5. Vaccinations and Immunizations
Immunizations and vaccinations protect
you from diseases. A vaccine is usually given by injection or taken
orally. Each vaccine dose contains a very small amount of a weakened
form of the disease. When you receive a vaccine, your immune system
makes antibodies to fight the disease in the future. In most cases, this
is enough to keep you from getting a disease. However, in some cases,
it doesn’t prevent the disease entirely but lessens the symptoms.
Vaccines come in three forms—live virus,
killed (dead) virus and toxoids (chemically altered proteins from
bacteria that are harmless). Most vaccines are made from killed viruses;
it’s nearly impossible to get the disease after receiving this type of
vaccine. With a live-virus vaccine, the virus is so weakened that if
your immune system is normal, you probably won’t get sick from it.
Many women of childbearing age in the
United States and Canada have been immunized against measles, mumps,
rubella, tetanus and diphtheria. A blood test for measles and rubella is
necessary to determine immunity. Physician-diagnosed mumps or a mumps
vaccination is necessary to know you’re immune.
Risk of Exposure.
During pregnancy, try to reduce your chance of exposure to disease and
illness. Avoid visiting areas known to have diseases. Avoid people
(usually children) who are sick. But it’s just about impossible to avoid
all exposure to all diseases. If you’re exposed, or if exposure is
unavoidable, the risk of the disease must be balanced against the likely
effects of vaccination.
The vaccine must also be measured in terms
of its effectiveness and its expected effect on a pregnancy. There’s
not a lot of information on harmful effects of a vaccine on the
developing baby. However, live-measles vaccine should never be given to a pregnant woman.
Vaccinations You Should Have during Pregnancy. The only immunizing agents recommended for use during pregnancy are the Tdap (or DPT) vaccine and the flu vaccine.
The Tdap vaccine (tetanus, diphtheria, pertussis) can help you avoid
whooping cough. Be sure to get a Tdap booster if it’s been 10 years
since your last one. If you work in the garden, with your hands in dirt,
you need a booster.
If you get the flu during pregnancy, you
may have complications, such as pneumonia. Pregnancy can alter your
immune system, which can increase your risk.
It is recommended that all women
who will be pregnant during flu season get a flu shot. A flu shot can
protect you against three strains of influenza. Flu shots can be given
safely during all three trimesters. Talk to your healthcare provider
about it.
Other Vaccines during Pregnancy.
As many as 35% of all pregnant women are at risk of getting measles,
mumps or rubella because they haven’t been vaccinated or they have been
vaccinated but their immunity has weakened. The MMR vaccine
should be given before pregnancy or after delivery. The Centers for
Disease Control and Prevention (CDC) recommends a woman should wait at
least 1 month to get pregnant after receiving the MMR vaccine.
A pregnant woman should receive a vaccination against polio only if her risk of exposure to the disease is high. Only inactivated polio vaccine should be used.
If your healthcare provider believes you may be at risk for getting hepatitis B, it’s safe to take the vaccine during pregnancy. Talk to your healthcare provider if you have concerns.
Ask about receiving the pneumococcal
vaccine if you have a chronic medical condition, such as lung problems,
asthma or heart problems. This vaccine protects you against bacteria
that can cause pneumonia, meningitis and ear infections. A plus to
taking this vaccine is that antibodies you make after taking the vaccine
pass to your baby and may protect him or her from ear infections for up
to 6 months!
Human papillomavirus (HPV) vaccine
is a series of shots over 6 months to protect against HPV. HPV is
responsible for 70% of cervical cancers and 90% of genital warts cases.
Don’t have this vaccine during pregnancy; it’s not recommended. If a
woman discovers she is pregnant while she is receiving the vaccine, she
should delay finishing the series until after she gives birth. Women who
are breastfeeding can receive the vaccine.
Thimerosal Use during Pregnancy. Thimerosal
is a preservative used in vaccines that contains ethyl mercury. It was
barred from childhood vaccines several years ago but is still used in
most flu vaccines. Some experts recommend pregnant women ask for a
thimerosal-free flu vaccine.
The Centers for Disease Control and
Prevention (CDC) believes it’s OK for pregnant women to receive flu
vaccine that contains thimerosal. They state the benefits of flu vaccine
with thimerosal outweigh the risk. The American College of
Obstetricians and Gynecologists (ACOG) has issued a similar statement.
Until 2001, thimerosal was used in RhoGAM
preparations. However, thimerosal is no longer used in RhoGAM in this
country.
6. Influenza (Flu)
The flu seems to be a problem every year
because different flu viruses come and go. In 2009 and 2010, the H1N1
flu affected many people. When an outbreak of H1N1 or other type of
influenza occurs, it can impact a pregnant woman more greatly because of her altered immune system.
If you are pregnant when a breakout occurs, you should receive the specific flu vaccine and
the seasonal flu vaccine. You can be vaccinated any time during
pregnancy. There are ways to protect yourself in addition to getting a
seasonal flu shot. Use “social distancing” to protect yourself. Avoid
crowded areas, use a mask and wash your hands frequently (flu virus can
live up to 2 hours on surfaces like doorknobs and telephones).
Before you get a flu shot, go to bed
extra early the night before. When you’re well rested, your body
produces twice as many infection-fighting antibodies.
Follow your healthcare provider’s
guidelines about using medicine you are advised to take. The benefits
of taking a medicine outweigh any risk to the baby. Treatment should
begin as soon as possible; don’t wait for lab results to confirm the
type of flu.
7. Rubella Immunity
It’s a good idea to get checked to see if
you are immune to rubella before you get pregnant. Rubella (German
measles) during pregnancy can be responsible for various pregnancy
problems. Because there’s no known treatment for rubella, the best
approach is prevention.
If you’re not immune, you can receive a
vaccination after delivery, while you take reliable birth control. Don’t
have a vaccination shortly before or during pregnancy because of the
possibility of exposing baby to the rubella virus.
