Vaccines During Pregnancy

What are vaccines?

Vaccines are treatments that can prevent certain serious or deadly infections. They work by preparing the body to fight the germs that cause the infections. Vaccines usually come in shots, but some come in nose sprays or medicines that people swallow. Vaccines are also called “vaccinations” or “immunizations.”

Why should I get vaccinated?

Getting vaccinated can help keep you from getting certain serious infections. It’s important to be vaccinated even if you don’t become pregnant. But if you are pregnant and get certain infections, you can have problems during your pregnancy. Being vaccinated can also help keep your baby from getting sick.

What should I know about vaccines if I am planning to get pregnant?

If you are planning to get pregnant, you should make sure that your vaccines are up to date. This means that you have gotten all the vaccines that your doctor or nurse recommends. If you are not sure if you got all your vaccines, your doctor or nurse might do a blood test to check. It’s especially important that women be up to date with their vaccines for measles, mumps, rubella, and chicken pox before they get pregnant. That’s because the vaccines to prevent these infections cannot be given to pregnant women. If women who have not been vaccinated do get these infections during pregnancy, some of the following problems can occur:

• Pass the infection to the baby, either during pregnancy or in the first few months after birth
• A miscarriage – this is when a pregnancy ends on its own before the baby can live outside the womb
• Give birth too early
• Have a baby with a birth defect

Women who need the measles, mumps, rubella, or chicken pox vaccines should get them at least 1 month before getting pregnant.

It’s also important that women be up to date with a vaccine called the HPV vaccine before they get pregnant. The HPV vaccine is not given during pregnancy, although if a woman gets it before knowing she is pregnant, it is safe.

Do I need the chickenpox vaccine if I had the chickenpox infection?

No. If you had the chicken pox infection in the past, you do not need to get the vaccine. People who have had chicken pox cannot get it again.

Which vaccines are safe to get during pregnancy?

• Some vaccines are safe to get during pregnancy. These include vaccines to prevent:
  • Influenza (flu) – All adults should get the flu vaccine each year. But it’s especially important for pregnant women to get the flu vaccine. That’s because pregnant women tend to get more severely ill with the flu than people who are not pregnant. The flu vaccine can keep a woman from getting sick. It can also keep a baby from getting the flu during the first few months of life.
  • Tetanus, diphtheria, and pertussis – Tetanus causes the muscles to work abnormally. Diphtheria can cause a thick covering in the back of the throat that can lead to breathing problems. Pertussis, also known as “whooping cough,” causes a severe cough. All pregnant women should get the tetanus, diphtheria, and pertussis vaccine at 27 to 36 weeks of pregnancy, even if they got it before. This is mostly to protect the baby from getting whooping cough in the first few months after birth. Whooping cough in babies can be serious or even deadly.

Menopausal symptoms

When a woman enters menopause, her estrogen and progesterone levels fall and will cause symptoms such as hot flashes and vaginal dryness. The best way to relieve hot flashes and other symptoms that can accompany menopause is to replace the hormones that your body is no longer producing. Estrogen can be given alone if a woman no longer has a uterus. If a woman still has her uterus than she would receive a combination of estrogen and progesterone (synthetic or natural). Estrogen has the best ability to relieve the symptoms of menopause. However, some women are unable to take it in instances such as a woman with breast cancer. There are also those who choose not to use hormone therapy.

For those that cannot take estrogen or those that choose not to, there are other options.

• Paroxetine (Brisdelle/Paxil) – This is the only nonhormonal therapy approved in the US to treat hot flashes. Other antidepressants such as venlafaxine (Effexor), desvenlafaxine (Pristiq), citalopram (Celexa), and escitalopram (Lexapro) proved to be effective in studies and are used as well.
  • Women who have breast cancer and take tamoxifen should not use Paroxetine because it may interfere and make tamoxifen less effective.
• Other options used to treat hot flashes include:
  • Gabapentin (Neurotin) – usually given as a single dose before bed but can be taken in the daytime
  • Plant-derived estrogens (phytoestrogens) –These often appeal to some women because they are advertised as natural, safer options. They can be purchased in health food stores and found in a variety of foods. Some foods include lentils, soybeans, flaxseed, chickpeas, red clover, and grains but also in other fruits and vegetables.
  • Progesterone – the injectable version, medroxyprogesterone (Depo-Provera), is not commonly used but can reduce hot flashes.
  • Herbals – These are also advertised as natural options. Black cohosh has been used to treat hot flashes but clinical studies found it is not more effective than a placebo pill. Black cohosh has presented concerns that it may stimulate breast tissue similar to estrogen and cause a recurrence of breast cancer. However, there is no current evidence that it is harmful. Experts would like more studies on this and recommend women with breast cancer avoid it. Overall herbals are not recommended to treat menopausal symptoms including hot flashes.
  • Cognitive behavioral treatment, stress management, yoga, deep breathing, and relaxation were helpful to some women.