Maternal immunisation to improve the health of HIV-exposed infants

Lancet Infect Dis. 2019 Apr;19(4):e120-e131. doi: 10.1016/S1473-3099(18)30545-0. Epub 2018 Dec 7.


HIV-exposed but uninfected (HEU) infants are at an increased risk of many infectious diseases that can contribute to the high mortality seen among HEU children. Maternal immunisation could be a promising strategy to reduce infections in HEU infants. However, very little research has explored the effect of HIV on the immunogenicity and effectiveness of vaccines given during pregnancy. We review the available evidence on maternal immunisation among women living with HIV (WLWH) for all vaccines recommended, considered, or being investigated for routine or risk-based use during pregnancy. Of the 11 vaccines included, only three have been investigated in WLWH. Available evidence suggests that maternal HIV infection limits the immunogenicity of several vaccines, leaving HEU infants more susceptible to infection during their first few months of life. Whether maternal immunisation reduces the infectious morbidity and mortality associated with infectious diseases in HEU children remains unknown. We conclude the Review by identifying future research priorities.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • AIDS Vaccines / administration & dosage*
  • Bacterial Vaccines / administration & dosage*
  • Child
  • Female
  • HIV Infections / immunology
  • HIV Infections / mortality
  • HIV Infections / prevention & control*
  • HIV Infections / virology
  • Humans
  • Immunogenicity, Vaccine
  • Infant
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology
  • Pregnancy Complications, Infectious / mortality
  • Pregnancy Complications, Infectious / prevention & control*
  • Pregnancy Complications, Infectious / virology
  • Survival Analysis
  • Treatment Outcome
  • Vaccination / methods*
  • Vaccination / statistics & numerical data
  • Viral Vaccines / administration & dosage*


  • AIDS Vaccines
  • Bacterial Vaccines
  • Viral Vaccines