Vaccination and Pregnancy in Southern New England

Vaccines strengthen people’s immune systems so their bodies can fight off serious infectious diseases. Vaccines also benefit society by preventing the spread of communicable diseases.

Many women might not realize they are not up-to-date on their immunizations and are susceptible to diseases that can harm them or their unborn child. Pregnant women should talk to their physicians to figure out which vaccines they might need and whether they should get them during pregnancy or wait until after their child is born.

All vaccines are tested for safety under the supervision of the Food and Drug Administration (FDA). The vaccines are checked for purity, potency and safety, and the FDA and Centers for Disease Control and Prevention (CDC) monitor the safety of each vaccine for as long as it is in use. Some people might be allergic to an ingredient in a vaccine, such as eggs in the influenza vaccine, and should not receive the vaccine until they have talked to their doctors.

A number of vaccines, especially live-virus vaccines, should not be given to pregnant women because they might be harmful to the baby. (A live-virus vaccine is made using the live strains of a virus). Some vaccines can be given to the mother in the second or third trimester of pregnancy, while others should only be administered either at least three months before or immediately after the baby is born.

Depending on the circumstance, your doctor will weigh the risks of vaccination against the benefits the vaccine can provide.

The following vaccines are considered safe to give to women who might be at risk of infection:

• Hepatitis B — Pregnant women who are at high risk for this disease and have tested negative for the virus can receive this vaccine. It is used to protect the mother and baby against infection both before and after delivery.
• Influenza — This vaccine can prevent serious illness in the mother during pregnancy. If you have a serious medical condition that can lead to flu-related complications, you can receive the vaccine at any stage in your pregnancy.
• Tetanus/Diphtheria — This combination of vaccines is routinely recommended for pregnant women, both those who have never been immunized and those who have not received a booster in 10 years.

The following vaccines can potentially be transmitted to the unborn child and might result in miscarriage, premature birth or birth defects.

• Hepatitis A — The safety of this vaccine hasn’t been determined and it should be avoided during pregnancy. Women at high risk for exposure to this virus should discuss the risks and benefits with their doctors.
• Measles, Mumps, rubella (MMR) — Women should wait at least three months to become pregnant after receiving these live-virus vaccines. If the initial rubella test shows you are rubella non-immune, then you will be given the vaccine after delivery.
• Varicella — This vaccine, used to prevent chicken pox, should be given at least one month before pregnancy.
• Pneumococcal — Because the safety of this vaccine is unknown, it should be avoided in pregnancy except for women who are at high risk or have a chronic illness.
• Oral polio Vaccine (OPV) and Inactivated polio Vaccine (IPV). Neither the live-virus (OPV) nor the inactivated-virus (IPV) version of this vaccine is recommended for pregnant women. Also, the risk of getting polio in the United States is very low.

Side effects vary from none to those that can occur up to three weeks after vaccination. If you experience any severe side effects, be sure to tell your doctor.

• Hepatitis A — Soreness and redness at injection site, headache, fatigue, severe allergic reaction in very rare cases.
• Hepatitis B — Soreness at injection site, fever.
• Influenza — Redness and swelling at injection site that can last up to two days, fever
• Tetanus/Diphtheria — Low-grade fever, soreness and swelling at injection site
• Measles, Mumps, rubella (MMR) — Non-contagious rash, swelling of neck glands and cheeks, pain and stiffness of joints one to two weeks after vaccination
• Varicella — Fever, soreness or redness at injection site, rash or small bumps up to three weeks after vaccination
• Pneumococcal — Fever, soreness at injection site
• Oral polio Vaccine (OPV) — None
• Inactivated polio Vaccine (IPV) — Redness, discomfort at injection site