New vaccination guidelines for women undergoing infertility evaluation and care have just been released. Usually the primary care doctor handles vaccination concerns for patients, but they will commonly defer to the woman’s OB/GYN or fertility specialist if the patient is pursuing fertility care. Vaccinations before or during pregnancy can protect women from potentially serious illnesses, prevent transmission of the infection to the fetus, and confer immunity to the baby protecting it from infection after birth. While some vaccinations should be avoided in pregnancy (MMR, herpes zoster, varicella) many vaccines are known to be safe and can be given prior to, or in, pregnancy.
Here are the current recommendations for vaccinations:
Flu vaccine: preventing influenza during pregnancy is an essential part of prenatal care. The flu season is October through May of each year. Getting flu during pregnancy can worsen the medical complications associated with flu. Pregnant women experienced excess rates of death and disease during flu pandemics of 1918, 1957 and 2009. The best way to prevent it is annual immunization. CDC recommends vaccination for everyone over 6 months of age, even pregnant women. No studies show harm to pregnant women or their offspring from flu vaccinations.
Hepatitis B: Hepatitis B can infect the liver and should be given to women at high risk for infection: health care and child care workers, IV drug users, women with sexually transmitted infections or multiple partners, travelers to countries where Hepatitis B is common, such as Asia, India and Central America. The vaccine can be given in pregnancy and poses no threat to the fetus.
Tetanus-Diphtheria-Pertussis: The CDC has recommended use of tetanus toxoid and accelular pertussis vaccine (Tdap) for pregnant women. Because of recent outbreak in pertussis (whooping cough), women should be vaccinated if pregnant or might become pregnant (if they haven’t previously received Tdap) particularly those high risk individuals are in contact with infants. If pregnant, vaccinate in the late 2nd or early 3rd trimester.