ArticleVaccine2026
Timing and frequency of antenatal care visits in relation to maternal respiratory syncytial virus vaccine opportunities in four Latin American countries.
Article in Vaccine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe Latin American and Caribbean region (LAC) has historically been an early adopter of new vaccines, including the recently introduced maternal vaccine to protect infants against respiratory syncytial virus (RSV). Since maternal RSV vaccination requires gestational age (GA)-specific administration, antenatal care (ANC)-based delivery feasibility depends on ANC visit timing and frequency. We assessed ANC attendance relative to recommended vaccination windows in four LAC countries to inform planning for maternal RSV vaccine implementation and future maternal immunization programs.
methodsWe conducted a retrospective, cross-sectional analysis from Perinatal Information System data across eight tertiary facilities in Bolivia, Ecuador, Honduras, and Uruguay. Women 15-45 years old with ≥1 ANC visit in 2023 and a live, singleton birth at a study facility were included. GA per visit was extracted or derived from last menstrual period or birth data. We defined RSV vaccination eligibility according to Pan American Health Organization (PAHO) (32-36 weeks) and World Health Organization (WHO) (≥ 28 weeks) recommendations. Descriptive analyses summarized ANC initiation, visit timing, and the proportion of women attending visits within eligibility windows.
resultsWe included 37,604 women. The median GA at ANC initiation was 12 weeks, ranging from 10 weeks (Uruguay) to 15 weeks (Ecuador). Overall, 63.5% of women attended at least one ANC visit during the PAHO window, with country-specific proportions from 53.6% (Honduras) to 82.3% (Uruguay). Attendance within the WHO window was higher (91.4%). Median ANC attendance was five visits, ranging from five (Honduras) to eight (Uruguay). Earlier ANC initiation was associated with higher visit counts. DISCUSSION: There is substantial potential for achieving high maternal RSV vaccine coverage in LAC, particularly per broader WHO vaccine recommendations. Where ANC begins later or visits are fewer, narrower vaccine-eligible windows may limit achievable coverage. Strengthening early ANC engagement and immunization counseling may increase vaccination opportunities.
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