Vaccines are an effective way to protect against serious and potentially life-threatening diseases. Ideally, vaccinations should be completed before conception and pregnancy, and the National Adult Immunization Program should be followed.
Vaccines should be administered to protect the mother (pregnant woman), the fetus, and subsequently the newborn and infant.
The immune response of a pregnant woman to vaccines is considered identical to that of a non-pregnant woman. Antibody concentration increases as pregnancy progresses, and by the end of pregnancy the antibody concentration in the newborn is equivalent to that of the mother.
Which vaccines are recommended for all pregnant women?
The vaccines that should be administered routinely during pregnancy and are safe are:
1. The inactivated (consisting of killed virus) influenza vaccine
2. The diphtheria, tetanus, and pertussis (Tdap) vaccine
Influenza vaccine
Studies have shown that women during pregnancy or lactation are at risk of severe illness from influenza even if they have no other risk factors. The influenza virus can have serious effects on the health of the pregnant woman and the fetus; therefore, administration of the flu vaccine is recommended for every pregnant woman during the flu transmission season (winter months). Additionally, maternal influenza vaccination protects infants under 6 months of age who cannot yet be vaccinated against the flu.
Diphtheria, tetanus, and pertussis vaccine (Tdap)
Maternal vaccination with the tetanus vaccine is one of the weapons against neonatal tetanus, which has been one of the most common causes of neonatal death.
At the same time, in recent years the frequency of pertussis has been increasing due to the waning immunity (the protection provided by the vaccine diminishes over time). Adults are the main source of transmission of the disease to infants under three months, who are at high risk of severe illness from pertussis.
For this reason, the Advisory Committee on Immunization Practices (ACIP) of the CDC recommends Tdap vaccination for all pregnant women during every pregnancy, preferably between the 28th and 36th weeks of gestation. This applies regardless of whether the woman has a history of pertussis, since past infection does not provide lifelong immunity.
The vaccine is considered safe, with no adverse effects for the fetus or the newborn. About two-thirds of women experience mild local reactions. It is considered effective in 90–93% of cases, and effectiveness in reducing infant mortality is >95%.
Other vaccines permitted during pregnancy
· Meningococcal and pneumococcal vaccines
· Hepatitis A and B vaccines
· Haemophilus influenzae type B (Hib) vaccine
Which vaccines are best avoided during pregnancy?
Vaccines made from live viruses—such as those for chickenpox, measles, mumps, and rubella (MMR)—are recommended to be avoided during pregnancy. For this reason, efforts should be made to vaccinate women before or after pregnancy for these diseases. These vaccines can, however, be administered during breastfeeding.
