Immunization in Pregnancy
Immunization in pregnancy is indicated for short term (passive) or long term (active) protection against maternal and or fetal infection.Active immunization is contraindicated in pregnancy.
• Active immunization uses attenuated live organisms, inactivated organisms, or components of the organisms for which immunization is being performed.
Live attenuated vaccines include –
BCG (Bacille Calmett-Guerin).
Theses are generally contraindicated in pregnancy.
Active immunization produces an antibody response, IgM initially and IgG later.
• Passive immunization utilizes human immunoglobulin to achieve rapid protection but this lasts only a few weeks. Immunoglobulin specific for a condition is obtained from pooled plasma containing the required antibody.
• Except when there is a specific risk of infection (e.g. travel to an endemic area), vaccines containing attenuated or inactivated organisms are avoided in pregnancy.
• The main conditions for which immunization may be required in pregnancy include varicella zoster and hepatitis B virus infection.
Tetanus toxoid and tetanus immunoglobulin are safe in pregnancy. They are used when the risk of acquiring tetanus infection is high for inducing active immunity (by using tetanus toxoid) or passive immunity (by using tetanus immunoglobulin).
In parts of the world where neonatal tetanus is a major health problem, vaccinating the mother in pregnancy induces transplacental passive immunity in the fetus.
Rubella vaccination is not recommended in pregnancy. Instead, non-immune antenatal patients should be vaccinated after delivery. However, active surveillance in many countries has failed to reveal any case of congenital rubella syndrome in cases of inadvertent vaccination of non-immune women shortly before pregnancy or in early pregnancy.
There is no evidence that the vaccine is teratogenic and the pregnancy need not be terminated because of such inadvertent vaccination.
Read more on immunization in pregnancy for the following conditions-
Hepatitis B vaccination during pregnancy
Varicella Zoster Virus Vaccination during pregnancy
Travel Vaccination During Pregnancy
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