Immunization and pregnancy

Key point

No evidence exists of risk from vaccinating pregnant women with inactivated virus or bacterial vaccines or toxoids.

Influenza

Inactivated influenza vaccine is now recommended for pregnant women in many industrialized countries because of evidence of benefit to the mother and the infant. LAV vaccines pose a theoretical risk to the fetus and are generally contraindicated in pregnant women.

An additional vaccination recommended for pregnant women is seasonal inactivated influenza vaccine. It is considered safe and is recommended for all pregnant women during the influenza season. This recommendation is motivated not only by the potential severe course of influenza during pregnancy, but also to protect infants against influenza during their vulnerable first months of life73. WHO’s Strategic Advisory Committee of WHO (SAGE) has recently discussed seasonal influenza vaccination and recommended pregnant women as the most important risk group for seasonal influenza vaccination. SAGE also supported the recommendation, in no particular order of priority, of vaccination of the following targeted populations:77

  • Healthcare workers,
  • Children 6 to 59 months of age,
  • The elderly,
  • Those with high-risk conditions.

Tetanus

Worldwide, all countries are committed to "eliminationEliminationReduction to zero (or a very low defined target rate) of new cases of an infectious disease in a defined geographical area as a result of deliberate efforts; continued measures to prevent re- establishment of transmission are required." of maternal and neonatal tetanusNeonatal tetanusTetanus that occurs in a newborn infant. (MNT), i.e. a reduction of neonatal tetanus incidence to below one case per 1000 live births per year in every district. As of 2012, 35 countries have yet to eliminate MNT.

All women of childbearing age, either during pregnancy or outside of pregnancy, should be vaccinated against tetanus to protect themselves and their newborn babies. Neonatal tetanus is almost always fatal and is completely preventable by ensuring that pregnant women are protected through vaccination.

Benefits of vaccinating pregnant women usually outweigh potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm. This should be assessed on a case-by-case basis.