Importance of immunization during pregnancy

Vaccination during pregnancy is a critical component of prenatal care, aimed at safeguarding both the mother and the unborn child from infectious diseases. As pregnancy modifies a woman’s immune system, heart, and lungs, it increases her susceptibility to certain infections, which can lead to severe health complications for both her and the baby, including preterm birth and low birth weight. Vaccination helps mitigate these risks by providing immune protection to the mother, which in turn extends passive immunity to the fetus.

The importance of vaccination during pregnancy

Pregnant women are particularly vulnerable to certain diseases because their immune systems adapt to support the growing fetus. These adaptations make them more susceptible to severe complications from infections. Administering specific vaccines during pregnancy not only helps prevent these severe diseases in mothers but also passes on early protection to the newborn, who will not have a fully developed immune system at birth.

Recommended Vaccines During Pregnancy

Influenza vaccine

The seasonal influenza vaccine is recommended for all pregnant women, as influenza can be particularly severe during pregnancy. The vaccine is safe to be administered at any stage of gestation and has been provided to millions of pregnant women over many decades, demonstrating a robust safety record.

Tdap vaccine

The Tdap vaccine, which protects against tetanus, diphtheria, and pertussis (whooping cough), is critical during pregnancy. Pertussis is particularly dangerous for newborns but vaccinating during pregnancy — specifically between the 27th and 36th week — can transfer protective antibodies to the fetus. This provides the newborn with a layer of immunity before they are old enough to receive their own vaccinations.

Covid-19 vaccine

Given the severity of COVID-19, particularly in pregnant women, vaccination is strongly recommended. Numerous studies have affirmed that the COVID-19 vaccines are safe and effective during pregnancy and help prevent severe illness, hospitalizations, and adverse pregnancy outcomes.

Vaccines To Avoid During Pregnancy

Vaccines that contain live viruses, such as the MMR (measles, mumps, and rubella) vaccine and the varicella (chickenpox) vaccine, are generally not recommended during pregnancy due to theoretical risks to the fetus. These vaccines should ideally be administered at least one month before pregnancy.

Safety and efficacy

The recommended vaccines have undergone rigorous testing and monitoring to ensure their safety and efficacy in pregnant populations. Side effects are generally mild and temporary, such as soreness at the injection site or a mild fever. Severe reactions are extremely rare.

Addressing vaccine hesitancy

Vaccine hesitancy among pregnant women can stem from misinformation or a lack of information. Healthcare providers are pivotal in educating their patients about the benefits and risks associated with vaccines, dispelling myths, and providing reassurance based on scientific evidence.

Government guidelines and public health impact

The Government of India recommends specific vaccinations during pregnancy, including the tetanus toxoid (TT) to prevent neonatal tetanus, and the Tdap vaccine to protect against pertussis, tetanus, and diphtheria. Similarly, influenza and COVID-19 vaccinations are strongly advocated to protect against severe outcomes associated with these infections. These guidelines align with global public health recommendations and emphasize the importance of vaccinating every pregnant woman as part of comprehensive prenatal care. The consistent message across various health organisations about the importance of vaccinations for pregnant women highlights the global consensus on this preventive measure. Adhering to these guidelines can significantly reduce maternal and neonatal morbidity and mortality from preventable diseases, ensuring a healthier start for newborns and safer pregnancies for women.

(The writer is a Senior Consultant, Obstetrics & Gynecologist, Apollo Cradle & Children’s Hospital, Hyderabad)