Although they are more frequent during childhood, vaccines can be administered at any stage of life, but like any other medicine, they can also have contraindications and raise doubts if they have to be administered in sensitive periods such as pregnancy.
Today we talk about vaccination during pregnancy : is it safe to get vaccinated? What vaccinations should I get if I’m pregnant and which ones should I avoid? What precautions should I take if I have to get vaccinated during pregnancy?
Why it is essential to review your vaccination schedule before you get pregnant
Vaccination is important as part of pregnancy planning. So, if you are thinking about having a baby, check your vaccination record to make sure you are protected against the main diseases, such as rubella or chickenpox, in case you have not had the disease.
Rubella infection in a pregnant woman can cause serious problems in the fetus with lifelong consequences, and can sometimes even lead to death. In the case of chickenpox , if the woman becomes infected during pregnancy, the consequences for the baby are also very serious, especially if it is contracted in the first 20 weeks or in the last days before delivery (here you can consult the information with more detail).
The varicella-zoster and rubella vaccine (which is part of the MMR along with measles and mumps) are live attenuated virus vaccines . In case you have to receive any of these vaccines during the fertile period, you should know that you will not be able to get pregnant in the four weeks after the administration of the vaccine.
If you are already pregnant, one of the first tests they will do is a serological test . It is a blood test that detects the presence of specific antibodies or antigens to certain infectious agents. In the case of detecting an active infection or a situation of vulnerability to some type of serious disease if it is contracted during pregnancy (as we have just mentioned, this may occur because the disease has not been passed or a vaccine against it has not been received) , the doctor will tell you how to proceed.
Can I get vaccinated if I am already pregnant?
Pregnancy has specific peculiarities in terms of vaccination , since at this stage a series of immunological and physiological changes take place in the mother and the baby that make some vaccines especially beneficial, while others are not recommended.
Contraindicated vaccines during pregnancy
Live virus vaccines inoculate live microorganisms, but very attenuated, so that the defenses generated by the body can easily reduce them. However, they are contraindicated during pregnancy .
They are live virus vaccines, in addition to the MMR and chickenpox vaccine mentioned above, yellow fever (a disease transmitted by the bite of a mosquito) and oral typhoid fever (made up of live, weakened bacteria). These two vaccines are usually recommended when traveling to risk areas such as Africa, Central and South America or Asia, however, in the case of pregnant women it is preferable to avoid them whenever possible .
On the other hand, although the human papillomavirus vaccine is not a live virus vaccine, but an inactivated one, it is not recommended during pregnancy, as data on its efficacy and safety are limited.
Safe and Recommended Vaccines During Pregnancy
There are two safe and recommended vaccines during pregnancy :
- Inactivated influenza vaccine, to be administered when the campaign begins regardless of the trimester of pregnancy in which you are
- Whooping cough vaccine.
In case of contracting the flu during pregnancy there is an increased risk of hospitalization, which increases especially during the second and third trimesters, and during the postpartum period. Additionally, flu in pregnancy increases the risk of premature birth, low birth weight, and neonatal sepsis. An increased risk of miscarriage and stillbirth is also associated.
For its part, the pertussis vaccine not only immunizes the mother, but is also 90% effective in preventing cases of whooping cough in children under two months, a potentially fatal disease in newborns. It has been proven that by administering the vaccine between weeks 27 and 36 of gestation (preferably between weeks 28 and 32), the antibodies generated by the mother pass through the placenta and increase the baby’s defenses, protecting it until it receives the first doses of the vaccine according to the schedule.
The pertussis vaccine can be combined with the tetanus and diphtheria vaccine , and also administered during pregnancy. In fact, as we read in this document prepared by the Spanish Association of Primary Care Pediatrics (AEPap), “during childbirth there is a risk of tetanus infection, both for the mother and the newborn, so the pregnant woman must be properly immunized before it “ .
Women with an allergy to eggs, hypersensitivity to egg proteins, or who have had a previous severe allergic reaction to inactivated influenza vaccines should not receive the flu vaccine. Neither will women with an acute illness with a high fever be vaccinated against the flu or fair cough. In this case, they will have to wait for the symptoms to subside to get vaccinated.
Other vaccines advised in special situations
There are specific situations in which the administration of certain vaccines during pregnancy may be recommended. For example:
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Hepatitis A vaccine is an inactivated vaccine that could be recommended in situations of risk of contagion for the pregnant woman (injecting drug users, travelers to endemic areas, when there is professional risk …) or if she has pathologies that increase the risk of complication in case of contracting hepatitis A.
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Hepatitis B is an infection of the liver caused by the hepatitis B virus. If this disease is contracted during pregnancy, there is a risk of transmitting it to the baby during delivery, causing serious health problems. For this reason, the vaccine is indicated in seronegative pregnant women at risk of exposure to the virus or in case of prophylaxis after exposure.
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The pneumococcal vaccine is recommended for women at high risk of invasive pneumococcal infection, such as immunosuppressed, transplanted, chronic kidney disease, or HIV-infected patients. In these cases, the CDC recommends, due to greater experience in its use, the polysaccharide vaccine versus the conjugate one.
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In epidemic situations, certain health problems of the pregnant woman or trips to areas during meningitis season, the polysaccharide or conjugate meningococcal vaccine could also be indicated.
Specific vaccines when traveling to risk areas
When traveling it is important to bear in mind that there are certain countries with a higher risk of tropical diseases, epidemics or that require a specific vaccination. When the trip is unavoidable and involves a risk for the pregnant woman , the administration of certain vaccines should be considered:
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Yellow fever vaccine : although as we mentioned above, this vaccine is not recommended during pregnancy, when the woman travels to areas where the disease is endemic and unavoidable, she should be vaccinated.
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Typhoid fever vaccine : this disease is caused by the Salmonella tiphy bacteria, and although the oral vaccine would be contraindicated because it contains an attenuated strain of this bacterium, the inactivated parenteral polysaccharide vaccine could be considered in case of travel to endemic areas, s provided the risk of exposure outweighs the potential risk of the vaccine.
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Rabies Vaccine : Rabies is a deadly viral disease that affects the central nervous system. There is a higher risk of contracting it if you travel to Eastern Europe, Africa, Asia, and countries in Central and South America. It is an inactivated vaccine, and there is no evidence of adverse effects on the fetus when used during pregnancy.
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The Japanese encephalitis vaccine may be recommended if you travel to Southeast Asia and the West Pacific, where there is a higher risk of contracting the disease. This vaccine contains inactivated viruses, and although there are no studies in pregnant women, there is no evidence of maternal-fetal damage in animals.
Vaccine against COVID and pregnancy
Initially, pregnant women (and also infants) were excluded from the COVID vaccine trials , so it is currently not recommended to apply them in this group in a generalized way, leaving it to the discretion of the pregnant woman and the health professional after evaluating the benefits and risks according to each case.
Little by little we are having more data on the safety of the vaccine in this group. Thus, the latest study published has concluded that the Pfizer and Moderna vaccines against Covid-19 are effective in pregnant women, and can transmit protective antibodies to their newborns.
Can I get any vaccinations after giving birth?
Once you have given birth, there are certain vaccinations that you will need to get if you have not received them during pregnancy . This is the case of the whooping cough vaccine and the flu vaccine, if it is in season. In addition, vaccination against chickenpox and MMR is recommended if you have not been previously vaccinated or have had the disease.
On the other hand, certain circumstances, such as the birth of a premature baby, require the indirect protection of all the people who live with him. Hence the importance of the mother having her vaccination schedule up to date.
If you are breastfeeding your baby, we remember that breastfeeding does not contraindicate any vaccine, nor does it have negative effects on the breastfed baby or on the mother. On the contrary, mothers who breastfeed their children and are vaccinated, also give them defenses in the form of antibodies and other substances that pass through the milk.
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Via Types of vaccines – CDC, Vaccines for pregnant women – CDC, Vaccination in pregnancy – AEPap
In Babies and More | Vaccines during pregnancy, Did anyone ask you if you were vaccinated during pregnancy? Getting vaccinated against flu and whooping cough during pregnancy is safe for the baby
