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

  • Ashley L. Graham
Vaccines in Pregnant Women & Infants (D Schwartz and C Krubiner, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Vaccines in Pregnant Women & Infants


Purpose of Review

In 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 Findings

The 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.


Despite 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.


Pregnancy Maternal immunization Reproductive governance Fair inclusion Epidemic Risk 


Compliance with Ethical Standards

Conflict of Interest

The author declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ashley L. Graham
    • 1
    • 2
  1. 1.University of ConnecticutStorrsUSA
  2. 2.AtlantaUSA

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