Vaccination Guidelines for Pregnant Women

According to the Huffington Post, the state of California is requesting pregnant women take the Tdap vaccination during pregnancy if they have not been vaccinated. Tdap, or tetanus / diptheria / pertussis helps prevent pertussis, which can be life threatening to an infant. Despite the order by the state of California, Tdap has never been tested for use by pregnant women.

The Centers for Disease Control states " [Tdap] could interfere with the infant's immune response to infant doses of DTaP, and leave the infant less well protected against pertussis." Tdap is not the only vaccination pregnant women may be faced with during gestation. Below is a list of common vaccinations and any threats associated with use during pregnancy.

Contraindicated Vaccinations for Pregnant Women - Not Suggested

Influenza (LAIV)

Measles

Mumps

Rubella

BCG or bacille Calmette-Gueri (Tuberculosis)

Vaccinia (Smallpox)

Zoster (Shingles)

Considered Safe for Vaccination During Pregnancy - If Needed

Hepatitis B

Influenza (Inactive)

Tetanus - Diptheria

Meningococcal or MPSV4 (Meningococcus)

Rabies

Vaccinations with No Recommendation - Use Caution

Hepatitis A - No testing has been completed on pregnant women. The risk is thought to be low, but this thought is not clinically supported.

Human Papillomavirus (HPV) - Not recommended for vaccination during pregnancy. Manufacturers of the vaccine, Merck and GlaxoSmithKline are collecting information from women vaccinated while pregnant.

Meningococcal or MCV4 - No testing has been completed on pregnant women.

Pneumococcal - No testing has been completed for first trimester vaccination, but no reports of fetal impairment have been reported.

Polio - No testing has been completed, but doctors suggest the vaccine not be used during pregnancy.

Tdap - No pregnancy testing has been performed. The ACIP, Advisory Committee on Immunization Practices, suggest pregnancy vaccination is pertussis infection is a risk. Vaccinations should be given in the second or third trimester when possible.

Anthrax - No known studies have been completed on the safety of Anthrax vaccination during pregnancy.

Japanese Encephalitis - No studies have been published regarding risk of vaccination in the pregnant community.

Typhoid - No testing has been completed or published on pregnancy safety for Typhoid vaccination.

Yellow Fever - No safety guidelines have been established, but experts suggest vaccination if a pregnant women is traveling to an infected area or where risk of infection is high.

Having vaccinations during pregnancy may be appropriate in some cases, especially when the mother or fetus are in danger or at high risk for contracting a disease they have not been vaccinated for. The final call should always be made as an educated collaboration between obstetrician and pregnant patient.

Resources

"Dr. Bob Sears: Government Okays Untested Vaccine for Pregnant Women."Breaking News and Opinion on The Huffington Post. Web. 01 Sept. 2010.

"Vaccines: Pubs/Guidelines for Vaccinating Pregnant Women."Centers for Disease Control and Prevention. Web. 01 Sept. 2010.