Vaccination of pregnancy
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Vaccination of pregnancy

In case of particular risk  infection, it may be preferable to be protected by vaccination. But what to do when you’re pregnant? The information must be weighed for each vaccine based on side effects during pregnancy.

Vaccines pregnancy Most vaccines appear safe for pregnant women. But in general, we prefer to avoid vaccinations during this period. The wisest course would be to maintain the recommended vaccinations up to date, and to verify that it is well protected against rubella, if one was not vaccinated in childhood, before considering pregnancy. But sometimes neglected his reminders or so we are led to consider a vaccination, because of an outbreak or travel to an endemic area. What are the important points to remember?

Three types of vaccines

Schematically There are three categories of vaccines:

The so-called vaccines “living” because products with viruses whose virulence has been attenuated by special processes.

Killed vaccines which are produced with killed viruses.

Vaccines produced with a fraction of virus or bacteria (inactive) recovered from viruses or fragmented bacteria. This fraction is generally a protein that can in some cases be artificially produced (it will be much more pure).

Vaccines can be performed during pregnancy (on indication of your doctor)

Influenza vaccination may be of particular interest for pregnant women, because of the frequency of infection and its potential severity. In the US, it is recommended to pregnant women in the second or third trimester of pregnancy, because of the risk of miscarriage that may pose infection. The occurrence of a serious epidemic could justify to implement this recommendation in France. Learn more about the flu in pregnant women.

Some vaccinations may be considered depending on the epidemic context. Thus vaccines against typhoid, cholera, hepatitis A and B, meningococcal types may be recommended when traveling in endemic areas. The injectable polio vaccine may also be performed in pregnant women, as well as tetanus vaccine. However tetanus serum is against-indicated.

Influenza vaccine: This vaccine is effective and well tolerated during pregnancy, it also protects the child until the age of 6 months. It is produced with a killed virus.

Vaccine Hepatitis B: Although the vaccine is completely safe during pregnancy are usually vaccinated pregnant women when there is a significant risk for the disease (addiction, contact with an affected individual, etc.). The vaccine keeps a good efficiency in pregnancy, it is made with a fraction of the inactivated virus.

Tetanus vaccine: This vaccine is widespread in Europe which allowed to see virtually disappear obstetrical tetanus, vaccination during pregnancy not exposed to particular risks, the efficiency is good. Vaccination in the month preceding delivery is usually enough to prevent the disease in that time. It is manufactured with tetanus bacilli giving tetanus (Clostridium tetani).

Antipolyomyélite vaccine: This vaccine can be done during pregnancy but should be reserved for women traveling in endemic areas, it has a good efficiency. The immunity will protect the child until the age of 6 months. The injectable form is composed of killed virus.

Rest a few contingencies. Thus, vaccination against pneumococcus is justified in case of removal of the spleen after an accident, given the high risk of infection. Similarly, given the extreme gravity of the disease, the vaccine against rabies is to be used if a bite from a rabid animal is suspected. But this event is exceptional in France.

Vaccines against-indicated during pregnancy

All basic attenuated live virus vaccines are cons-indicated during pregnancy because of the theoretical risk that the virus crosses the placenta and infect the fetus. Are concerned vaccines against measles, rubella, mumps, chicken pox, yellow fever, and polio vaccine orally. BCG, made from attenuated live bacilli, is also not recommended. However, none of these vaccines for the fetal risk has been confirmed until now.

TB vaccine (BCG): This vaccination should not be taken during pregnancy, it is made with a mild form of the tubercle bacillus. TB antibiotic treatment can be given if necessary.

Antipolyomyélite oral vaccination: This vaccination is against during pregnancy although no problem has ever been encountered in women having received it. This is a live vaccine.

Rubella vaccine: The vaccine is composed of an attenuated form of the rubella virus. Vaccination is still against in pregnant women and should be performed only in patients under 2 months before birth and 2 months later. Yet if the transmission of the virus to the embryo exists in 1-2% of cases, no particular problems appeared significantly significantly in children over thousands of cases with several years of decline to some studies.

Pregnancy test for varicella and rubella

Cases of rubella and varicella deserve special attention. Fetal damage risk associated with these infections during pregnancy is well known. Vaccination against rubella is recommended for non-immune women and it will soon be the same for the vaccination against chickenpox. However, these vaccines should not be carried out in women of childbearing age, if no pregnancy is confirmed by a negative test and if these women avoid becoming pregnant within two months after vaccination.

What if it turns out you were still pregnant at the time of vaccination? This possibility should not worry beyond measure. The vaccine against rubella has a long history and cases of vaccinations performed in pregnant women do not indicate any particular risk to the fetus. US data showed no cases of serious malformation of nearly 350 births. Regarding the vaccine against chickenpox, later, a pregnancy registry has been established in 1995 in the United States, which revealed no cases of congenital varicella. An abortion can not be recommended due to vaccination whatsoever during pregnancy.

Last important point: if done routinely in early pregnancy tests have shown the absence of immunity against rubella, it is imperative to be vaccinated after delivery, to be protected in subsequent pregnancies. Vaccination is not cons-indicated for breastfeeding women.

Regarding the vaccine against yellow fever or yellow fever vaccine, the question arises of vaccination only for women to travel in endemic areas. The wisest course is, obviously, to avoid going to areas where the risk of serious infections are high. However, if the trip can not be postponed, the vaccine should be practiced. The data collected to date showed no risk to the fetus.

Vaccines to prevent pregnancy

Other vaccines do not cause any risk of fetal infection, as they are made on the basis of virus or bacteria killed or inactivated or antigenic fractions, but are nonetheless not recommended for pregnant women because they are poorly tolerated and can cause miscarriages. This is the case of pertussis vaccine, which can result in significant febrile reactions, and diphtheria vaccine.

Pertussis vaccine: The vaccine is made from killed virus. It should not be given during pregnancy because it is often accompanied by fever itself may lead to preterm labor.

Diphtheria vaccine: It is made with the tetanus diphtheria bacillus (Mycobacterium Löffler). It is not usually given during pregnancy as poorly tolerated.

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