Dr Melina Georgousakis explains what women need to know about vaccinations they may need before and during pregnancy, as well as after their baby has been born.
Vaccines For Women Planning To Become Pregnant
It is important that women are up to date with the vaccinations recommended for their age, before they try to become pregnant. It is particularly important that women are immune to rubella (often referred to as German measles) because if it is contracted during pregnancy, it can result in foetal infection which often causes foetal abnormalities. Healthcare providers can perform a blood test when a woman is planning to become pregnant to check whether she is immune to rubella, and if vaccination is needed.
A blood test can also be done to check for immunity against chickenpox. While many adult women have had chickenpox or have been vaccinated against it, those who have not can be vaccinated before becoming pregnant. Contracting chickenpox during pregnancy can result in infection in the unborn child which can lead to skin scarring and limb deformities in some cases.
Influenza Vaccination is Recommended During Pregnancy
The influenza vaccine is strongly recommended for pregnant women. While many people consider influenza (often referred to as 'the flu') to be a mild disease, pregnant women are at higher risk of serious influenza than non-pregnant women, particularly in the later stages of pregnancy. This is partly due to changes in the immune system and lung capacity during pregnancy. Studies have found women are up to five times more likely to be hospitalised by influenza when pregnant than when not. Pregnant women who get influenza are also at greater risk of premature labour.
In addition to the benefits that influenza vaccination provides to pregnant women, there are also benefits for the newborn. Studies have shown that babies of mothers vaccinated against influenza while pregnant are less likely to get influenza in their first six months. This is because the mother's antibodies to the vaccine are passed on to the foetus during pregnancy. These antibodies remain in the newborn's body for the first few months of life, giving them some protection until they can start receiving influenza vaccine themselves.
A review of the research on influenza vaccination in pregnancy has shown it is safe for both the mother and her unborn child.
Pertussis (Whooping Cough) Vaccine For Mums and Other Family Members
Pertussis is a disease most prevalent and severe in infants under six months of age. At this young age, infants have not completed their immunisations against pertussis and so are not fully protected. To reduce transmission of pertussis to newborns at this vulnerable time, it is recommended new mothers who have not been vaccinated against pertussis in the past five years receive a diphtheria-tetanus-pertussis booster vaccination (dTpa) as soon as possible after giving birth. Another option for expectant mothers is to receive the dTpa vaccine in the third trimester of their pregnancy rather than after delivery. This has an added advantage that the mothers' antibodies to whooping cough can be passed to the foetus during pregnancy. This gives the newborn some protection against pertussis until they themselves can be vaccinated. A pregnant woman should talk with her doctor or obstetrician about the most appropriate pertussis vaccination option for her and her unborn child.
Other family members who will be close to the infant in the early months can also help protect them against pertussis by ensuring they have been vaccinated. This is called 'cocooning', as the newborn is surrounded or cocooned by people who are less likely to spread the disease to them.
Some Types Of Vaccines Should Not Be Given To Pregnant Women
Apart from influenza and pertussis vaccines as outlined above, other vaccines are not usually required during pregnancy and not recommended. However, in situations where the risk of infection is high (such as some types of travel), other vaccines, like that against hepatitis A, might be considered. The need for other vaccines during pregnancy is best discussed with your doctor.
Certain vaccines, known as 'live attenuated' vaccines should not be given to pregnant women because these vaccines are made with live, but weakened, organisms which may be able to infect the foetus. The live attenuated vaccines used in Australia include the measles-mumps and rubella vaccine and the vaccines against chicken pox (varicella), shingles (zoster) and yellow fever. If a woman has been given a live attenuated vaccine, it is recommended that she wait 28 days before falling pregnant.
Where Do You Go For More Information?
If you are planning to become pregnant or are pregnant, speak with your GP or obstetrician about the most appropriate vaccinations for your specific circumstances, as well as the benefits and any risks involved.
General information on vaccines is available at the Federal Government's Immunise Australia website.
Dr Melina Georgousakis is senior research officer at the National Centre for Immunisation Research and Surveillance in Sydney.