Pregnancy and Vaccination Pocket Guide

Pregnant women may be at risk for infectious diseases and their complications. Consider vaccination - even during pregnancy - to protect the woman and the fetus.


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On this page:
Considerations
Tdap/Td
Vaccine-related prenatal serologic screening
Vaccinating household contacts of pregnant women
Vaccinating breast-feeding women
Vaccinating newborns

Considerations

Recommended - Vaccine is recommended regardless of pregnancy.

Contraindicated - Vaccine is contraindicated for pregnant women because of the theoretical risk of transmission of the vaccine virus to the fetus.

If indicated - Certain vaccines are indicted based on patient risk factors (e.g., medical, occupational, lifestyle, international travel) and should be given if susceptible regardless of pregnancy.

Tdap/Td

  • Give Tdap between 27 and 36 weeks gestation during each pregnancy.
  • Tdap can be given regardless of the interval since last Td or Tdap.
  • Give Tdap instead of Td for wound management during pregnancy.
  • Pregnant women who never received a primary Td series should receive three doses. Give Td/Tdap at intervals of 0, 1, and 6 months. One of the three doses should be Tdap given after 20 weeks gestation, preferably between 27-36 weeks.

Vaccine-related prenatal serologic screening

  • Test for rubella: if susceptible, vaccinate postpartum.
  • Test for hepatitis B: vaccinate if susceptible and at risk. Send results to birthing hospital; if HBsAg-positive, report results to the Minnesota Department of Health.

Vaccinating household contacts of pregnant women

  • Household contacts of pregnant women should receive Tdap and influenza vaccines, as well as hepatitis B (if pregnant woman is HBsAg-positive).
  • No vaccine - except smallpox - is contraindicated for household contacts or the children of a pregnant woman.

Vaccinating breast-feeding women

  • Neither inactivated nor live-virus vaccines given to a breast-feeding woman affect the safety of breast-feeding for mothers or infants.
    • Most live-virus vaccines are not secreted in breast milk; however, if this does occur (i.e., with attenuated rubella vaccination) it produces asymptomatic infection in infants.
  • Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine - except smallpox.

Vaccinating newborns

  • Stress the importance of vaccinating newborns, starting with the hepatitis B birth dose.

Updated Tuesday, 19-Feb-2013 11:51:48 CST