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What Vaccines Do You Need Before and During Pregnancy?

pregnant woman

Consider this: The vaccines you get before and during pregnancy not only play an important role in protecting your health but safeguard your baby's health too. Your immunity is your baby's first line of defense against certain serious illnesses. So if you're pregnant or planning a pregnancy, now is the time to make sure your vaccinations are up to date.

But not all vaccines are safe to get during pregnancy. Vaccines come in three forms: live virus, dead virus, and toxoids (harmless, chemically altered proteins drawn from bacteria). Pregnant women shouldn't get live virus vaccines, such as the combined measles, mumps, and rubella vaccine (MMR), because there's a slight chance these will harm the unborn baby. Vaccines made from dead viruses, such as the flu shot, and toxoid vaccines, such as the tetanus/diphtheria (Td) shot, are safe. Here's a rundown of what you need to know about vaccinations before, during, and after pregnancy.

Certain preventable infections can be harmful during pregnancy. That's why you should ask for a blood test during a pre-pregnancy checkup to find out if you're immune to these diseases. If you're not, you should get vaccinated before becoming pregnant. Just be sure to postpone pregnancy for one month because these shots are made from live viruses that can harm your baby.

Rubella vaccine Also called German measles, the rubella virus presents flu-like symptoms often followed by a rash. It can be harmful during pregnancy: Up to 85 percent of babies of moms who contract it during the first trimester develop serious birth defects, such as hearing loss and mental retardation.

Chickenpox vaccine An extremely contagious disease, chickenpox causes fever and an uncomfortable, itchy rash. About 2 percent of babies of women who develop chickenpox during the first five months of pregnancy have birth defects, including malformed and paralyzed limbs. What's more, a woman who develops chickenpox around the time of delivery can also pass a life-threatening form of the infection to her baby.

Flu shot The Centers for Disease Control and Prevention (CDC) recommends a flu shot for all women who will be pregnant during the flu season, which is November through March. The flu shot is made of dead viruses, so it's safe for both you and baby. But you should avoid FluMist, a nasal-spray vaccine made from live viruses.

The best time to get a flu shot is in October or November, before the flu season is in full swing. And because flu strains change every year, the vaccine does too -- so don't rely on last year's shot to get you through this year's season.

Moms-to-be who come down with the flu, especially during the second half of pregnancy, are more likely than other women to suffer severe symptoms or complications such as pneumonia. Even a moderate case of the flu can make you feel miserable, resulting in fever, headaches, muscle pain, sore throat, and coughing. Most of these symptoms last about four days, although coughing and fatigue can drag on for two weeks or longer.

If you do get the flu, contact your doctor, get plenty of rest, and drink lots of fluids. Tell your doctor if you're not feeling better after several days or if you have trouble breathing, as this can be a sign of more serious complications such as pneumonia. Fortunately, although the flu can be a real drag for you, it's unlikely to harm your baby.

Tetanus/diphtheria shot If you haven't had a Td shot in the past 10 years, get a booster now. The vaccine is made with toxoids, so it's safe to get during pregnancy.

Tetanus, also called lockjaw, is a disease of the central nervous system that causes painful muscle spasms and convulsions. The bacterium that causes tetanus can be found in soil and in animal waste. It can enter the bloodstream through a cut in the skin, so follow up with your doctor if you get a deep or dirty wound. If contracted during pregnancy, tetanus can cause fetal death.

Diphtheria is a respiratory infection that can cause breathing problems, paralysis, coma, and even death. It's now rare in this country, but you need a booster shot every 10 years; otherwise your immunity is likely to wane.

Your job or lifestyle can make you more susceptible to specific illnesses, as can certain chronic health conditions, such as diabetes. If you fall into one of these categories, your doctor may recommend additional vaccinations before or during pregnancy.

Hepatitis B vaccine It's safe to get this shot when you're pregnant, and if you're a healthcare worker or you live with someone who has the disease, consider vaccination.

Hepatitis B is a viral infection that causes liver inflammation, nausea, fatigue, and jaundice (yellowing of the skin and eyes). In some cases, it can cause chronic liver disease, liver cancer, and death. A pregnant woman with hepatitis B can pass the infection to her baby during delivery, and without prompt treatment, the baby has a high risk of contracting serious liver diseases as an adult.

The CDC recommends that all pregnant women be screened for hepatitis B because it's possible to have it without knowing.

Hepatitis A vaccine This vaccine protects against a liver disease that spreads through contaminated food or water. Symptoms include fever, fatigue, and nausea. It isn't usually as serious as the B version of the disease, and the illness won't affect an unborn baby most of the time. In rare cases, hepatitis A may contribute to premature labor and infection in the newborn.

The safety of this vaccine has yet to be determined, but because it's produced from dead viruses, the risks are likely low. If you're traveling to a developing country or if you work with the virus in a laboratory setting, you should discuss vaccination with your doctor.

Pneumococcal vaccine If you have a specific chronic condition, such as diabetes or kidney disease, your doctor may recommend the pneumococcal vaccine, which protects against some forms of pneumonia. Although potential harm to an unborn baby is unknown, researchers believe that the risk is low.

Now is the time to catch up on any vaccines you may have been unable to get during pregnancy or before becoming pregnant, such as the MMR and chickenpox vaccines. Moms who are breastfeeding can get vaccinated according to a normal adult vaccination schedule.

If you're due for a Td booster, your doctor will probably recommend the version that also protects against pertussis, also known as whooping cough. This version may also be recommended in certain situations during pregnancy, such as when the mom-to-be is at high risk for pertussis.

Women younger than 26 should also consider getting the new HPV (human papillomavirus) vaccine that helps protect against cervical cancer. The shot isn't recommended during pregnancy because studies haven't yet determined its safety for a developing baby.

Serious reactions to vaccines are rare. However, your doctor may tell you to skip certain shots if you have an allergy to a substance they contain. Those who are allergic, for example, to baker's yeast (used in making bread) shouldn't get the hepatitis B vaccine; those with a severe egg allergy should avoid the flu shot; and people with a severe allergy to gelatin or to the antibiotic neomycin shouldn't get the measles, mumps, and rubella or varicella vaccine. If you're skipping any shots, you should discuss alternate ways to prevent illness with your doctor.

Originally published in the June 2008 issue of American Baby magazine.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.