Vaccinations and pregnancy

31/01/2018

I thought it would be interesting to write about topic that interests all pregnant women: vaccinations. And why's that? Because in the flu vaccination campaign pregnant women are one of the population groups for which the vaccination is recommended. However, it's true that when I bring up the topic with my patients in the consultation room, I usually get the same reaction from all of them: Are you sure I should get the vaccination? It's all a bit unclear to me... What vaccinations are indicated during pregnancy? Is it safe to get the vaccination while I'm pregnant? Keep on reading this article. I hope to answer all these questions!

1. Which vaccinations are recommended nowadays for pregnant women?

• The flu vaccination. It's highly recommended during any trimester of pregnancy as long as it is available (October to May). Pregnant women are more at risk of contracting the flu than women of the same age who are not pregnant. This is because they have physiological immunosuppression (that is to say, their defences are somewhat more "idle"). Plus, if a pregnant woman catches the flu it's also possible she presents more symptoms than when she's not pregnant.   

Commercial vaccines in Spain are inactivated vaccines (their basis is a non-active virus), meaning they do not pose any risk to a pregnant woman nor her foetus. During pregnancy, the flu can be a serious illness, particularly in the 2nd and 3rd trimesters, which is why the vaccination is indicated during the flu vaccination campaign. Not only will this reduce the risk of the mother getting sick but it will also protect the baby during its first few months of life.

• The tetanus-diphtheria-whooping cough combined vaccination. It is particularly indicated for protecting the baby against the whooping cough during the first few months of their life until their first vaccination. This indication came about due to the increase in serious whooping cough cases among babies under the age of six months over recent years. All women who are currently at motherhood age received the vaccination in their childhood, but as the years pass, immunity wears off. The administration of a single dose during the third trimester of the pregnancy (beyond 28 weeks) will lead to transplacental passage of the antibodies against the whooping cough and thus the baby will be born with a certain level of protection against this disease, which can end up being serious in the case of breastfeeding women. It's also a good idea for the father to be vaccinated in the days following the birth of the baby.
• Hepatitis B vaccination. It is only indicated for patients at risk (with chronic liver diseases, HIV, workers in professional contact with contaminant materials (police officers, firefighters, etc) and haemodialysis patients. Thus, this vaccination is not routinely given to pregnant women, but if you are part of one of the risk groups, then your gynaecologist will indicate it.

2. Which vaccinations are not safe during pregnancy?

All vaccines made with attenuated microorganisms are contraindicated during pregnancy, as theoretically speaking, the baby could be at risk of infection. These vaccines are:

• Chicken pox
• MMR vaccine (Mumps, Measles and Rubella)
• Yellow fever
• Typhoid
• Tuberculosis

3. What vaccinations are advised before pregnancy?

If you're thinking about pregnancy and you tell your gynaecologist, they will normally ask you for a blood sample, which tests if you are immune to certain types of infectious diseases that it's convenient to already have had before pregnancy (or to have received a vaccination against). And if you haven't had these illnesses or you've lost immunity over the years and don't have enough antibodies, vaccines will be indicated. It's good to have these vaccines "updated" before you fall pregnant:

• Chicken pox
• MMR, particularly to guarantee immunity against rubella.
• Hepatitis B: if you meet one of the above mentioned risk criteria.

The period you must wait between the administration of the last dose of the vaccination and falling pregnant is one month in the case of chicken pox and MMR.

Anyhow, when pregnant before you receive any vaccines, I'd recommend that you see your gynaecologist to assess your case individually. OK?

Sofía Fournier Fisas

Author of “Voy a ser mamá ¿y ahora qué?” (I'm going to be a mum. Now what?) published by Planeta.

Author of the blog www.unamamiquesemima.com