Understanding Immunizations During Pregnancy

When it comes to common vaccination requirements, in the United States, most individuals are vaccinated against measles, mumps, and rubella as children, known as the MMR vaccination. However, if these have not been received, it is recommended to do so prior to pregnancy, as these diseases, rubella in particular, can cause serious complications for the baby’s health.

For women who have not received the MMR vaccination, it is recommended to receive this at least one month prior to trying to become pregnant.

Additional common vaccination includes the chickenpox/Varicella vaccine, which, if contracted during pregnancy, can cause birth defects or pregnancy complications.

For women who have not received the chickenpox/Varicella vaccine, it is recommended to receive this vaccine at least one month prior to trying to become pregnant.

The HPV vaccine, though not specifically recommended during pregnancy poses no additional threats should it be administered while pregnant. Because this vaccine is typically given in two or three doses, additional doses may be postponed until after pregnancy if they were started during or prior to confirmed pregnancy.

Typically, this vaccine is administered to individuals younger than 26, however receiving it before the age of 45 may be recommended if risk factors are present.

There are two types of Pnemococcal vaccines, one or both may be needed and this may only be suggested during pregnancy if certain risk factors are present. If not recommended during pregnancy, it is advised that this vaccine be administered prior to pregnancy or postpartum if mother needs it.

The shingles vaccine is not advised to be given during pregnancy due to a lack of research to determine its impact on pregnancy and fetal health, however inadvertent vaccination has not shown any specific risks.

Typical vaccination for this is received at the age of 50 or older in a two-dose series of vaccinations.

During pregnancy, a woman’s body gives most of its energy and attention to creating the baby, thus suppressing the immune system. Influenza shots are critical for protecting both the mother and her unborn child from the flu virus after exposure. One of the most commonly known yearly vaccines deemed safe at all stages of pregnancy, the flu vaccine should be administered in shot form, which is made from an inactivated virus, in preparation for flu season. The rarer flu nasal spray vaccine, LAIV, is not recommended for women who are pregnant, or who are trying to conceive as it contains a live strain of the virus. Although the flu may seem like an insignificant virus, it is important to know that contracting it during pregnancy may cause severe damage to a pregnant woman’s body.

While healthy adults can carry the flu virus without showing any symptoms, expectant women tend to show a number of signs as the immune system tries to fight off the infection. Symptoms may include the following:

• Respiratory complications
• Premature labor
• Severe nausea, Vomiting, or Diarrhea
• Shortness of breath/Cough
• Loss of appetite
• Fatigue
• Episodes of confusion
• Fever or Sudden chills
• Body aches
• In severe cases, miscarriage

Studies shows that women who get the flu during pregnancy find themselves sicker than they would be at any other time, and have an increased risk of premature labor, premature birth, premature birth weight, and miscarriage. Additionally, women who get the flu during pregnancy may be required to be hospitalized after birth and in some rare cases infection may be fatal.

Additional precautions can include ensuring that all persons who are in close contact should also be vaccinated and women should avoid contact with those sick with the flu to reduce the risk of flu exposure.

Offering protection against tetanus, diphtheria, and whooping cough (pertussis), the Tdap vaccine, can be administered safely at multiple stages depending on previous vaccination.

The U.S. Centers for Disease Control and Prevention reports that on average, whooping cough accounts for about 1,000 infant hospitalizations and five to 15 infant deaths each year in the United Stated. For this reason, the whooping cough/Pertussis vaccine is the number one vaccine suggested for pregnant women.

This vaccine offers protection to both the mother and unborn child, with optimal administration of the vaccine occurring around 27 weeks gestation to maximize the maternal antibody response and passive antibody transfer to the infant. Because the newborns and infants are at the highest risk of infection, Tdap vaccination is administered with the purpose of optimal protection to the baby during gestation and after birth.

Because Tdap vaccination does not last as long as experts would like, preconception vaccination is not suggested as it may not provide optimal protection to the infant after birth. If Tdap vaccination is administered prior to conception, it is recommended that additional vaccination between weeks 27 and 36 occur.

Hepatitis B is a vaccine-preventable severe liver infection that is spread through contact with infected blood and bodily fluids. The disease can easily be passed from mother to unborn child during delivery. Getting the hepatitis B vaccine during pregnancy can help protect the unborn baby from getting infected with the disease.

If women have received prior hepatitis B vaccination, it can be beneficial to receive the vaccine again to prevent future infection of both mother and child. Additionally, those at a higher risk for contraction, such as those working as healthcare providers, should also consider getting this vaccination. For full immunity against hepatitis B, doctors may recommend a series of three doses. The first dose should be administered before pregnancy, the second at one month and the third at six months after the initial dose.

Hepatitis A is a low-grade liver disease. This disease is not as serious as hep B, however it is something to consider taking precautions for. It is not likely the disease will be passed on to an unborn fetus, however, the possibility is there. Hepatitis A can cause infection in the newborn and premature labor. This is a vaccination that should be especially considered for women with chronic liver disease or residing with someone with the disease, or if they are traveling during their pregnancy, as hepatitis A is a disease that can be contracted through contaminated water and food.

Research results on COVID-19 vaccines during pregnancy show that there is no negative risk of receiving the vaccine during pregnancy. Because of the highly contagious nature of COVID-19, it is important to provide the body with vaccination for preventative measures, even if full immunity is not possible. Like other immuno-compromised conditions, pregnancy presents an increased risk of severe complications and long-term symptoms due to infection with COVID-19. COVID-19 infection during pregnancy poses an increased risk of hospitalization, preterm birth, stillbirth and maternal fatality. Additionally, studies have found that pregnant women diagnosed with coronavirus had over a 60 percent chance of developing preeclampsia, even if the mother was asymptomatic (experienced no symptoms while infected with virus).

While vaccination is highly recommended for all individuals, it is especially recommended for all women, even in those with a history of previous infection, who are pregnant, breastfeeding, or trying to get pregnant, as antibodies from the vaccine can be shared with the unborn baby, providing them with some immunity at birth.