Vaccination during pregnancy: issues in translational ethics and research ethics

The vaccination of pregnant women has the potential to be an important way of promoting the health of the women themselves and their children. Young infants are vulnerable to bacterial and viral pathogens, but their immature immune systems often make vaccination unsuccessful for many infectious diseases - e.g. pertussis and influenza. Yet maternal antibodies transmitted prior to birth can confer early protection against a myriad of infections such as measles and chicken pox. Even though vaccines promise to be beneficial for these populations, the vaccination of pregnant women confronts many difficult ethical questions. The ethical concerns derive from the need to avoid exposing the fetus to risks in vaccine research and in the implementation of vaccine programs. The research project proposed here aims to develop ethics guidelines for vaccine research involving pregnant women, and for policies designed to increase the utilization of safe vaccines (i.e. for influenza) among pregnant women. Ensuring that vaccine research and implementation is ethical may increase the likelihood that pregnant women and their children will benefit from vaccines, without being exposed to unnecessary risks.