Everything You Need To Know About Vaccines and Pregnancy

Aparna Ramanathan, MD MPH FACOG
Aparna Ramanathan, MD MPH FACOG
Published: April 25, 2022Updated: April 25, 2022
An arm with a heart drawn on it in red with a bandaid in the center of it.

04/25/22

Reviewed by Dr. Lisa Czanko MD, MPH

Vaccines have been saving lives long before recent events have given them their superstar status. Have you known anyone with polio? No? It’s because a vaccine almost entirely eradicated it. 

But with the spotlight on vaccines comes questions and a need for education.

You may have been wondering about what vaccines are, how they work, and how to decide when and which ones to get. What are the risks? How do they affect pregnancies? So let’s take a deep dive into this important topic!

How Do Vaccines Work?

Vaccines prepare our bodies to better fight off infections. They do this by introducing our body to a weakened form of a virus or bacteria so that our body can build up its natural defenses ahead of time. This way, when a fully functional virus or bacteria enters our body, we are already prepared to fight it and are less likely to get severely ill.

The proteins our body produces while building its defenses are called antibodies. During pregnancy, these protective antibodies are shared with the growing fetus, helping protect the baby from infections after they are born.

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Vaccines to Get Before Getting Pregnant:

Measles, Mumps, and Rubella (MMR)

Because the MMR vaccine is so effective, it is likely that many of us have never seen a measles, mumps, or rubella infection in real life. However, infections among unvaccinated people do occur. Here’s what the MMR vaccine prevents:

  • Measles is a virus that causes fever, cough, eye and nose inflammation, and 

rash. It can also cause death from infection of the brain. Pregnant people who 

get measles are at increased risk of having a premature delivery or a 

miscarriage.

  • Mumps is a virus that causes swelling in the parotid gland, which is responsible 

for producing saliva in the mouth. It can also infect the testes, ovaries, and 

brain. The most serious complications happen more frequently in adults than in 

children.

  • Rubella is a virus that usually causes a rash on the face. It is particularly 

dangerous in pregnant women because it can cause significant birth defects for 

the fetus as well as miscarriage or fetal death.      

People interested in becoming pregnant should wait 28 days after receiving the MMR vaccine before trying to become pregnant.

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Varicella

 

The varicella zoster virus causes the infection commonly known as “chickenpox.” Chickenpox can be debilitating or even deadly for at-risk groups including adults, pregnant people, and people with diseases that affect the immune system. However, the varicella vaccine can’t be given during pregnancy so it’s important for people who aren’t already immune to get the vaccine before trying to get pregnant.

Human papillomavirus (HPV)

The human papilloma virus can cause cervical, vulvar, anal, and vaginal cancers as well as cancers of the mouth and throat. It is important to get this vaccine early in life before potential exposure through sexual activity. However, there have not yet been enough studies to confirm that the vaccine is safe in pregnancy so it’s important to get it before trying to get pregnant. 

Hepatitis B 

The hepatitis B virus causes liver disease and kills more than 800,000 people a year. The hepatitis B vaccine is recommended for any person who is at high risk for hepatitis B, such as healthcare workers, people with sexual partners or family members with hepatitis B, men who have sex with men, and injection drug users. The vaccine series may be started before getting pregnant and continued during pregnancy or started during pregnancy.

For People interested in becoming pregnant should wait 28 days after receiving the MMR vaccine before trying to become pregnant.

Vaccines Recommended During Pregnancy

Influenza 

The flu can cause severe illness and an increased risk of death in pregnant people. For this reason, it is recommended that any person who is pregnant receive their yearly flu vaccine. And rest east, the inactivated flu vaccine is safe to take in pregnancy. 

Tetanus, Diphtheria, and Pertussis (TDap)

It is generally recommended that a pregnant person receive a dose of TDap between 27-36 weeks each time they are pregnant, regardless of their vaccination history. This is to maximize the amount of antibody that is passed from the parent to the fetus. When the antibody is passed to the fetus, it can protect them from disease in infancy. Here’s what the TDap vaccine prevents:

  • Tetanus is a disease caused by a bacteria that enters the body through contaminated wounds. The bacteria produces a toxin that affects the brain and nerves to cause muscle spasms and rigidity. Without access to an Intensive Care Unit (ICU), the risk of death for babies who contract tetanus is close to 100%.  
  • Diphtheria is a disease caused by a bacteria that secretes a deadly toxin into the bloodstream. Throughout history, diphtheria has been one of the most feared infectious diseases globally and caused devastating epidemics mainly affecting children.   
  • Pertussis, more commonly known as “whooping cough,” is a bacterial infection  that was a common cause of severe illness and death before development of the vaccine. It is estimated that without vaccination, there would be greater than 1.3 million deaths from pertussis per year globally.    

COVID-19 

The successful creation of vaccines against the Sars-COV-2 viral infection has been a critical success in the global efforts to combat the pandemic. There are multiple vaccines available, utilizing different methods. 

Pregnant women were not included in the initial studies. However, subsequent data shows that the vaccine is safe for use in people before pregnancy, during pregnancy, and while breastfeeding.

People who are pregnant or were recently pregnant are at higher risk of severe illness from COVID-19. Severe illness can lead to hospitalizations, intensive care, the need for a ventilator, or even death. 

The CDC recommends that all people who are pregnant, breastfeeding, trying to become pregnant, or might become pregnant get vaccinated against COVID-19 and stay up to date on booster doses.

Are There Any Risks Involved In Vaccinations?

Most vaccines are safe to administer, causing only minor temporary side effects such as fever, body aches, or a small reaction at the site of injection.

You may have heard a rumor that vaccines cause autism. However there is absolutely no scientific data to support that claim, which has been widely debunked. 

People who have had a severe allergic reaction after a previous vaccination should first talk to their doctor before receiving another dose of the same vaccine. 

Our Simple Note

Vaccines are one of the most important medical innovations in the past century and have saved millions of lives. We are fortunate to have these tools to prevent severe disease and keep ourselves and our families healthy. When you are thinking about pregnancy, it is an excellent time to make sure you are up to date on your vaccines. Talk to your doctor to review your vaccination record and make sure you have gotten everything you need.

Citations

1. Murthy N, Wodi AP, Bernstein H, McNally V, Cineas S, Ault K. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(7):229. Epub 2022 Feb 18. 

2. Watson JC, Hadler SC, Dykewicz CA, Reef S, Phillips L. Measles, mumps, and rubella--vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1998;47(RR-8):1. 

3. Marin M, Güris D, Chaves SS, Schmid S, Seward JF, Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007;56(RR-4):1. 

4. Gardasil 9 (Human papillomavirus 9-valent vaccine, recombinant. US FDA approved product information; Whitehouse Station, NJ: Merck & Co, Inc. June 2020.

5. Frazer IH, Cox JT, Mayeaux EJ Jr, Franco EL, Moscicki AB, Palefsky JM, Ferris DG, Ferenczy AS, Villa LL. Advances in prevention of cervical cancer and other human papillomavirus-related diseases. Pediatr Infect Dis J. 2006;25(2 Suppl):S65. 

6. The World Health Organization. Hepatitis B. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b (Accessed on August 23, 2020).

7. The World Health Organization. Weekly epidemiological record - Diphtheria vaccine: WHO position paper - August 2017. 31(92): 417-36.

8.  The World Health Organization. Weekly epidemiological record - Tetanus vaccine: WHO position paper - February 2017. 6(92): 53-76.

9. The World Health Organization. Weekly epidemiological record - Tetanus vaccine: WHO position paper - August 2015. 35(90): 433-60.

10.  Centers for Disease Control. Pregnancy and Vaccination.  Accessed Mar 11, 2022. https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html#flu1

11. Pickering LK, Baker CJ, Freed GL, Gall SA, Grogg SE, Poland GA, Rodewald LE, Schaffner W, Stinchfield P, Tan L, Zimmerman RK, Orenstein WA, Infectious Diseases Society of America. Immunization programs for infants, children, adolescents, and adults: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(6):817

12. DeStefano F, Bodenstab HM, Offit PA. Principal Controversies in Vaccine Safety in the United States. Clin Infect Dis. 2019;69(4):726. 

13. CDC National Center for Immunization & Respiratory Diseases. COVID 19 vaccine safety update. Advisory Committee on Immunization Practices (ACIP) March 1, 2021 https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2021-02/28-03-01/05-covid-Shimabukuro.pdf (Accessed on March 02, 2021).

14. Fu W, Sivajohan B, McClymont E, Albert A, Elwood C, Ogilvie G, Money D. Systematic review of the safety, immunogenicity, and effectiveness of COVID-19 vaccines in pregnant and lactating individuals and their infants. Int J Gynaecol Obstet. 2022;156(3):406. Epub 2021 Nov 13. 

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