Pr Med: Vaccination in Pregnancy
meduploader - 05-16-09 13:41

A. These vaccines only have a very Small risk in controlled animal studies
Td (Tetanus and Diphtheria Toxoid) - Give after first trimester if the last dose was more than 10 years
Hepatitis A Vaccine -Give if patient is travelling to endemic area or hx of IVDA in pregnancy
Hepatitis B Vaccine - Recommended in pregnancy if they have Hepatitis B risk factor (having more than one sex partner during the previous 6 months, been evaluated or treated for an STD, recent or current injection drug use, or having had an HBsAg-positive sex partner
Influenza Vaccine - Indicated in all pregnant woman in Influenza season, Give after first trimester ( inactivated vaccine should be used. Not live attenuated influenza vaccine)
Polyvalent pneumococcal Vaccine - preferably, avoid during pregnancy
Polio Vaccine (live and inactivated) - Avoid during pregnancy. But if high risk polio exposure may give IPV
Rabies Vaccine for post exposure prophylaxis
B. These vaccines have strong evidence of risk to the human fetus
Yellow Fever Vaccine (Live vaccine) – AVOID! ( should be given only if travel to endemic area is unavoidable and if risk of exposure determined as high)
C. These have Very high risk to the human fetus : CONTRAINDICATED!
Measles Vaccine
Mumps Vaccine
Rubella Vaccine
BCG vaccine
Small Pox Vaccine ( but pregnant women with definitive evidence of small pox exposure should be vaccinated as benefit outweighs risk )
Varicella Vaccine (Varivax) – theoretic risk of congenital varicella. So, avoid! If pregnant woman is exposed to chicken pox, use VZIG
D. Quadrivalent HPV vaccine is not recommended for use in pregnancy. ( Data on safety limited)

MMR – Pregnancy
Measles-mumps-rubella (MMR) vaccine and its component vaccines should not be administered to pregnant women.
A risk to the fetus from administration of these live virus vaccines cannot be excluded for theoretical reasons à So, women should be counseled to avoid becoming pregnant for 28 days after vaccination with MMR or its components.
If vaccination of an unknowingly pregnant woman occurs or if she becomes pregnant within 4 weeks after MMR vaccination, she should be counseled about the theoretical basis of concern for the fetus à Remember, however, MMR vaccination during pregnancy should not be regarded as a reason to terminate pregnancy
Rubella-susceptible women who are not vaccinated because they state they are or may be pregnant should be counseled about the potential risk for CRS and the importance of being vaccinated as soon as they are no longer pregnant. à but, never give vaccine during pregnancy.
Women who inadvertently received Rubella vaccine should be counseled about theoretical risk of CRS but its not an indication to terminate pregnancy à A registry of susceptible women vaccinated with rubella vaccine between 3 months before and 3 months after conception – the "Vaccine in Pregnancy (VIP) Registry" – was kept between 1971 and 1989. No evidence of CRS occurred in the offspring of the 226 women who received the current RA 27/3 rubella vaccine and continued their pregnancy to term.