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Immunizations for Pregnant Patients

Guidelines for Vaccinating Pregnant Women-
From the Advisory Committee on Immunization Practices (ACIP)

The ACIP General Recommendations on Immunization states

Risk from vaccination during pregnancy is largely theoretical. The benefit of vaccination among pregnant women usually outweighs the potential risk when

a) the risk for disease exposure is high,
b) infection would pose a special risk to the mother or fetus, and
c) the vaccine is unlikely to cause harm.

The following vaccines should be considered if otherwise indicated:

  • Hepatitis B
  • Influenza
  • Tetanus/Diphtheria
  • Meningococcal

Generally, live-virus vaccines are contraindicated for pregnant women because of the theoretical risk of transmission of the vaccine virus to the fetus. If a live-virus vaccine is inadvertently given to a pregnant woman, or if a woman becomes pregnant within 3 months after vaccination, she should be counseled about the potential effects on the fetus. But it is not ordinarily an indication to terminate the pregnancy.

The following vaccines are contraindicated during pregnancy:

  • Measles
  • Mumps
  • Rubella
  • Varicella

The following vaccines have special recommendations reprinted from ACIP General Recommendations on Immunization:

  • Hepatitis A: "The safety of hepatitis A vaccination during pregnancy has not been determined; however, because hepatitis A vaccine is produced from inactivated [hepatitis A virus], the theoretical risk to the developing fetus is expected to be low. The risk associated with vaccination should be weighted against the risk for hepatitis A in women who may be at high risk for exposure to [hepatitis A virus]."
  • Pneumococcal: "The safety of pneumococcal polysaccharide vaccine during the first trimester of pregnancy has not been evaluated, although no adverse consequences have been reported among newborns whose mothers were inadvertently vaccinated during pregnancy."

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