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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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.