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Immunizations during pregnancy

Author
Vanessa A Barss, MD, FACOG
Section Editors
Charles J Lockwood, MD, MHCM
Peter F Weller, MD, FACP
Deputy Editor
Allyson Bloom, MD

INTRODUCTION

Maternal immunization protects both the mother and fetus from the morbidity of certain infections. It can also provide the infant passive protection against infections acquired independently after birth [1]. Ideally, immunizations are given prior to conception, but administration during pregnancy is indicated in some situations.

Immunizations to give and avoid during pregnancy and postpartum are discussed in this topic. Other aspects of prenatal care are discussed elsewhere. (See "Initial prenatal assessment and first trimester prenatal care" and "Prenatal care (second and third trimesters)".)

GENERAL PRINCIPLES

Ideally, women should be vaccinated against preventable diseases in their environment prior to conception according to the recommended adult immunization schedule (figure 1 and figure 2) (see 'Preconception immunization' below). Vaccination during pregnancy is warranted when the risk of exposure is high, the infection poses risks to the mother and/or fetus, and the vaccine is unlikely to be harmful. Vaccines appropriate for immunization before, during, and after pregnancy are shown in the table (table 1). Despite maternal immunological adaptations to pregnancy, immunization of pregnant women appears to be as effective as in nonpregnant women [2].

The Infectious Diseases Society of America and the American College of Obstetricians and Gynecologists have each published general guidelines for immunization of pregnant women [3,4]:

Providers should be aware of immunizations routinely recommended for all pregnant women: tetanus, diphtheria, pertussis, and influenza. Providers and patients should be aware that these immunizations have a good safety profile in pregnancy, can provide passive protection to the newborn, and are not associated with miscarriage. (See 'Routine prenatal immunizations' below.)

                                         

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Literature review current through: Mar 2015. | This topic last updated: Apr 6, 2015.
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