Immunisation must for pregnant women

Immunisation is a word often associated with children. According to the Indian Academy of Pediatrics and the National Immunization Programmes, adults too need preventive immunisation against many deadly diseases. Vaccination in healthy adults, especially women who are of reproductive age, has been prescribed depending on their childhood immunisation record and demography.

The government offers many free vaccines as part of its free vaccination programme in India. Besides other vaccines, the health programme has laid much emphasis on the use of HPV (Human papilloma virus) vaccines in women.

This is given the fact that in India, 132,000 new cervical cancer cases are diagnosed leading to more than 70,000 fatalities every year. While there are many vaccines such as for Hepatitis B, Pneumococcal, Influenza, and Tetanus recommended for adults, pregnant and nursing women need extra protection.

There are many vaccines that are safe and prescribed for pregnant women to prevent serious ailments in their unborn children.

Some of the commonly recommended vaccines for women are as follows.

Vaccines for young women
Human Papillomavirus (HPV): This vaccine protects against all common types of HPV that cause genital warts and cancers of the cervix, vulva, vagina, anus and oropharynx. It can be given to those between 11 and 26 years of age. However, it is not found to be effective in women over the age of 26, who need to be screened at regular intervals for cervical cancer. Only 2 doses of the vaccine are required if it is administered before the age of 15.

In older girls, three doses at 0 months, 6 months, and 12 months are prescribed. Immunisation in the preconception phase and during pregnancy It is best to be up-to-date with your vaccination record if you are planning to get pregnant. Two immunizations are strongly recommended during this period.

Influenza: The Influenza vaccine needs to be administered annually. It can be given to healthy women who are below the age of 50 and are not pregnant. Two variants of the vaccines are available in the market: the live attenuated influenza vaccine (LAIV) or the trivalent inactivated vaccine (TIV). The trivalent variant can be safely given to pregnant women as well during any trimester of pregnancy.

Tdap: This vaccine protects against tetanus and diphtheria. The Tetanus, Diphtheria, and Acellular pertussis vaccine also called Tdap is recommended for women who have not been given any primary tetanus toxoid and diphtheria containing vaccine previously. A booster shot of tetanus and diphtheria vaccine (Td) can be given every 10 years to those women who have received primary vaccines of this category. This is particularly helpful in preventing neonatal tetanus and pertussis in newborns.

Hepatitis A: For those women who are at risk of acquiring the Hepatitis A virus, a double-dose single antigen shot is a must at 0, 6, and 12 months. The same can be given as a three-dose combined shot of Hepatitis A and B vaccine at 0, 1, and 6 months.

Hepatitis B: Infants who get infected with HBV at the fetal stage are at a very high risk of developing chronic HBV at birth that can cause fatal liver damage. Therefore, women at risk are given a three-dose primary shot of HB vaccine at 0, 1-2, and 4-6 months.

MMR: The measles, mumps, and rubella vaccine is recommended for those pregnant women who have not had any preventive immunization for these diseases previously. This vaccine helps prevent congenital rubella syndrome in newborns.

Some of the other important vaccines recommended for pregnant women include meningococcal, pneumococcal, and varicella.Immunisation in the postpartum phase Immediately after childbirth, women can ensure protection for themselves and the newborn from many other preventable diseases. This is a time when both the mother and baby are highly vulnerable, and the following vaccines can be safely administered to prevent a number of infections.

Influenza: As discussed earlier, TIV or LAIV vaccines can be given if not already done during pregnancy.

MMR: One dose of MMR vaccine should be given to those women who have not been already vaccinated before being discharged post-delivery.

Tdap: If not already vaccinated, the mother can be given one dose of Tdap to help protect the newborn from pertussis, during the first few months of life.

Varicella: This is indicated in women with no previous history of this immunisation. The first dose of varicella is given before leaving the hospital, while the second dose follows at 6 to 8 weeks after delivery.

Immunisation can offer protection against many preventable diseases. By protecting women, these vaccines also extend early protection to the unborn children. This acquired immunity will also help protect the baby from some diseases during the first few months of life, till the they are ready for their own immunisation programme.

By: Dr Ramananda Srikantiah Nadig