Everything you need to know about pregnancy vaccines

What vaccines? Why? And most importantly - when?

A super-duper important issue, which is of course also indirectly related to pediatrics.

If you’ve already asked, I’ll tell you a secret. My dream in the past was to set up a clinic for infectious diseases in pregnancy, with an emphasis on pregnancy vaccines. I even went so far as to think of a gift that could be given to a couple getting married – a clinic appointment.

This is to emphasize that optimally and if possible, thinking about infectious diseases and vaccines in pregnancy, should be done even before getting pregnant. In addition, there is room to think not only about the mother but also maximize immunizations in the father.

In conclusion, it would be best if a couple planning to go to the family doctor about six months before the date of getting pregnant, with the vaccine book of both partners and together will build an orderly immunization program.

PREGNANCY

Please note, this is not a summary of all potential infectious diseases in pregnancy, but only of those diseases that can be prevented by vaccination. A reading should also be expanded regarding the prevention of two other important diseases in pregnancy – cytomegalovirus infection (summarized on the website In the following link ) And toxoplasmosis ( In the following link ).

Some basic points that are important to understand:

What are the reasons for getting vaccinated during pregnancy?

Several reasons:

Direct protection of the pregnant mother – Pregnancy is a type of medical condition that puts the pregnant woman at high risk for various infections and complications. There are infectious diseases, which because of pregnancy are more severe, so we want to protect the pregnant woman from any possible infection.

Direct protection of the fetus – The pregnant mother transmits antibodies against many contaminants to the newborn, especially in the third trimester but also during breastfeeding. For example, vaccinating a pregnant woman against whooping cough will cause her to produce antibodies against the pathogen. The antibodies will pass to the fetus passively and protect it for a period of time from infection with the disease.

Protection from congenital syndrome – There are a number of infectious diseases in pregnancy, against which there is a vaccine, in which maternal infection can lead to unpleasant congenital syndromes in the fetus. Examples: rubella and chickenpox.

Premature Infection – Many infectious diseases in pregnancy, in fact almost every fever in pregnancy, has been linked to prematurity. And if it can be prevented, what good.

Is it possible to give all vaccines during pregnancy?

No. Attenuated live vaccines should be avoided for pregnant women. So the idea is to plan ahead and vaccinate some of the vaccines even before pregnancy.

What are the diseases against which there is a vaccine that every pregnant woman should be vaccinated against?

See below for details on one of the following diseases:

Hepatitis B.

Whooping cough (and on the way also tetanus and diphtheria).

Chickenpox.

rubella (and on the way also measles and mumps).

the flu.

Hepatitis B vaccine in pregnancy

The only vaccine that can be vaccinated, which according to the Ministry of Health must be tested during pregnancy. Recalls that since 1992 all children of the State of Israel have been vaccinated routinely for hepatitis B. But here and there there are infiltrators who have not been vaccinated and here and there there are also people who have fallen ill, become chronic carriers and do not know they are carriers. Therefore, for those who do not have a record of receiving 3 doses of hepatitis B vaccine and for those who do not have an antibody test against hepatitis B, start a new series of vaccines. It is best to get vaccinated before pregnancy, but the vaccine is also allowed during pregnancy.

See what happened To Shimon Hamra , Who developed liver failure and needed a liver (goose) transplant, although not from hepatitis B …

Whooping cough (and on the way also tetanus and diphtheria)

Genius. After all, whooping cough in pregnancy is a super unpleasant disease. I myself have seen pregnant women who broke a rib because of the severe cough. So really worth protecting the pregnant woman.

But no less important – the purpose of the vaccine is to protect the baby. This is because whooping cough at the age of less than six months is a potentially serious illness. Since infants in the State of Israel are vaccinated against pertussis at the age of two months and 4 months (and later at the age of six months and a year), some do not develop antibodies fast enough to be protected in that first half year. A very nice scientific work has found that giving a vaccine at the beginning of the third trimester to pregnant women lowers the incidence of the disease in their babies after birth. how? Both because their mother is not sick or infecting them and also because of the same passive antibody transfer I wrote about earlier.

In the State of Israel, it is recommended that pregnant women receive a pertussis vaccine, during each pregnancy and regardless of the number of years that have passed since the previous pregnancy between the 27th and 36th weeks of pregnancy. I recommend early around week 27 to maximize the arrival of antibodies to the fetus and to also protect the mother in time for delivery.

What is the connection between tetanus and diphtheria? There is no vaccine in the State of Israel only for whooping cough and therefore the vaccine given is a triangle – whooping cough, tetanus and diphtheria. It is not harmful to get vaccinated against tetanus every few years but there is also a disadvantage. what is it? The hand hurts after the tetanus vaccine the more times you get in life. Not the end of the world.

Chickenpox

Most of us have had chickenpox in our childhood. But the incidence of the disease is slowly declining, and the current generation of children has been vaccinated against chickenpox and has not contracted the disease. But here and there there are adults who did not get sick and were not vaccinated as children and are prone to infection in pregnancy. Smallpox infection in general in old age is a more serious disease than in young age including pulmonary involvement. In addition, infection in the early stages of pregnancy can also lead to congenital syndrome in the fetus. Since it is not possible to vaccinate during pregnancy, I recommend that all women (and men) who do not clearly remember that they became ill or have been vaccinated with two doses against the virus, perform an antibody test at the HMO. If there are no antibodies, it is highly advisable to prepare for pregnancy by vaccination (a dose or two as needed). Note, for those women, as you will see below, that also need a rubella vaccine the two vaccines can be combined in the same vaccine (called quadruple or MMRV).

The chickenpox vaccine is a live attenuated vaccine and cannot be given during pregnancy. Optimally it should be given at least three months before getting pregnant. Remember that some women need two doses of vaccine that can be given one month apart. In short, we returned to the starting point, have to plan ahead.

Rubella (and along the way also measles and mumps)

Rubella (be careful not to get confused with German measles ) Is not a serious childhood disease. But infection during pregnancy can harm the fetus in the form of an unpleasant congenital syndrome. Therefore, all women in the State of Israel must be vaccinated to the rubella before becoming pregnant, since the vaccine is a Attenuated live vaccine and cannot be given to pregnant women and this is another reason to plan the pregnancy.

Who is considered immune to rubella:

A woman who has a record (vaccination book) of receiving two doses of vaccine given after the age of one year and at a distance of at least 4 weeks from each other.

A woman who did a blood test for antibodies to the rubella and the result came out that she has antibodies (value of 31 or more international units).

In many cases, the women are sent for antibody testing to the rubella even though they have documentation of receiving two doses of rubella, and sometimes in these cases the antibody calibrator comes out lower than 31. What to do:

Understand that this is an unnecessary test and the woman should not have been sent for this blood test.

There is no need to give a third dose of rubella because the woman is considered vaccinated.

Measles and mumps – Two other viral diseases, which are unpleasant in pregnancy and in general, and the only reason mentioned here is because the measles vaccine will always be given in combination with these two diseases – triple vaccine or MMR. As mentioned, the vaccine is live attenuated and will be given at least 3 months before becoming pregnant. Who should get vaccinated against measles? See At the following link .

the flu

Well, there is no need to show the importance of the flu vaccine in general and pregnancy in particular. Let’s just say that one of the known risk factors for flu complications is pregnancy and therefore it is recommended for every pregnant woman to get vaccinated during the flu season. Keep in mind that the baby that is born cannot be vaccinated against the flu in the first half of its life, so vaccinating the mother (and the whole family) will reduce the chance that the virus will enter the house and protect it from an unpleasant disease.

And if the woman did not get vaccinated before or during pregnancy?

Note that both the postpartum period (the six-week postpartum period) and postpartum is an opportunity to complete vaccinations, especially if another pregnancy is planned later.

So how do we sum up?

Pregnancy is a time when we have no control over quite a few parameters. But those parameters that we have control over, are worth taking in hand, stopping and planning and getting ready.

For those who want to expand the reading on the prevention of other diseases in pregnancy against which there is no vaccine – a chapter on prevention in pregnancy of g Congenital Cytomegalovirus (CMV) – It is very important! And another chapter on the prevention of another important infectious disease in pregnancy – Toxoplasma .

Successfully.