Expert consensus on vaccination as a primary prevention strategy for women of reproductive age, pregnant, or adulthood

Objective: To generate recommendations for vaccinating women at different stages of their lives, in order to reduce potential variability in current use in Colombia. Materials and Methods: The guideline development group consisted of professionals from the health sector. All participants submitted written conflict-of interest declarations. Answerable clinical questions were formulated, outcomes were graded, and a literature search was conducted in Medline/PubMed, Embase, and LILACS. The search also included grey literature sources and was updated on May 14, 2024, with no restrictions on date or language. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to determine the quality of evidence and the strength of recommendations. Due to the limitations of the retrieved studies—particularly concerning the applicability of the evidence—expert opinion was sought. Formal consensus was achieved following the RAND/UCLA methodology (RAND Corporation/University of California, Los Angeles). Prior to publication, the document underwent peer review. Results: The following recommendations were developed: 1. The development group suggests that women who are not immune to mumps, measles, or rubella (e.g., IgG negative) should be vaccinated during the preconception period. Quality of evidence: low ⨁⨁◯◯ 2. The development group suggests that all women in the preconception period be vaccinated against varicella if they lack confirmed natural immunity (e.g., negative varicella-zoster virus IgG antibodies). Quality of evidence: very low ⨁◯◯◯ 3. The development group suggests that women living in yellow fever endemic areas be vaccinated during the preconception period if they have not been previously immunized. Quality of evidence: very low ⨁◯◯◯ 4. The development group suggests that adolescent girls and young adult women receive the human papillomavirus (HPV) vaccine , 3 doses (0.2 and 6 months) to reduce cervical cancer incidence and mortality. Quality of evidence: moderate ⨁⨁⨁◯ 5. The development group suggests that pregnant women be immunized against tetanus, diphtheria, and pertussis during pregnancy to reduce infection risk in both the mother and newborn. Quality of evidence: low ⨁⨁◯◯ 6. The development group suggests inf luenza vaccination at any stage of pregnancy to reduce infection risk in the mother and in infants up to six months of age. Quality of evidence: very low ⨁◯◯◯ 7. The development group suggests maternal COVID-19 vaccination at any stage of pregnancy to reduce the risk of hospitalization and death of the mother and the newborn during the first four months of life. Quality of evidence: very low ⨁◯◯◯ 8. The development group suggests vaccination against respiratory syncytial virus (RSV) during pregnancy to reduce hospitalization risk in the newborn. Quality of evidence: very low ⨁◯◯◯ 9. The development group suggests that older adult women be vaccinated against herpes zoster to reduce morbidity associated with this condition. Quality of evidence: moderate ⨁⨁⨁◯ 10. The development group suggests that older adult women receive influenza vaccination to reduce the incidence of acute respiratory infections (ARI). Quality of evidence: moderate ⨁⨁⨁◯ 11. The development group suggests that older adult women be vaccinated against pneumococcus to reduce the incidence of pneumonia and invasive pneumococcal disease. Quality of evidence: low ⨁⨁◯◯ 12. The development group suggests that older adult women be vaccinated against RSV to reduce the incidence of ARI and lower respiratory tract infections. Quality of evidence: low ⨁⨁◯◯ 13. The development group suggests that older adult women living in yellow fever endemic areas be vaccinated if they have not been previously immunized. Quality of evidence: very low ⨁◯◯◯ Conclusions: Vaccination is recommended as a primary prevention strategy throughout the different stages of a woman's life. Given the quality of the available evidence and the significant limitations in the applicability of some studies—particularly among pregnant women—further research is needed to evaluate the safety and effectiveness of this intervention during this stage of life.