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Vaccination Guidelines for Women Considering Pregnancy

As you are contemplating pregnancy – either with or without the assistance of fertility treatment – it is important to maximize your health so that you can improve your chances of having a safe and healthy pregnancy. One thing to consider is how protected you are against a variety of forms of illness for which there are vaccinations. The Centers for Disease Control and Prevention (CDC) have established standard recommendations for vaccinations in women contemplating pregnancy.
Ideally immunizations should be completed before pregnancy occurs as some vaccinations are not safe in pregnancy. Vaccinations before or during pregnancy can protect women from potentially serious illnesses; importantly, the protection that women develop against these illnesses can be passed on to the fetus – especially in the last few weeks of pregnancy.
Patients may feel reluctant to have a vaccination because of the fear of affecting the pregnancy adversely. However, the vaccinations that are recommended have been used extensively and safely, and there is no indication that there is any risk to the pregnancy by the recommended vaccinations.

Measles, Mumps, and Rubella (MMR vaccine; Rubella = German measles) –

This vaccine is recommended for all women who have not been previously vaccinated or if bloodwork does not show protection. It should be administered before pregnancy – and pregnancy should not occur within a month of the vaccine.

Varicella (Chicken Pox) –

This vaccine should be considered for patients who have not had chicken pox and do not show evidence of protection against chicken pox with bloodwork. Pregnancy should be avoided for 1 month following the vaccine.

Influenza (Flu) –

This vaccination is recommended for any women who may be in the 2nd or 3rd trimester during flu season (January through March). The injectable version is safe at any time during pregnancy; the intranasal vaccination is not safe.

Tetanus Diptheria Pertussis (DTaP vaccine; Pertussis = Whooping Cough) –

This vaccine is recommended for adults who will have close contact with an infant of less than 12 months of age. Thus, any woman who might become pregnant or is immediately postpartum should be encouraged to receive it. A booster should be considered if it has been more than 10 years since the previous vaccination.

Pneumococcus –

This vaccine is recommended for any person at increased risk for pneumococcal infection. Individuals at high risk include patients with: chronic heart or lung disease, history of spleen removal, diabetes, or other immune compromised states. Ideally the vaccine should be given before pregnancy but can be given during pregnancy.

Hepatitis A –

This vaccine is recommended for any woman at high risk of exposure, including those who receive blood products, those with chronic liver disease, and those women traveling to countries with high prevalence. This vaccine is safe to give during pregnancy.

Hepatitis B –

This vaccine is recommended for any woman at high risk, including women who receive kidney dialysis or frequent blood products, healthcare workers who have frequent exposure to blood, women with multiple sexual partners, women traveling to countries with a high prevalence of hepatitis B, and women living in the same household as a known infected individual. The vaccine can be given during pregnancy.

Meningococcal –

This vaccine should be considered for people at high risk of exposure, including women living in high endemic areas (e.g. sub-Saharan Africa and parts of the Middle East) as well as those living in dormitories. Ideally the vaccine would be given before pregnancy.

Summary

Vaccinations can help protect women and their unborn children during and after pregnancy against illnesses with potentially severe side effects.  It is ideal to complete vaccinations before pregnancy, as some vaccinations are not safe to administer during pregnancy.
If you have any questions about which vaccinations are appropriate for you, consider speaking with your OBGYN or general health provider.

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