Vaccines are one of the greatest triumphs of modern medicine. They prevent illness and save millions of lives.In our country, universal maternal immunisation has almost eradicated deadly diseases like Neonatal Tetanus.However, many pregnant women and their families are sceptical about the safety of vaccination for the growing fetus.
According to the ACIP guidelines, there is no evidence of the risk of vaccinating women with inactivated viral or bacterial vaccines or toxoids.However, live vaccines administered to pregnant women may pose a theoretical risk to the fetus. Thus, live attenuated virus and live bacterial vaccines are generally contraindicated during pregnancy.
Here, we discuss in detail the indications and safe usage of various vaccines in pregnancy.
Rubella - Rubella virus infection usually causes mild flu-like symptoms. However, if infected during pregnancy, it can cause major structural defects and growth problems in the baby. The good news is that 90 per cent of the population is already immune to this virus. So, you are advised to take a blood test to check your antibodies. If your immunoglobulin test is negative, take the vaccine before pregnancy.
Varicella - The Varicella virus causes an infection commonly known as chickenpox in childhood and shingles in adults. This is also a self-limiting viral disease of childhood. However, chickenpox infection during pregnancy can cause pneumonia in the mother or congenital disabilities in the fetus. If you've never had chickenpox and your blood test is negative, you may be advised to take the Varicella vaccine pre-pregnancy. Since rubella and varicella are live attenuated virus vaccines, avoiding pregnancy for 1 month is advised. These vaccines are contraindicated during pregnancy.
Covid-19 Vaccine - After the pandemic, it's recommended that all women planning to have a baby get vaccinated against Covid-19.
Human Papilloma Virus Vaccine - HPV vaccination for cervical cancer prevention is approved for females aged 9 to 45. Because adequate safety data are not available, HPV vaccines are not recommended during pregnancy. It is best to complete the 3-dose course before pregnancy. You can take the remaining doses after delivery if you get pregnant before completing the full course. It's safe to take this vaccine during breastfeeding.
Other Vaccines - Depending on your medical condition and degree of risk of exposure to these organisms, you may be advised to take the meningococcal, pneumococcal, typhoid, and Japanese B encephalitis vaccines prior to getting pregnant.
Immunisation during Pregnancy
Recommended vaccines in pregnancy
Influenza – Influenza is usually a mild viral disease, but it can sometimes cause severe pneumonia. The chances of severe disease and hospitalisation are increased during pregnancy. Thus, WHO and CDC recommend that all pregnant women receive the latest strain of influenza vaccine.
Tetanus – You will be given 2 doses of tetanus toxoid vaccine at least 28 days apart to prevent neonatal tetanus. Neonatal tetanus is a lethal disease causing muscle spasms and seizures.
Diphtheria and Acellular pertussis – These are serious respiratory infections that can be passed to infants from their mothers and other family members. So, now the Indian Academy of Paediatrics recommends giving Combined Diphtheria, Pertussis and Tetanus toxoid vaccines instead of 2nd dose of tetanus vaccine between 27 to 36 weeks.
TheSafety profile of other vaccines during pregnancy
Hepatitis A
If you are travelling to areas of high exposure, a food handler, or have any other high-risk factor, your doctor may advise you to take the Hepatitis A vaccine. It's made from Inactivated Hepatitis A virus, so theoretically, the risk is low.
Rabies
Rabies vaccine is a killed virus vaccine. Because of the serious and potentially fatal nature of the disease caused by the rabies virus, post-exposure vaccination is not contraindicated in pregnancy. In cases where exposure is expected to be high, pre-exposure prophylactic vaccination may also be advised.
Hepatitis B
Hepatitis B vaccination is recommended for all adults from 19 - 59 years. If pregnancy is not a contraindication for this vaccine, as it's a recombinant antigen vaccine, you may be advised to take this vaccine.
Yellow Fever
The vaccine against the yellow fever virus is the only live vaccine that is not contraindicated during pregnancy. If you must travel to an area of high exposure to the yellow fever virus, such that your risk outweighs vaccination risks, the vaccination is advised.
As per the Centre for Disease Control (CDC), 'neither inactivated nor live-virus vaccines administered to the lactating woman affect the safety of breastfeeding for women or their infants.'
Thus, Vaccines are the tugboats of preventive health. They provide protection to you and your baby. Please follow your doctor's advice and get immunisation at the appropriate time
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