Robinson Research Institute, University of Adelaide, South Australia
Helen Marshall is a medical graduate and clinician researcher who has completed a Master of Public Health and Doctorate of Medicine on the safety and effectiveness of vaccines at the University of Adelaide. She is the Medical Director of the Vaccinology and Immunology Research Trials Unit at the Women’s and Children’s Hospital and Deputy Director of the Robinson Research Institute at the Univesity of Adelaide. She has published 88 papers in international peer-reviewed journals and has served as an editorial board member of the Paediatric Infectious Diseases Journal. She is a member of the Australian Technical Advisory Group on Immunisation and a member of the WHO taskforce on influenza immunisation in pregnancy.
Pregnant women are at increased risk of serious disease, related complications and death from influenza with the potential for adverse fetal and neonatal outcomes. Infant deaths from pertussis still occur despite national immunisation programs. Maternal influenza and more recently pertussis immunisation has been introduced in several countries to prevent maternal and infant morbidity. Despite this, uptake of these vaccines during pregnancy remains low. Influenza immunisation for pregnant women has been provided in Australia since 2010. In April 2015, South Australia introduced a funded program for all pregnant women to receive diphtheria-tetanus-acellular pertussis vaccine during the third trimester, in each pregnancy. Uptake of vaccines in pregnancy at a tertiary obstetric and paediatric hospital in South Australia was 26% for influenza vaccine and 14% for pertussis vaccine in February 2015 (additional 22.4% received pertussis vaccine in preceding 5 years). A midwife delivered maternal immunisation program for influenza and pertussis immunisation was implemented in the antenatal clinic with maternal immunisation added to and documented in the pregnancy hand-held-record from April 2015. For women delivering at the hospital in June 2015, 92% had received a pertussis vaccine, either in pregnancy (83%) or in the preceding 5 years (9%), with 75% receiving influenza vaccine in pregnancy and 1% prior to pregnancy. High uptake of maternal immunisation can be achieved with health care provider endorsement, midwife delivery and inclusion of maternal immunisation as part of standard maternal care. The higher uptake of pertussis compared to influenza vaccine suggests pertussis vaccine uptake is driving influenza vaccine uptake in pregnant women.