Which vaccines are safe in pregnancy? Find out!

Dear Dr. Ombeva,

Your article on safety of hepatitis vaccine in pregnancy left me wondering what other vaccines are safe during pregnancy. Beth

Dear Beth,

The safety of Hepatitis A vaccination during pregnancy has not been determined but the risk to the baby is expected to be low because Hepatitis A vaccine is produced from inactivated virus (viruses that have been grown in the laboratory and then killed). Limited data suggests that developing foetuses are not at risk when Hepatitis B vaccine is administered.

Women who are at risk of Hepatitis B virus infection during pregnancy (for instance those with more than one sex partner during the previous six months, those that have been evaluated or treated for a sexually transmitted infection, those with recent or current injection drug use problem, or having had an Hepatitis B surface antigen positive sex partner) should be vaccinated. Human Papilloma Virus vaccines are not recommended for pregnant women.

If a woman is found to be pregnant after initiating the vaccination series, the remainder of the three-dose series should be delayed until she delivers. Pregnancy testing is not needed before vaccination. If a vaccine dose has been administered during pregnancy, no intervention is needed.

Inactivated influenza vaccination can be administered at any time during pregnancy, before and during the flu season. However, live attenuated influenza vaccine is not recommended for use during pregnancy. Measles, Mumps, Rubella (MMR) vaccines should not be administered to pregnant women or those attempting to become pregnant.

If the vaccine is inadvertently administered to a pregnant woman or a pregnancy occurs within 28 days of vaccination, she should be counseled about the theoretical risk to the foetus. Pregnancy should not preclude vaccination with Meningococcal (MenACWY or MPSV4) vaccine if indicated.

Recommendations regarding Pneumococcal Conjugate or polysaccharide vaccines in pregnancy have not been published. Although no adverse effects of Injectable Polio Vaccine (IPV) have been documented among pregnant women or their foetuses, vaccination of pregnant women should be avoided on theoretical grounds.

However, if a pregnant woman is at increased risk for infection and requires immediate protection against polio, IPV can be administered in accordance with the recommended schedules for adults.

Tetanus, diphtheria and pertussis vaccines are safe during pregnancy. Because the effects of the varicella virus on the foetus are unknown, pregnant women should not be given varicella vaccine.

Women who are vaccinated for varicella should avoid becoming pregnant for a month after each injection. Zoster vaccine should not be administered to pregnant women.