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  • With Mayo Clinic obstetrician and medical editor-in-chief

    Roger W. Harms, M.D.

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Question

Vaccines during pregnancy: Are they safe?

I'm wondering about vaccines during pregnancy. Which vaccines are recommended and which ones should I avoid?

Answer

from Roger W. Harms, M.D.

Generally, vaccines that contain inactivated (killed) viruses can be given during pregnancy. Vaccines that contain live viruses aren't recommended for pregnant women.

Two vaccines are routinely recommended during pregnancy:

  • Influenza (flu) shot. The flu shot is recommended for women who are pregnant during flu season — typically November through March. The flu shot is made from an inactivated virus, so it's safe for both you and your baby. Avoid the nasal spray vaccine, which is made from a live virus.
  • Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine. One dose of Tdap vaccine is recommended during each pregnancy to offer protection from whooping cough (pertussis), tetanus and diphtheria, regardless of when you had your last Tdap or tetanus-diphtheria (Td) vaccination. Ideally, the vaccine should be given between 27 and 36 weeks of pregnancy. Whooping cough can be dangerous — even life-threatening — for infants. Getting the Tdap vaccine during pregnancy can help protect you from the infection and might also help protect your baby after birth.

In addition, if you're traveling abroad or you're at increased risk of certain infections, your health care provider may recommend other vaccines during pregnancy — such as hepatitis A, hepatitis B, meningococcal or pneumococcal vaccines.

Certain vaccines should generally be avoided during pregnancy, including:

  • Varicella (chickenpox)
  • Human papillomavirus
  • Measles, mumps and rubella
  • Zoster

If you're planning a pregnancy, talk to your health care provider about any vaccines you may need beforehand. Live vaccines should be given at least a month before conception.

Next question
Air travel during pregnancy: Is it safe?
References
  1. Gerbie MV, et al. Pertussis disease in new mothers: Effect on young infants and strategies for prevention. Obstetrics and Gynecology. 2009;113:399.
  2. Immunization and pregnancy. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/downloads/f_preg.pdf. Accessed Dec. 8, 2010.
  3. Centers for Disease Control and Prevention, et al. Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedules for Persons Aged 0 Through 18 years and Adults Aged 19 Years and Older — United States, 2013. MMWR. 2013;62:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a3.htm. Accessed Jan. 31, 2013.
  4. Key facts about seasonal flu vaccine. Centers for Disease Control and Prevention. http://www.cdc.gov/flu/protect/keyfacts.htm. Accessed Dec. 8, 2010.
  5. Immunizations during pregnancy. American Academy of Pediatrics. http://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Immunizations-During-Pregnancy.aspx. Accessed Dec. 9, 2010.
  6. Recommended adult immunization schedule: United States, 2011. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/adult-schedule.pdf. Accessed Feb. 14, 2011.
  7. Centers for Disease Control and Prevention, et al. Appendix A: Summary of ACIP recommendations for prevention of pertussis, tetanus and diphtheria among pregnant and postpartum women and their infants. MMWR. 2008;57:48. http://www.cdc.gov/mmwr/pdf/rr/rr5704.pdf. Accessed Feb. 14, 2011.
  8. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 10, 2010.
  9. Pertussis (whooping cough) — What you need to know. Centers for Disease Control and Prevention. http://www.cdc.gov/Features/Pertussis. Accessed Nov. 11, 2011.
AN01886 Feb. 15, 2013

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