**Medical Outcomes in Women Who Became Pregnant after Vaccination with a Virus-Like Particle Experimental Vaccine against Influenza A (H1N1) 2009 Virus Tested during 2009 Pandemic Outbreak**

**Arturo Cérbulo-Vázquez 1, Lourdes Arriaga-Pizano 2, Gabriela Cruz-Cureño 3, Ilka Boscó-Gárate 2, Eduardo Ferat-Osorio 4, Rodolfo Pastelin-Palacios 5, Ricardo Figueroa-Damian 6, Denisse Castro-Eguiluz 7, Javier Mancilla-Ramirez 8, Armando Isibasi <sup>2</sup> and Constantino López-Macías 2,9,10,\***


Received: 20 July 2019; Accepted: 15 September 2019; Published: 17 September 2019

**Abstract:** The clinical effects and immunological response to the influenza vaccine in women who later become pregnant remain to be thoroughly studied. Here, we report the medical outcomes of 40 women volunteers who became pregnant after vaccination with an experimental virus-like particle (VLP) vaccine against pandemic influenza A(H1N1)2009 (influenza A(H1N1)pdm09) and their infants. When included in the VLP vaccine trial, none of the women were pregnant and were randomly assigned to one of the following groups: (1) placebo, (2) 15 μg dose of VLP vaccine, or (3) 45 μg dose of VLP vaccine. These 40 women reported becoming pregnant during the follow-up phase after receiving the placebo or VLP vaccine. Women were monitored throughout pregnancy and their infants were monitored until one year after birth. Antibody titers against VLP were measured in the mothers and infants at delivery and at six months and one year after birth. The incidence of preeclampsia, fetal death, preterm delivery, and premature rupture of membranes was similar among groups. All vaccinated women and their infants elicited antibody titers (≥1:40). Women vaccinated prior to pregnancy had no adverse events that were different from the nonvaccinated population. Even though this study is limited by the sample size, the results suggest that the anti-influenza

A(H1N1)pdm09 VLP experimental vaccine applied before pregnancy is safe for both mothers and their infants.

**Keywords:** virus-like particle; influenza A(H1N1)pdm09; vaccination; pregnant women; antibody titers
