Vaccination: Before, During or After Pregnancy?

Vaccination is one of the best ways to protect yourself and your unborn child from disastrous effects of many infectious diseases. The aim of vaccination is to introduce your body inactivated or weakened virus so that your immune system learns how to fight the real viruses should they someday attack your body.

Different infections may affect you, your pregnancy and your unborn baby in various ways. For example, if you are not immune to German measles (Rubella) or chicken pox (Varicella), and if you get infected during the first three months of pregnancy, then these microorganisms could attack the baby and potentially result in birth defects. On the other hand, if you have the flu while you are pregnant, it is more likely to turn into pneumonia than when you are not pregnant. Moreover, the symptoms of the disease, like fever, may affect your baby, again resulting in complications such as spinal cord damage.

In this blog, we will discuss what vaccinations are recommended before pregnancy, which ones are considered safe during pregnancy, and finally, what vaccinations you will receive after child birth before you leave the hospital.

If you are trying to conceive, and not pregnant yet, it is highly recommended that you get evaluated to find out whether you have immunity against German measles and chicken pox. Although chicken pox has very specific symptoms and majority of the people who had it will remember having it, the symptoms of German measles are very similar to other childhood viral infections and hence, majority of us will not know whether we had it or not. If acquired during the first half of pregnancy, both infections can be teratogenic, meaning they can cause birth defects in the baby. If a pregnant woman acquires chicken pox during the third trimester of the pregnancy, especially close to delivery, then the baby may be born with a brain infection. In order to prevent these infections during pregnancy, here at RMA of New York, we recommend that women who are attempting pregnancy have their blood tested. If you are not immune to these diseases, then we recommend vaccination prior to becoming pregnant. The most effecting vaccine against German measles is MMR (measles, mumps, rubella), which is given as a single dose. The chicken pox vaccine, on the other hand, is given in 2 doses, 1 month apart. Since both vaccines are live attenuated vaccines, it is important not to get pregnant for at least one month after the last dose of the vaccine. Another important point to keep in mind is that, if you are not immune to measles and you are pregnant already, your obstetrician will recommend you receive the vaccine right after delivery before you leave the hospital.

If you are attempting pregnancy or are already pregnant during flu season, then it is recommended that you get the flu vaccine. Influenza may have serious health effects when acquired during pregnancy compared to non-pregnant state. Flu vaccine often comes in two forms: Live attenuated (nasal spray) and inactivated (shot). The shot is the recommended form during the pregnancy. If you are planning pregnancy or if you are already pregnant during the flu season, it is highly recommended that you get the flu shot.

Another vaccine that is strongly recommended before or during pregnancy is the Tdap. If given during pregnancy, it is administered during the late second or third trimester. This is a combination vaccine that protects against tetanus, diphtheria and pertussis (whooping cough). It is recommended by CDC that to protect your baby, you get vaccinated against whooping cough. Booster shots against tetanus and diphtheria should be repeated every ten years. Tdap is safe during pregnancy since it does not contain live virus.

The above mentioned vaccines are the minimum requirements before or during pregnancy. There are other vaccines that may be needed depending on special circumstances, and independent of pregnancy. For example, if you have a weak immune system, you should be vaccinated against pneumonia; if you have HIV, then immunization against pneumonia, meningitis and hepatitis B is highly recommended. Or if you are a health care worker, make sure you had the hepatitis B shot.

Like most medications, vaccines may also have side effects however their benefits far outweigh their risks. For example, vaccines decrease the incidence of tetanus and diphtheria by 99% and that of whooping cough by 80%. On the other hand, you may need to avoid certain vaccines in case you are allergic to the vaccine or its ingredient, or in case you had a seizure following administration of a particular vaccine. Your doctor will discuss these with you before administering the vaccine.

Do not hesitate to ask your doctor about your vaccination needs, ideally before you conceive. Keep in mind; prevention of the disease doesn’t only bring a healthy life, but avoids the complications and sequelae of the diseases and lowers health care costs; and vaccination is one of the best ways to prevent infectious diseases.

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