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