Are Vaccinations Safe in Pregnancy?
Keeping your baby safe during pregnancy is likely the most important concern on your mind if you are pregnant, and it depends on many factors. Just like taking your prenatal vitamins and keeping your doctor’s appointments, one of the best things you can do for the health of your baby is to protect him or her from getting sick, and many women go through pregnancy without realizing that they can prevent certain diseases simply by keeping up with all recommended vaccinations.
What are vaccines?
Vaccines contain substances that prepare your body’s immune, or defense, system so that it can fight off certain infections when exposed to a particular virus or bacteria in the future. In this way, your body is trained to resist a disease, and you become immune to it. Vaccines can help prevent certain infections and serious complications during your pregnancy and in the first few months of your baby’s life.
Are vaccines safe in pregnancy?
Certain vaccines are safe in pregnancy and certain ones are not. In general, vaccines that contain inactivated or killed viruses are considered safe, while those that contain live viruses may be harmful to an unborn baby, and are therefore not given during pregnancy.
Which vaccines should I get during pregnancy?
Two vaccines are routinely recommended for all pregnant women and will be offered to you during your prenatal visits. They are the influenza vaccine and Tdap.
Influenza – You may think of having “the flu” as having a fever, runny nose, and muscle aches, however this infection can actually be especially dangerous in pregnant and post-partum women and can lead to serious complications including hospital stays and even ICU admissions. The influenza vaccine, or flu shot, can help prevent these serious complications. And by delivering protective antibodies to your baby through the placenta during pregnancy and through breastfeeding post-partum, the flu shot also helps protect your baby during his or her first few months of life, as babies cannot receive the flu shot before they are six months old and can also get very sick from an infection. The flu shot is recommended for all women who are pregnant or who might be pregnant during the flu season (typically October through March). It can be safely given at any week of pregnancy (even in the first trimester), and is in fact recommended as soon as it becomes available during a season and ideally before the outbreak of the flu in the community. While the inactivated influenza vaccine, which is given in an intramuscular injection, is safe in pregnancy, the nasal spray influenza vaccine is made from a live virus and is therefore avoided during pregnancy.
Tdap – The tetanus toxoid, reduced diptheria toxoid, and acellular pertussis, or Tdap vaccine is safe in pregnancy and is recommended to be given to all pregnant women between 27 and 36 weeks. It most importantly protects against Pertussis, or the “whooping cough,” a bacterial disease that can spread through air droplets by coughing or sneezing. This disease has the most severe consequences in infants less than three months of age, and in the 1900s before the vaccine was available, it was a major cause of sickness and death in babies and children. After the vaccine was developed, the number of cases significantly decreased, however in recent years we are again seeing a rise in the disease and it is important for everyone to get vaccinated. You likely received DTaP, another form of the vaccine that is given in five doses during childhood, however Tdap is a booster you need to get in every pregnancy (even if you just got it during your last pregnancy) in order to protect you from getting sick and allowing for transfer of protective antibodies through the placenta to protect your baby during the first few months of life when he or she is too young to get vaccinated. If TDap is missed during pregnancy, it should be given immediately postpartum so that your baby can receive the protective antibodies through your breast milk. The TDap booster is also recommended for all teenagers and adults who have not previously received it and especially for household members who will be having close contact with an infant.
Should I receive any other vaccines during pregnancy?
You may need a certain vaccine to be given during pregnancy if you are at risk for a particular infection due to travel, a certain job, or other risk factors. These may include Hepatitis A or B, meningococcus, Yellow fever, or others. Don’t forget to tell your doctor if you plan on international travel, especially to tropical areas of South America and sub-Saharan Africa, although travel to such places should be avoided during pregnancy if possible.
What if I’m not pregnant yet but planning for pregnancy?
It is important to be up to date on all your vaccines and boosters prior to pregnancy. This can help prevent certain serious complications when you do become pregnant. Besides routine vaccines that you should have received as a child or teen, it is also important to receive immunity against measles, mumps, and rubella (MMR) and varicella (chicken pox) if you are not already immune. The reason is that these vaccines cannot be given during pregnancy as they contain live virus, and getting one of these infections during pregnancy can have serious consequences such as miscarriage or birth defects. If you do receive one of these vaccines, it is recommended to wait at least one month (or 3 months with varicella) prior to conceiving. You should see your doctor for a “preconception counseling visit” during which your doctor will review your vaccine history (bring your immunization record if you have one) and possibly draw some blood tests to help identify what vaccines if any you should receive in order to prepare for a healthy pregnancy.
Influenza vaccination during pregnancy. Committee Opinion No. 608. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;124:648–51.
Update on immunization and pregnancy: tetanus, diphtheria, and tetanus vaccination. Committee Opinion No. 566. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013; 121:1411-4.