Ideally, women should be immunized before becoming pregnant in order to be protected against infectious diseases, but staying up-to-date with
immunizations can be difficult. When health professionals recommend vaccinations during pregnancy, they must weigh the risks versus benefits.
These decisions may vary based on vaccine type, vaccine safety profile, and risk of the disease.
Generally, pregnant women are not included in clinical trials carried out by vaccine manufacturers. This limits vaccine safety data available
for this group of people. Based on available data from post-marketing studies and vaccine registries, public health officials and healthcare
providers make recommendations about which vaccines are beneficial during pregnancy. Several vaccines are recommended for women to take
during pregnancy, especially because they may offer the baby passive immunity (antibodies) against disease. Generally during pregnancy
inactivated vaccines are recommended more often than live vaccines. Live vaccines pose a theoretical risk of harm to the fetus, so it is
generally recommended that women wait to be vaccinated with live vaccines until after pregnancy. The CDC suggests that inactivated vaccines,
when given, generally be delayed until the second trimester.
Please see the boxes below for a listing of vaccines that are generally recommended during pregnancy and those that should be avoided during pregnancy.
*These vaccines are not routinely recommended during pregnancy, but may be recommended for women at increased risk for infection such as during travel,
working in a healthcare facility,or due to certain existing chronic conditions
** Tdap is recommended with each pregnancy. To maximize the maternal antibody response and passive antibody transfer to the infant,
optimal timing for Tdap administration is between 27 and 36 weeks of gestation although Tdap may be given at any time during pregnancy.
*Anthrax is not a live vaccine, but it is not recommended during pregnancy- See more information below
**HPV is not a live vaccine but is a newer vaccine and its safety during pregnancy is still being studied.
Pregnant women are more likely than the general population to become severely ill and are at a higher risk for serious complications
from influenza illness. Because of this, pregnant women are a priority group for influenza vaccination. Despite current guidance
from the Advisory Committee on Immunization Practices to get vaccinated, many pregnant women struggle with making the decision to vaccinate.
Why is Influenza Vaccination Recommended for Pregnant Women?1
1. Reference: Tamma PD, Ault KA, del Rio C, Steinhoff MC, Halsey NA, Omer SB.
Safety of influenza vaccination during pregnancy.
Am J Obstet Gynecol. 2009 Dec;201(6):547-52. Epub 2009 Oct 21.
Pregnant women often have concerns about the safety of vaccines for themselves and their baby. When recommending any vaccine the benefits
of the vaccine are weighed against the risks of the disease, as well as possible vaccine side effects. The United States Food and
Drug Administration (FDA) introduced a set of guidelines that establish safety profiles, defining risks for fetal harm caused by vaccinations and
other medications used in the United States. The FDA safety category information is available for each vaccine and is included within all package inserts.
FDA Medicine Categories are summarized below:
Table Reference: Pregnancy and Medications, Womenshealth.gov
Sometimes a woman is vaccinated inadvertently while she is pregnant. In these circumstances, we encourage pregnant women to contact the
Immunization Healthcare Branch (IHB). The
IHB Clinical Services can help address questions and provide information,
including current research findings and recommendations. IHB Clinical Services
staff can also provide contact information for Pregnancy Registries available through vaccine manufacturers.
If an active duty pregnant woman is vaccinated with smallpox vaccine, she should contact the DOD Pregnancy Registry at:
DoD Center for Deployment Health Research
National Smallpox Vaccine in Pregnancy Registry
(619) 553-9255 DSN 553-9255
Breastfeeding mothers should be vaccinated according to routine and recommended schedules except for
yellow fever vaccination.