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immunization during pregnancy; maternal immunization
Indications:
- influenza virus vaccine (inactivated)
- acellular pertussis vaccine/diphtheria toxoid/tetanus toxoid (TdaP)
- 3rd trimester TdaP 78% effective & 91% effective at preventing pertussis-related hospitalization [2]
- special circumstances
- anthrax vaccine (travel)
- BCG (travel)
- hepatitis A vaccine (risk factors)
- hepatitis B vaccine (risk factors)
- Japanese encephalitis virus vaccine (risk factors)
- meningococcal conjugate vaccine (risk factors)
- pneumococcal vaccine (PCV13 & PPSV23)*
- poliovirus vaccine inactivated (risk factors)
- rabies vaccine (risk factors)
- smallpox vaccine (exposure)#
- typhoid polysaccharide vaccine*
- yellow fever vaccine (risk factors)$
* insufficient data to assess any benefit
# entire world supply of smallpox in secure facility
$ if benefit exceeds risk; may be exception to rule of contraindication of live virus vaccine during pregnancy [1]
Contraindications:
- live virus vaccines
- HPV vaccine (not recommended) [1]
- live attenuated influenza virus vaccine
- measles, mumps & rubella combined vaccine (MMR)
- smallpox vaccine (absence of exposure)
- Herpes zoster vaccine
Related
pregnancy (gestation)
General
immunization (vaccination)
References
- Omer SB
Maternal Immunization.
N Engl J Med 2017; 376:1256-1267. March 30, 2017
PMID: 28355514
http://www.nejm.org/doi/full/10.1056/NEJMra1509044
- Skoff TH, Blain AE, Watt J et al.
Impact of the US maternal tetanus, diphtheria, and acellular
pertussis vaccination program on preventing pertussis in
infants < 2 months of age: A case-control evaluation.
Clin Infect Dis 2017 Sep 28;
PMID: 29028938