: 69 · 2019: 95 · 2018: 66 · 2017: 94 · 2016: 94 · 2015: 80 · 2014: 89 · 2013: 88 · 2012: 103
FWCI
49.89
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Health and Human Services
  • United States Agency for International Development
  • Bill and Melinda Gates Foundation
  • Sanofi
  • Thrasher Research Fund
  • Johns Hopkins University
  • Johns Hopkins Bloomberg School of Public Health
Topics
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
Keywords
maternal influenza vaccination, inactivated influenza vaccine, infants under 6 months, vaccine effectiveness, febrile respiratory illness, laboratory-confirmed influenza, 23-valent pneumococcal polysaccharide vaccine, Bangladesh, maternal and newborn health
MeSH terms
Adolescent, Adult, Bangladesh, Female, Humans, Infant, Infant, Newborn, Influenza, Human, Influenza Vaccines, Male, Pregnancy, Pregnancy Trimester, Third, Prospective Studies, Respiratory Tract Infections, Vaccines, Inactivated, Treatment Outcome, Pneumococcal Vaccines

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