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Vaccinations in pregnancy.

Denise K Sur1, David H Wallis, Theodore X O'Connell

  • 1David Geffen School of Medicine, University of California-Los Angeles, California, USA. dsur@mednet.ucla.edu

American Family Physician
|August 2, 2003
PubMed
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Misconceptions about vaccine safety hinder adult immunization. During pregnancy, routine vaccines like diphtheria and influenza are safe, while others like MMR are contraindicated to protect the fetus.

Area of Science:

  • Immunology
  • Obstetrics
  • Public Health

Background:

  • Adult immunization rates are below national targets due to safety and benefit misconceptions.
  • These concerns are amplified during pregnancy, leading to physician hesitancy and patient reluctance regarding vaccinations.

Purpose of the Study:

  • To review the safety and indications of various vaccines during pregnancy.
  • To address misconceptions that may impede appropriate maternal immunization.

Main Methods:

  • Literature review of vaccine safety data in pregnant populations.
  • Categorization of vaccines based on safety profiles during gestation.
  • Analysis of risks versus benefits for maternal and fetal health.

Main Results:

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  • Routine vaccines such as diphtheria, tetanus, influenza, and hepatitis B are generally safe for pregnant individuals.
  • Vaccines like measles, mumps, rubella (MMR), varicella, and bacille Calmette-Guerin (BCG) are contraindicated due to theoretical fetal risks.
  • Meningococcal and rabies vaccines may be considered based on individual risk assessment.

Conclusions:

  • Physicians and patients should be aware of which vaccines are safe and contraindicated during pregnancy.
  • Weighing theoretical vaccination risks against disease risks is crucial for informed decision-making.
  • Inadvertent administration of contraindicated vaccines does not warrant pregnancy termination.