Maternal Immunisation Readine​​ss Network in Africa and Asia (MIRNA)​​

Maternal immunisation refers to the vaccination of women during pregnancy to reduce illness and death for both mothers and their infants, both during pregnancy and the first six months of life. When a pregnant woman gets vaccinated, antibodies are produced in her blood. Antibodies act as soldiers th​​at fight infections and provide protection for the mother and baby. These antibodies are passed from the mother to her baby during pregnancy, protecting the baby after birth. ​

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Current maternal vaccines​​​​

1. Tdap

Single dose given between
24 and 34 weeks of pregnancy

  • Tetanus, also known as lockjaw, is an infection caused by contact with the bacterium Clostridium tetani. This bacterium enters the body through open wounds that come in contact with contaminated objects or substances. In newborns, tetanus can be acquired through the umbilicus that is cut with unsterilised instruments. Infected people may experience painful muscle spasms, fever, sore throat, and difficulty swallowing.
  • Diphtheria is a disease caused by a bacterium that produces a toxin that affects the nose, tonsils, and throat (respiratory tract), and can damage the heart and nerves. It spreads through coughs or sneezes from an infected person. 
  • Pertussis, also known as whooping cough, is a respiratory illness caused by the Bordetella pertussis bacteria. It is especially dangerous for newborns. Pertussis spreads through coughs and sneezes from infected individuals, and can cause heavy coughing, fever, congestion, and difficulty breathing.
2. COVID-19 vaccines
(Pfizer, J&J, Moderna)
  • COVID-19, or the coronavirus disease, is caused by the SARS-CoV-2 virus and results in respiratory illness. During pregnancy, mothers are at higher risk for serious illness or death due to COVID-19. Infection also exposes babies to complications both during pregnancy and after birth.  

3. Influenza vaccine

Pregnant women are prioritized during seasonal influenza vaccination campaigns

  • Seasonal influenza is a respiratory infection caused by influenza viruses and results in a high number of people becoming sick especially during the winter months. Seasonal influenza can result in serious illness and complications such as pneumonia (lung infection). ​

New maternal vaccines under development​
  • Respiratory syncytial virus 



  • Group B streptococcus 
​​RSV causes acute respiratory illness, which is especially dangerous for infants below six months of age and may lead to hospitalisation and even death.

GBS is a bacteria that can lead to neonatal and infant infection and meningitis (the inflammation of tissue around the brain and spinal cord). GBS also contributes to preterm births, stillbirths, and problems with the development of the child.

​​​​Maternal Immunization Readiness

Before countries can start giving pregnant women vaccines as part of their National Immunization Programme, they need to assess their capacity, strengths and weaknesses and identify a list of priorities to make sure it happens smoothly. In the past, the introduction of maternal vaccines in low- and middle-income countries has often been delayed by many years, as a result of which a higher number of infant and maternal deaths take place.

To avoid a repeat of such delays, the Maternal Immunization Readiness Network in Africa & Asia (MIRNA) wants to build country preparedness for the timely delivery of life-saving maternal vaccines in order to reduce preventable morbidity and mortality.​

Maternal Imm​unization Readiness Network in Africa & Asia

MIRNA is a partnership between seven African and two Asian countries to assess and support country readiness to deliver new maternal vaccines currently being developed, specifically for RSV and GBS infections. The partnership has been formed to accelerate the country adoption, delivery, and uptake of new maternal vaccines in Pakistan and Bangladesh, Burkina Faso, Ethiopia, Ghana, Kenya, Nigeria, Uganda, South Africa. Ultimately, MIRNA will contribute to achieving Sustainable Development Goal 3.2, i.e. ending preventable deaths of newborns and children under 5 years of age by 2030.​​

MIRNA Work Packages

​​​Our MIRNA Pakistan work is divided into five packags:

​Situational Analysis of MI Delivery Pathways and Care Levels
This work package aims to identify strengths to leverage and gaps to address during the new maternal vaccine introduction with the goal to develop a harmonized approach to assess MI readiness across different pathways, care levels, and interventions. The situational analysis will include a desktop review, in-person meetings and in-depth interviews with key country-level stakeholders, surveys, and health facility visits.
​Burden of Disease
Synthesis of in-country burden of disease data on RSV and GBS, identification of gaps for further research and identification of systems that can capture disease data prospectively. To achieve these objectives, each partner will undertake 3 in-country reviews using a standardized approach: a scoping review on existing surveillance systems and data sources in the country, and systematic reviews on the respective burden of RSV and GBS disease in the country.
​Cost-effectiveness
Synthesis of disease modeling and cost-effectiveness studies, identification of critical data gaps and conducting additional analyses as needed. The work package goal is to complete a scoping exercise, then identify data gaps, develop standardized methods of data collection for costing, and build/adapt tools for assessing the cost of MI programs in partner countries.
​Vaccine Demand
Select, adapt and apply social science approaches to understand vaccine demand and hesitancy. The goal is to build on the Behavioral and Social Drivers of Immunization framework by developing research tools to assess demand and supply-side barriers to MI; considering gender and understanding barriers; a three-phase approach to address factors influencing MI demand: a desk review, qualitative research, and context-specific targeted interventions.
​Stakeholder Mapping and Building Communities of Practice 
This is done primarily through engagement of obstetric and midwifery professional societies, doctors, midwives, communities, and pregnant women. The aim of the work package is to build early champions for MI and focus on stakeholders' interests and questions and show how MI programming benefits them.