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Vaccinations During Pregnancy

  • A. Kenneth Harper MD

Women are very concerned about exposure to any medication during pregnancy for fear of harm to the baby. Many women fear vaccinations especially since there has been discussion in recent years regarding a possible association of childhood vaccinations and autism. The CDC, ACOG and the American Academy of Pediatrics all support usual vaccinations including the ones recommended in pregnancy. There is no scientific evidence of a link between autism and mercury in vaccinations. A good review of vaccinations is on the CDC website:
www.cdc.gov/vaccines/parents/pregnant.html

All women should have regular vaccinations. If you are contemplating pregnancy it is wise to update

  • Tdap – tetanus/diphtheria/pertussis every 10 years. Tetanus is a severe neurologic infection that can result in paralysis or death (“lock jaw”) usually contracted from a contaminated wound (“rusty nail”) but can occur with lesser injury. Diphtheria is rare in this country but is a serious respiratory infection that has resulted in epidemics in the past. Pertussis (“whooping cough”) has been increasing in incidence in recent years. It can produce a serious respiratory infection especially in infants and children. Since babies do not receive this vaccine until 2 months of age, it is advised that all adults including pregnant women not up to date with the vaccine receive the Tdap. The ideal time to receive the vaccine is in the third trimester of pregnancy or before hospital discharge after delivery.
  • Influenza vaccine (“flu shot”) – advised annually and at any time during pregnancy each fluseason. Pregnant women are not only more susceptible to catching the flu but also have a higher risk of developing pneumonia as a complication of the flu. The oft reported reasons for not taking the flu shot are fear of hurting the baby or fear of getting the flu from the vaccination. The flu shot is safe in pregnancy, and, although there is a small risk of developing a flu-like illness after the shot, it is usually mild. The risk is far greater of contracting flu if you are not vaccinated. The flu shot is recommended but the flu mist is not recommended.

Vaccines that are NOT RECOMMENDED during pregnancy but can be given after delivery, because they are safe with breast feeding, are:

  • MMR – mumps, measles, rubella (“German measles”). Women are tested with each pregnancy for rubella immunity even if they received their childhood vaccines. About 10-15% of people will lose immunity to rubella with time. German measles during pregnancy can cause severe birth defects in the baby. Testing for immunity and vaccination before pregnancy is advised.
  • Varicella – (“chicken pox”) vaccine. Chickenpox in pregnancy is associated with a very high risk of pneumonia in the pregnant woman. If you do not have a history of chickenpox it is recommended to test for immunity and receive vaccination before pregnancy.
  • Flu mist – as stated above the flu shot is OK in pregnancy, but the flu mist is not recommended.
  • HPV vaccine - Human Papillomavirus vaccine.