FEATURE
THE MATERNAL IMMUNIZATION
PLATFORM (MIP): Revisited
Stanley A. Gall, MD
T
he Maternal Immunization Plat-
form (MIP) was proposed as a
routine prenatal action to en-
courage all pregnant patients to
be vaccinated with five critical
vaccines.
Adult vaccination is based on risk indi-
cations which are difficult to remember. The
five vaccinations are: influenza, Tdap, pneumococcal, hepatitis A,
and hepatitis B. Influenza and Tdap vaccines are now recommend-
ed for each pregnancy while pneumococcal and hepatitis A and
B are still the victims of “risk” assessment rather than universal
recommendation.
Maternal immunization is a special form of adult immuniza-
tion and needs its own platform to enhance its visibility to clini-
cians and to vaccine policymakers. The “vaccine paradigm shift”
which was proposed was to make each of the five vaccines listed
above a universal vaccine rather than a risk-based vaccine so that
every pregnant patient who has not received these vaccines before
pregnancy will receive them during pregnancy. (Table 1)
10
LOUISVILLE MEDICINE
TABLE 1: TYPES OF VACCINES AND NUMBER OF RISK
INDICATIONS FOR PREGNANT WOMEN IN THE MATERNAL
IMMUNIZATION PLATFORM (MIP) (2) (3) (4) (5) (6)
VACCINE TYPE OF VACCINE # RISK
INDICATIONS DOSES
Hepatitis A (3) Killed Viral 15 2
Hepatitis B (2) Recombinant 28 3
Hepatitis A + B Killed Viral and
Recombinant Pneumococcal Polysaccharide 21 1
Tetanus,
diphtheria Toxoid, bacterial Universal 1
Acellular
pertussis (4) Antigen Influenza (6) Killed viral Universal 1
5
Polysaccharide
Vaccine PPSV23
(5)
INFLUENZA
The influenza vaccine (first given to US soldiers in World War II,
by the way) is recommended annually for all persons greater than
age six months and has been recommended for pregnant women
since the 1960’s. It can be administered in any trimester. The justi-