Helping Mothers to Have a Healthy Start: Pregnancy and Vaccines

During pregnancy, parents are often thinking about baby names, nursery colors, and prenatal vitamins, but healthcare providers need to remind them to think about vaccines. Vaccines are an important component of a healthy pregnancy. Women should be up to date on their vaccines before becoming pregnant, and should receive vaccines against both the flu and whooping cough (pertussis) during pregnancy. These vaccines not only protect the mother by preventing illnesses and complications, but also pass on vaccine protection to her unborn child.

Women who are planning to become pregnant may need to receive some vaccines before the start of pregnancy. These vaccines may need to be administered a number of weeks before a woman becomes pregnant so that she is adequately protected. Some vaccine-preventable diseases, such as rubella, can lead to significant complications, including birth defects.

Pregnancy is a good opportunity to start learning about the safe, proven disease protection that vaccines will provide to their babies once they are born. Pregnant women should also plan on receiving the flu and whooping cough vaccines during each pregnancy. Pregnant women are at an increased risk for complications from the flu. The flu shot helps to protect a pregnant woman and her unborn child from the flu as well as lessen her symptoms if she does contract it. A flu shot also allows the mother to pass antibodies on to her newborn for some early flu protection. By getting a whooping cough vaccine in the third trimester, the mother also develops antibodies and passes them on to her baby so that her baby is born with protection against whooping cough.

Help mom get off to a healthy start by making sure that a her immunizations are up to date before becoming pregnant.

· Before becoming pregnant, a woman should be up-to-date on routine adult vaccines to help protect her and her child from vaccine-preventable diseases like rubella.

· Live vaccines should be given at least one month before pregnancy; vaccines received during pregnancy should be inactivated.

· It is very important for women to be up to date on their measles-mumps-rubella (MMR) vaccine before becoming pregnant. Rubella infection in pregnant women can cause unborn babies to have serious birth defects with devastating, life-long consequences, or death.

Women can have a pre-pregnancy blood test to see if they are immune to the disease. They probably received the MMR vaccine as a child, but they should confirm this with their.

If a woman needs to get an MMR vaccine, they should avoid becoming pregnant until one month after receiving the MMR vaccine and, ideally, not until their immunity is confirmed by a blood test.

Vaccines protect mothers against serious diseases and prevent them from passing diseases on to their baby after birth.

· Pregnant women are at high risk of serious flu complications and are more likely to become severely ill with the flu than women who are not pregnant.

o Getting the flu while pregnant increases an expectant mother's chances for serious problems, including premature labor and delivery.

o Getting a flu shot is the best way to be protected from the flu and prevent possible flu-associated pregnancy complications. When pregnant women get flu shots, they and their babies (after birth) get the flu less often.

· Whooping cough can lead to serious complications or be deadly for babies.

o Whooping cough can cause serious and sometimes life-threatening complications in babies, especially within the first six months of life. About half of babies who get whooping cough end up in the hospital.

o Receiving the whooping cough vaccine during the third trimester allows for the most antibodies to be passed on to the baby so he/she is born with protection.

o Two studies from the United Kingdom have shown whooping cough vaccination during pregnancy to be at least 90% effective in preventing whooping cough in babies younger than 2 months.

The vaccines a mother receives during pregnancy will provide her baby with some disease protection (immunity) that will last the first few months of life.

· By getting vaccinated during pregnancy, mothers can pass antibodies to their baby that may help protect against diseases.

· Infants in the first several months of life are at the greatest risk of severe illness from influenza and whooping cough but are too young to be immunized. This is why vaccination during pregnancy is so critical to help protect them.

· When an expectant mother gets a whooping cough vaccine and flu vaccine during a pregnancy, they will also have antibodies against these diseases in their breast milk that they can share with their baby as soon as their milk comes in.

During pregnancy, parents can start learning about the safe, proven disease protection that vaccines provide for their baby.

· Vaccinating children according to the recommended schedule is one of the best ways parents can protect their children from 14 serious and potentially deadly diseases before their second birthday.

· Families, health care professionals and public health officials must work together to help protect the entire community – especially babies who are too young to be vaccinated themselves.

· Children who don’t receive recommended vaccines are at risk of getting the disease or illness, having a severe case of the disease or illness, and passing it on to others in their communities who cannot get vaccinated because they are too young or have a medical condition.

· We as healthcare providers can’t predict or know in advance if an unvaccinated child will get a vaccine-preventable disease, nor can we predict or know how severe the illness will be or become. Most young parents in the United States have never seen the devastating effects that diseases like polio, measles or whooping cough can have on a family or community. It’s easy to think of these as diseases of the past. But the truth is they still exist, and they can spread especially in pockets of unvaccinated children.

· Parents can learn more at CDC’s vaccine website for parents: www.cdc.gov/vaccines/parents/index.html 

Breastfeeding moms can also receive some vaccinations.

· Antibodies are transferred to babies during pregnancy, and also through breastfeeding. A mother can pass antibodies against diseases she has had in the past, and those she has been vaccinated against, through her breast milk.

· When breastfeeding, women can receive the flu vaccine. Either the flu shot or the nasal spray flu vaccine is safe.

· When a mother receives a whooping cough vaccine during her pregnancy, she will have antibodies in her breast milk that she can share with her baby as soon as your milk comes in if she is breastfeeding. However, the baby will not get protective antibodies immediately if the mother waits to get the vaccine until after delivering her baby. This is because it takes about two weeks for the mother's body to create antibodies against whooping cough (and the flu).


OB/GYN TdapInfluenza Vaccination Referral Letter Resource
The Arizona Partnership for Immunization has developed an inactivated vaccine referral/follow up form (for pregnant patients) if practices does not do on site vaccination. Providers can download the Microsoft Word document and amend to fit their needs from this link. Patients can then give the form to Pharmacists and/or Vaccine Clinic where they will be receiving the necessary immunizations.

https://www.whyimmunize.org/employer/outbreak-information/tapi_tdap_ob_gyn_-preg_-referral-letter_version-4_14_2015-2/

If you would like more information about pregnancy and vaccines to share with patients, expectant parents and colleagues, please visit the following resources:

CDC: Vaccines and Pregnancy – flyers, guidance, recommendations, videos

http://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html. 

 

CDC: Pregnant Women & Influenza (Flu) – Spanish Langauge guidance, recommendation, infographic, fact sheets

http://espanol.cdc.gov/enes/flu/protect/vaccine/pregnant.htm

ACOG: Immunization Toolkit

immunizationforwomen.org

A special thank you and acknowledgement to the National Public Health Information Coalition and the CDC for providing the above information and resources.