Vaccinations in pregnancy

Vaccination during pregnancy has been shown to benefit both mother and baby; protective antibodies are transferred across the placenta protecting the baby for up to six months. Multiple studies have shown that better patient information is needed to improve the uptake of vaccines in pregnancy. A recent study from New Zealand found that most women who had recently been pregnant knew that whooping cough can be dangerous in infants, but many did not know they needed to have the vaccine during pregnancy to protect their infant.

Pertussis

Pertussis vaccination is free for all pregnant woman in NSW under the National Immunisation Program (NIP). The Australian Immunisation Handbook 10th edition recommends dTpa vaccine as a single dose during the third trimester of each pregnancy, ideally between 28 and 32 weeks. However, if the vaccine is not given during this period it should still be given at any time during the third trimester up to delivery. Vaccination is recommended with each pregnancy to provide maximal protection to every infant; this includes pregnancies which are closely spaced (e.g. <2 years).

The source of infection in infants is often a household contact, most frequently the infant’s mother. To reduce the risk of pertussis occurring in infants, pertussis vaccination is recommended for their close contacts. Adult household contacts and carers (e.g. fathers, grandparents) of infants less than six months of age should ideally receive a dTpa vaccine at least two weeks before beginning close contact with the infant. A booster dose of dTpa is recommended if 10 years have elapsed since a previous dose.

Influenza

Similarly, the seasonal influenza vaccine, is recommended and funded for pregnant women under the NIP. It is safe to administer at any time during pregnancy or whilst breastfeeding. Women face a high risk of severe consequences if they contract influenza during pregnancy. The timing of vaccination depends on the time of the year relative to the influenza season, vaccine availability, stage of pregnancy and the anticipated duration of immunity.

The rate of adverse events after vaccination in pregnant women is no different to the rate in women who are not pregnant. In addition, studies of mother–baby pairs have shown that receiving the influenza vaccine while pregnant does not increase maternal or foetal complications during pregnancy. A number of high quality studies have demonstrated that influenza vaccination during pregnancy provides protection not only to the mother but also to her newborn in the first few months of life when they are most vulnerable. Annual influenza vaccination is recommended for any person (such as household contacts) aged ≥6 months who wants to protect themselves from influenza.

For more information, NCIRS Factsheet is a useful tool to help raise awareness of the importance of vaccinations before and during pregnancy. NSW Health consumer resources are also available to order or download for your patients.

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