When Is It Acceptable to Vaccinate Pregnant Women? Risk, Ethics, and Politics of Governance in Epidemic Crises

AbstractPurpose of ReviewIn some countries, pregnant women experience disproportionately high morbidity and mortality during infectious disease outbreaks due to a variety of gender-based factors and pregnancy-related immunological changes. Despite this, the interests of pregnant women have largely been absent from policies that guide the design of clinical trials and the deployment of vaccines in epidemic contexts. This review examines historic precedent for both excluding and including pregnant women in vaccine trials and considers the rights of pregnant women in epidemic crises.Recent FindingsThe latest research reveals that perceptions of risk and vulnerability of pregnant women in clinical research are beginning to change, resulting in modest policy and guideline amendments. A growing advocacy movement calling for “fair inclusion” has played an important role.SummaryDespite the global-scale and far-reaching implications of vaccine research policies, the current debate appears to reside primarily in disciplinary siloes across Western academic and policymaking spaces. Conceptual ambiguity of “risk,” the pervasive view of pregnant women as “vulnerable,” and competing ethical values that construct research protocols, globally, call for more explicit guidelines.
Source: Current Tropical Medicine Reports - Category: Tropical Medicine Source Type: research

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AbstractPurpose of ReviewAs research efforts have advanced to understand the pathophysiology of viral hemorrhagic fevers (VHF) and other epidemic viral infections and develop medical countermeasures such as vaccines, pregnant women have remained an underexamined subgroup. To better understand the implications of future outbreaks of VHF for pregnant women amidst an evolving vaccine landscape, we examine three pathogens —yellow fever, Ebola, and Lassa fever—each with different levels of evidence and understanding of disease in pregnancy and at varying stages of vaccine development.Recent FindingsThere are very li...
Source: Current Tropical Medicine Reports - Category: Tropical Medicine Source Type: research
AbstractPurpose of ReviewEbola virus infection has one of the highest overall case fatality rates of any viral disease. It has historically had an especially high case mortality rate among pregnant women and infants —greater than 90% for pregnant women in some outbreaks and close to 100 % in fetuses and newborns. The Merck recombinant vaccine against Ebola virus, termed rVSV-ZEBOV, underwent clinical trials during the 2013–2015 West Africa Ebola epidemic where it was found to be 100% efficacious. It was sub sequently used during the 2018 DRC Équateur outbreak and in the 2018 DRC Kivu Ebola which is still...
Source: Current Tropical Medicine Reports - Category: Tropical Medicine Source Type: research
This article analyzes current issues related to maternal vaccination with a focus on emerging and epidemic viral infections and human rights.Recent FindingsHistorically, pregnant women have not been considered in the development of vaccines and have been excluded from participating in clinical trials and vaccination campaigns. Because of risk for injury and death of mothers and fetuses/infants during infectious disease outbreaks, it is important to consider their rights to receive any potential form of prevention or therapy available to non-pregnant individuals in order to enhance their well-being.SummaryIt is unacceptable...
Source: Current Tropical Medicine Reports - Category: Tropical Medicine Source Type: research
Authors: Abdulkadir A, Gebrehiwot TT Abstract Background: Rubella is a vaccine-preventable disease associated with a significant morbidity and adverse pregnancy outcomes, mainly if acquired in the first trimester of pregnancy with serious consequences to the fetus. Despite increased episodes of rubella epidemics (127 outbreaks in 2009-2015), rubella national vaccination is not yet introduced in Ethiopia. In January 2018, an increase of fever and rash cases was reported in Kuyu District of Oromia. We investigated the outbreak to confirm rubella, determine risk factors, and guide interventions. Methods: We identi...
Source: Interdisciplinary Perspectives on Infectious Diseases - Category: Infectious Diseases Tags: Interdiscip Perspect Infect Dis Source Type: research
her For the first 60 years following its isolation, Zika virus (ZIKV) remained a relatively poorly described member of the Flaviviridae family. However, since 2007, it has caused a series of increasingly severe outbreaks and is now associated with neurological symptoms such as Guillain-Barré syndrome and congenital Zika syndrome (CZS). A number of reports have improved our understanding of rare complications that may be associated with ZIKV infection in adults, the areas of the body to which it spreads, and viral persistence in various tissues. Likewise, studies on the effect of ZIKV infection during pregnan...
Source: Viruses - Category: Virology Authors: Tags: Review Source Type: research
Publication date: Available online 4 September 2019Source: Antiviral ResearchAuthor(s): Antonio E. Muruato, Chao Shan, Camila R. Fontes-Garfias, Yang Liu, Qiang Gao, Scott C. Weaver, Pei-Yong ShiAbstractZika virus (ZIKV) has drawn global attention as the etiologic agent of Zika Congenital Syndrome in babies born to infected pregnant women. To prevent future ZIKV outbreaks and protect persons at risk for severe disease, we developed two live-attenuated vaccine (LAV) candidates containing 10- or 20-nucleotide deletions in the 3′UTR of the viral genome (Δ10 and Δ20). After a single-dose immunization, both &D...
Source: Antiviral Therapy - Category: Virology Source Type: research
Abstract Zika virus (ZIKV) has drawn global attention as the etiologic agent of Zika Congenital Syndrome in babies born to infected pregnant women. To prevent future ZIKV outbreaks and protect persons at risk for severe disease, we developed two live-attenuated vaccine (LAV) candidates containing 10- or 20-nucleotide deletions in the 3'UTR of the viral genome (Δ10 and Δ20). After a single-dose immunization, both Δ10 and Δ20 LAVs protected mice and non-human primates against ZIKV infection. Here, we characterized the stability, safety, and efficacy of the LAVs after continuously culturing th...
Source: Antiviral Research - Category: Virology Authors: Tags: Antiviral Res Source Type: research
ard Hildt Infection with Zika virus (ZIKV) came first to public attention after it was found to be associated with congenital microcephaly during the outbreak in Brazil (2015–2016). Diagnosis of ZIKV suffers from extensive cross-reactivity with other Flaviviruses, which are circulating in many ZIKV epidemic areas. Due to the fatal outcome of ZIKV infection during pregnancy, detailed knowledge about neutralizing and non-neutralizing epitopes is crucial for the development of robust detection systems of protective antibodies. Therefore, additional information about ZIKV immunogenicity and antibody response is requi...
Source: Viruses - Category: Virology Authors: Tags: Article Source Type: research
More than 1,500 deaths and 2,500 people sickened – that’s the recent account of the ebola outbreak in the Democratic Republic of Congo (DRC) raging in the country since last August, and recently declared a public health emergency of international concern. Experts say efforts to contain the virus are hindered by biological, public health, political, and cultural issues, but we looked around what digital health technologies could do to mitigate the spread and the devastation of the infectious disease. The Spaghetti-like virus… The lethal Ebola virus first appeared in 1976 around a river in Congo &nda...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine Africa AI artificial intelligence Congo digital digital health digital maps disease disease outbreak ebola epidemic Innovation technology Source Type: blogs
Christina Hildebrand went down a rabbit hole and emerged at the statehouse in Sacramento. That’s how she describes it–going down a rabbit hole–and in her case it happened 14 years ago, when she was pregnant with her first child. In a world filled with chemicals and toxins, processed foods and GMOs, she decided her baby would be brought up as naturally and chemical-free as possible. It was when she was researching how best to achieve that goal that she bumped into vaccines. That was a bad time to begin thinking about such things. The fraudulent 1998 paper by British physician Andrew Wakefield ostensibly li...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized vaccines Source Type: news
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