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Even before the COVID-19 pandemic, pregnant women were at a high risk for negative health outcomes from certain vaccine-preventable infectious diseases such as the flu and whooping cough. The pandemic taught us two valuable lessons: pregnant women are an important group to include when assessing the impact of disease during an outbreak, and pregnant women should not be excluded from vaccination when safe and effective vaccines are available for the general population. It is important for the medical community to better understand and act on these lessons so we can use vaccines to prevent severe illness in pregnant women and their babies.

As a researcher and professor in pediatrics and infectious diseases, I want to share three key strategies that can be tackled now to improve maternal vaccination.

One strategy to increase maternal vaccination is to routinely include pregnant women in studies assessing the impact of vaccine-preventable diseases that affect women and their babies. They should also be included in clinical trials of new vaccine technologies. This is important to ensure maternal and childhood health in general -- and even more critical to prepare for the not-unlikely event that we face another pandemic. Proper funding and support can make this effort a national priority.

Despite the fact that pregnant women were from vaccine clinical trials, we have already seen tremendous progress on the issue of including pregnant women in vital research during the COVID-19 pandemic. Because of these efforts, we were able to determine the risks and benefits of COVID-19 vaccination in pregnancy.

However, COVID-19 vaccination among pregnant women is in the U.S., and other infectious diseases that affect pregnant women or their newborns could also benefit from expedited vaccine development, testing, approval, and distribution. Examples include:

• Cytomegalovirus (CMV), which is usually harmless to most women but is the most of birth defects
• Group B Streptococcus, which is a well-known cause of newborn sepsis

• Respiratory Syncytial Virus (RSV), which is a substantial cause of infant death in the first few months of life.

Vaccine development and implementation for these diseases have been challenging to date.

We must also improve public awareness of the importance and safety of vaccination for pregnant women and infants, particularly in underserved communities in the U.S. and globally that lack reliable access to healthcare. Throughout the world, of all deaths in children under 5 occur within their first month of life. Too often, both these babies and their mothers die of that could be prevented by vaccines.

When facing the decision about whether to get vaccinated against COVID-19, many pregnant women that the COVID-19 vaccine approvals by the FDA were premature and dangerous. We must get better at building trust between healthcare providers and their patients, and sharing our research with the public in a way that is unbiased and understandable.

Lastly, it is necessary to establish concrete actions to boost maternal immunization for vaccine-preventable diseases. Along with academic champions for maternal immunization, support from professional organizations, industry, funders, regulators, and patient and vaccine advocacy groups is crucial to improve maternal and infant health. I these strategies with my colleagues at the World Vaccine Congress.

Advancing this cause often feels like an endlessly uphill climb. But I remain optimistic because of how much we have accomplished in recent years, and I know we are making progress. We still have hard work ahead, but mothers and children around the world deserve nothing less.

is associate professor of Pediatrics and Infectious Diseases at Baylor College of Medicine, and director of Transplant Infectious Diseases at Texas Children's Hospital in Houston, Texas.

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