Vaccinating
pregnant women serves the dual purpose of protecting the women as well as her
unborn child. Maternal immunization has emerged as a successful strategy to
transfer immunity to unborn child and preventing many unnecessary deaths.
United Nations
Millennium Development Goals includes reducing maternal and neonatal mortality
by reducing vaccine preventable diseases as one of its important goal.
An e-poster
during the 2016 ACOG clinical meeting dealt with the clinical importance of
increasing acceptance for vaccination during pregnancy.
Dr. Emmie
Strassberg from the Geisinger Health System in Danville, Pennsylvania presented
results of a survey which showed that the rate of acceptance for the influenza
vaccination was 70.1%, compared with 76.3% for the Tdap vaccination.
The study
also showed that physician recommendation was the strongest predictor for Tdap
vaccine acceptance (P<.001) and educational material distributed
among patient increases the influenza vaccine acceptance (P<.001).
Specific Vaccinations
in pregnancy depends on age, lifestyle, medical conditions you may have, such
as asthma or diabetes, type and locations of travel, and previous vaccinations.
It is
advocated that physicians and patients should make sure that the immunizations
are up to date before planning to become pregnant.
According to
CDC the vaccines recommended in pregnancy are:
Vaccines Before Pregnancy
Most women
are vaccinated with MMR in childhood but it is better to confirm. If you need
to be vaccinated with Rubella, you should avoid pregnancy for at least a month
and ideally till you confirm your immunity by a blood test.
Vaccines During Pregnancy
Whooping Cough: (Pertussis) is one of the most common vaccine preventable disease. According to CDC all pregnant women should receive a dose of Tdap during each pregnancy, preferably at 27 through 36 weeks. In addition, all family members and caregivers (like babysitters or grandparents) of infants should also get vaccinated with Tdap. After delivery once the baby is 2 months old he should get his pertussis vaccine as recommended by pediatrician.
In June
2013, ACOG weighed in on this issue in a Committee Opinion (#566) from its
Committee on Obstetric Practice, agreeing on the importance of a Tdap
vaccination for pregnant women due to the safety concerns about
pertussis.
Flu: Pregnant women who get flu, can have serious complications like premature labor, babies that are small for gestational age, hospitalization, and, rarely, death. A woman can be vaccinated with the inactivated flu vaccine at any time during any trimester. The Centers for Disease Control and Prevention (CDC) affirms that pregnant women who get vaccinated for the flu not only receive protection personally but also so do their babies for up to 6 months after their birth. In addition, everyone who cares for the baby should also be vaccinated.
Hepatitis B
vaccine: All pregnant women should be
screened for hepatitis B. If she tested negative than vaccination can be considered
if she is high risk for the infection. A series of three doses is required to
have immunity. The 2nd and 3rd doses are given 1 and 6 months after the first
dose. If she tests positive for the disease, then the baby should receive within
12 hours of birth first dose for vaccine and Hepatitis B immunoglobulin (HBIG).
Other vaccines: Some women may need other vaccines like Hepatitis A and meningococcal vaccine depending upon the life style and travel requirements. These can be administered when needed.
Travel vaccines: Depending on your destination you could need additional vaccines. However, there are some vaccines that should be avoided during pregnancy, so it's best to weigh the risks and benefits of vaccination based on your destination.
References:
No comments:
Post a Comment