Vaccinations In Pregnancy

Immunization practices during pregnancy are important for both physicians and pregnant women.

In our country, the authority to regulate immunization services during pregnancy belongs to the Ministry of Health, and while making these regulations, various developments in the world are followed and the recommendations of the Immunization Advisory Board, which consists of academicians, are also taken into consideration.

Some infectious diseases during pregnancy can harm the baby as well as the mother. This harm can be in the form of permanent disabilities and mental retardation in the baby.

For this reason, pregnant women should first of all stay away from patients and diseases that are known to be contagious.

Maternal antibodies, which are passed from the mother to her baby before birth, are known to protect against many serious viral and bacterial diseases in the first few months of life. Therefore, maternal vaccination is a potential alternative strategy to protect newborns and infants against infections until they are able to respond adequately to active vaccination.

The most important concern about vaccination during pregnancy is the safety of the fetus.

However, although the risks from vaccination during pregnancy theoretically apply to the developing fetus, inactivated viral, bacterial and toxoid vaccines administered to pregnant women in the past have not been shown to have any significant adverse effects on the developing fetus, and live vaccines may pose a theoretical risk to the fetus.

A pregnant woman who has received a live virus vaccine or a pregnancy that occurs within 4 weeks of a live vaccine should be evaluated for potential effects on the fetus.

immune system in pregnancy

There is a noticeable decrease in immunity to histocompatibility antigens in pregnant women.

This is to prevent the expulsion of the fetus as a foreign tissue.

The main purpose of vaccination is to prevent premature birth by protecting the pregnant woman and to prevent neonatal infections through antibody transmission through the placenta.

This will contribute to the protection of the newborn against infections during the first 6-12 months of life.

VACCINATION APPROACH IN PREGNANT WOMEN

If vaccination is to be given during pregnancy, postponing it to the 2nd or 3rd trimester, if possible, is a rational measure that can minimize concerns about possible teratogenicity.

In general, live and live attenuated vaccines (such as mumps, measles, rubella, varicella)

is theoretically contraindicated during pregnancy as it poses a primary risk to the fetus (not applicable).

Ideally, all women of reproductive age should be vaccinated against measles, rubella, mumps, tetanus, diphtheria and poliomyelitis before pregnancy. Varicella, pneumococcal, hepatitis A, hepatitis B and meningococcal vaccines should also be given before pregnancy.

vaccines considered safe during pregnancy

Tetanus and diphtheria toxoids (Td), influenza (influenza vaccine), hepatitis B, meningococcal, rabies vaccines are vaccines considered safe during pregnancy.

tetanus and diphtheria toxoid vaccine (TD)

Tetanus has a high maternal and neonatal mortality. To prevent neonatal tetanus, tetanus vaccine should be routinely administered to pregnant women and a booster dose should be given to pregnant women who have been vaccinated but have not received a diphtheria and tetanus booster in the last 10 years. The primary series of unvaccinated or partially vaccinated women is completed.

Primary vaccination is done in 3 doses.

The first 2 doses should be given one month apart and the third dose should be given 6 to 12 months after the second dose.

HEPATITIS B VACCINE

Hepatitis B infection during pregnancy can cause severe maternal illness and fetal loss, and chronic infection in the newborn.

Chronic HBsAg carriers, especially pregnant women with “e” antigen (+), are highly likely to transmit the infection to their children in the perinatal period. When HBsAg is positive, appropriate follow-up and treatment should be planned; when HBsAg is negative, the pregnant woman should be considered for a vaccination program against hepatitis B after a risk assessment.

Every pregnant woman should be screened for Hepatitis B surface antigen (HBsAg) in the prenatal period.

To date, no teratogenic effects have been reported with this vaccine.

Hepatitis B vaccine is administered in three doses (0, 1-2, 4-6 months).

Hepatitis B vaccines contain non-infectious hepatitis B surface antigen and do not harm the fetus at any stage of pregnancy, but also provide partial protection during delivery by passive antibody transfer to the fetus.

RABIES VACCINE

Rabies vaccine is a live virus vaccine. Since maternal contact with rabies is 100% lethal, it should be done for preventive purposes. Immunoprophylaxis is recommended for pregnant women with rabies dead virus vaccine after exposure

MENINGOCOCCAL VACCINE

It is recommended as a single dose in meningococcal meningitis outbreaks in pregnant women. No side effects of the vaccine have been shown in the mother and fetus.

INFLUENZA (influenza) VACCINE

Pregnant women are at risk of complications following severe influenza infections.

More comprehensive data are needed on the safety of influenza vaccine in pregnancy, especially in the first trimester (first trimester). Administering the vaccine in the first trimester could theoretically raise some concerns. For this reason, it is recommended that pregnant women should only be vaccinated in the second and third trimesters. Influenza vaccine is not teratogenic. The Ministry of Health's recommendation for influenza vaccination in pregnant women is that women in the first 3 months of pregnancy should only be vaccinated against influenza if it is deemed necessary by a doctor.

recommended vaccines in special cases during pregnancy

Hepatitis A vaccine,

polio (IPV) vaccine,

Japanese encephalitis vaccine,

H. Influenza Type b (Hib) vaccine,

pneumococcal vaccine

typhoid vaccine (parenteral and Ty21a)

yellow fever vaccine and

is known as anthrax vaccine.

VACCINES GENERALLY CONTRAINDICATED TO BE CONTRAINDICATED IN PREGNANCY

BCG, MMR, Varicella, Human Papillomavirus (HPV) and Zoster vaccines are not administered during pregnancy.