Vaccines - safety in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Public Health

Background:

• Maternal vaccination provides active immunity for mothers and passive immunity for neonates against severe infectious diseases.
• Live vaccines are typically contraindicated in pregnancy due to potential fetal viremia/bacteremia risks.
• Inactivated vaccines are generally considered safe for use during pregnancy.

Purpose of the Study:

• To outline recommended vaccination strategies for pregnant women and postpartum individuals.
• To identify vaccines safe for all pregnant women, those for high-risk individuals, and those for post-exposure prophylaxis.
• To discuss upcoming vaccines for various infectious diseases.

Main Methods:

• Review of current guidelines and recommendations for vaccine administration during pregnancy and postpartum.
• Categorization of vaccines based on safety profiles and indications (routine, high-risk, post-exposure).
• Discussion of pre-pregnancy, third-trimester, and postpartum vaccination schedules.

Main Results:

• Tetanus toxoid (TT), tetanus, diphtheria, acellular pertussis (Tdap), and influenza (Flu) vaccines are safe for all pregnant women.
• MMR vaccination is recommended pre-pregnancy with a one-month waiting period before conception.
• High-risk women may need vaccines for Hepatitis A/B, pneumococcal, meningococcal, yellow fever, Japanese encephalitis, polio, typhoid, and cholera.

Conclusions:

• Routine vaccination with Tdap, TT, and Flu is crucial during pregnancy.
• Postpartum vaccination with HPV, MMR, Tdap, and Flu should be offered if not previously administered.
• Ongoing research is developing new vaccines for malaria, Zika, RSV, Group B Streptococcus, CMV, and COVID-19.