Melissa is not alone. Many people contact MotherToBaby to find the most up-to-date information about vaccines during pregnancy. Protecting yourself from circulating viruses can also help protect your developing baby. Infections such as influenza, pertussis, rubella, chicken pox, and COVID-19 can cause serious problems in both a pregnant person and their developing baby.  In light of August being National Immunization Awareness Month (NAIM), let’s navigate through the current recommendations.

Plan to Receive Some Vaccines Prior to Pregnancy

You may have heard there are some vaccines you should not receive during pregnancy. These “live” vaccines are avoided as they are made from viruses or bacteria that have been weakened, but not killed. Due to the small chance that a live vaccine might cause the disease itself, live vaccines are not routinely given to pregnant people.

So how can you protect yourself and your developing baby from viruses like measles, mumps, rubella and chicken pox (varicella) if it is not recommended (also known as contraindicated) to receive the vaccine during pregnancy? Your healthcare provider can take your titers (lab test that measures the antibody levels in the blood) before pregnancy to make sure you have enough antibodies to help protect yourself from these infections during pregnancy. Low titer levels? You can safely receive the necessary live vaccines needed before that positive pregnancy test! Out of an abundance of caution (small possibility of that infection) it is advised to wait at least one month before becoming pregnant after these vaccines. This is just one reason why it is beneficial to have a pre-pregnancy health checkup and to discuss any future conception plans with your provider!

Keep Up with Recommended Vaccines During Pregnancy and Encourage Others to Do So, Too

So, which vaccines should you receive during pregnancy?

The Centers for Disease Control and Prevention (CDC) recommend all people who are pregnant receive the influenza vaccine each year and a Tdap (tetanus diphtheria pertussis) vaccine for each pregnancy, and the most up-to-date COVID vaccine when you are due. These vaccines are not live vaccines and have not been associated with an increased chance for birth defects or pregnancy complications. An exception would be the live attenuated Influenza vaccine which is intranasal (given through the nose).

The flu vaccine usually becomes available in September and is offered throughout flu season. CDC recommends getting a flu vaccine by the end of October despite flu seasons varying in their timing from season to season. This timing helps protect a pregnant woman before flu activity begins to increase. Protection begins about two weeks after you get the flu shot and lasts at least six to eight months. It is necessary to receive the seasonal flu shot each year to be protected in the current flu season. Getting vaccinated during your pregnancy may also help protect your baby from getting sick during the first 6 months of life! This is especially important because infants less than 6 months of age cannot receive the flu vaccine.

“I just had a Tdap vaccine a couple years ago – so I don’t need another one, right?” Melissa asked a very common question we receive regarding the Tdap vaccine during pregnancy. Although this vaccine is recommended for adults every 10 years, for people who are pregnant, receiving the shot in the 3^rd trimester (specifically 27-36 weeks gestation) can help the baby get as many of the mother’s antibodies as possible. After delivery, these antibodies provide some protection against pertussis (a very contagious respiratory infection) until the baby can receive his/her own dTAP vaccine (at 2 months of age). Additionally, if everyone who lives with you and any caregivers get the vaccine, it can lower the chance for the baby to get pertussis.

It is well known that pregnant people are more likely to get very sick from COVID-19 compared to those who are not pregnant. This is why is so important to receive your COVID-19 vaccinations when you are due, anytime during pregnancy, for the best protection against severe illness. CDC recommends one updated (no longer called “booster”) Pfizer-BioNTech or Moderna COVID-19 vaccine to be up-to-date:  https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

Pregnant people who receive vaccines can also share their experiences with maternal health researchers, like MotherToBaby. Our studies are published in medical journals and product labels, and can help others like you when navigating vaccine decisions in pregnancy.

There are no Vaccines to Prevent Some Infections

Many people are packing their bags for a getaway during these summer months. If you are considering an upcoming vacation or babymoon, it’s important to protect yourself from viruses and infections with the appropriate vaccines for that area. Where are you headed? Check with your healthcare provider regarding any specific travel vaccines you might need. CDC recommends discussing any travel plans with your provider 4-6 weeks before your trip. Contact MotherToBaby to check the information on any vaccines your healthcare provider recommends.

Zika is a virus that is usually spread by mosquitos. Being infected with the Zika virus during pregnancy is known to increase the risk for serious and lifelong problems for the baby. While there are no current outbreaks of the Zika virus, it can still be circulating in some levels in many countries and there is no vaccine or treatment currently for Zika! The safest approach during pregnancy would be to not travel to areas with any possible level of risk; should you choose to travel, it’s important to protect yourself using the recommended insect repellents among other ways to help reduce risk.

Although masks are no longer required in most public areas, this is still a great way to reduce the risk for infections and illness while around others! Good hand washing, good ventilation, air conditioning, staying outdoors as much as possible, etc. can also be considered.

After chatting with Melissa, she decided to make her appointment for her COVID-19 and Tdap vaccines (you can get them at the same time!) and will go in ASAP when the flu vaccine for this season is available. She felt reassured knowing she had decided to give herself and her developing baby the best protection from these illnesses as possible.  “Thank you for all this info! I just want to make the best choice for me and my baby – I feel so much better.”

Do you have questions about vaccines during pregnancy? Call, chat, text, or email MotherToBaby!

References:

https://mothertobaby.org/fact-sheets/vaccines-pregnancy/

https://mothertobaby.org/pregnancy-studies/

https://www.cdc.gov/vaccines/parents/by-age/pregnancy.html

https://www.cdc.gov/vaccinesafety/concerns/vaccines-during-pregnancy.html

The post Immunization Education: Everything You Need to Know About Vaccines Before and During Pregnancy appeared first on MotherToBaby.

First, I was told that I needed to get revaccinated for certain diseases, even though I may have had them or may have been previously vaccinated in the past. Those vaccinations included measles, mumps and rubella (MMR), varicella, polio, tetanus diphtheria pertussis (Tdap), hepatitis B, and COVID-19. As soon as I heard this long list, I went online and checked the MotherToBaby facts sheets about those vaccines one by one to see what was known about their use in pregnancy. It turns out the Hepatitis B and COVID-19 vaccines are not associated with risk during pregnancy. Even more, it is recommended to get a Tdap vaccine during pregnancy to provide protective antibodies to your baby against pertussis (whopping cough). Live vaccines like MMR and varicella (chickenpox) are not recommended during pregnancy. Thankfully I was able to get bloodwork done to check antibody levels (protective proteins) showing prior protection. If you can show full protection, you no longer need to get vaccinated for these diseases after pregnancy. 

One other thing I had to find out was my tuberculosis (TB) status. This is done by blood work, but if the results don’t rule out the disease, you would need a lung x-ray. In general, X-rays are not recommended during pregnancy. However, if needed, studies show that a single chest x-ray is not associated with an increased risk for birth defects or pregnancy complications for the developing baby. It is important to know your tuberculosis status before pregnancy since active infection can be associated with preterm labor (early birth before 37 weeks), low birth weight of the baby, or even maternal death. Getting TB treated as soon as possible, even when you are pregnant, is so important. Tuberculosis is a slow-growing, pesky disease that is common in certain countries, including my home country, Turkey, but not common in the United States. That is why it is important to get it checked during the immigration process to prevent spread.

In addition to making sure I was getting my immigration to-do list sorted out, I also had to contend with new feelings brought on by pregnancy, both happy and stressful ones. This included all day nausea, aka the morning sickness, I had lots and lots of morning sickness. My first instinct was to call my mom and ask for help. She gave me a recipe for a concoction that included turmeric, sage, ginger, and mistletoe. I made it and drank it a couple of times without thinking whether that might be safe during pregnancy since it was all natural and herbal. A few days later, I was talking with one of my best friends, who was pregnant as well, complaining about morning sickness and asking for suggestions that have helped her. She said she would not drink any herbal tea without checking with her doctor. Ding ding, after talking with her, I was terrified to research the topic, and when I did, it confirmed my worst fears. The mistletoe in my nausea drink might cause miscarriage if consumed in large amounts. Many of the other herbs hadn’t been studied in pregnancy at all. I didn’t consume any more of the morning sickness drink and am fortunate that I had a healthy term baby. Lesson learned!

As immigrants, we bring our full heritage with us and try to combine the best of both worlds. Those herbal remedies and recipes are our culture; however, pregnancy is a special and very vulnerable time period. Everybody should be cautious about what we put into our bodies, especially herbal remedies since they are mostly not well studied during pregnancy to show whether they are associated with risks to the baby or not. Even if they are studied, the production and harvesting are not regulated or controlled by the Food and Drug Administration (FDA), or other governmental agencies, and contaminations might happen. Better safe than sorry, right?

Carrying my baby through the immigration process and following my dreams along the way was challenging, but I learned on that road that it is important to question my customs and traditional medications when pregnant. Not everything my mother or grandmother did is safe and effective. Also, I was glad that MotherToBaby was there for me when I was going through the immigration process while pregnant to ask my burning questions about vaccinations and x-rays.

Anyone with questions about herbals, vaccines, TB testing, or any other exposure in pregnancy should know that MotherToBaby is a great resource. Call or chat today to get your individual questions answered by a teratogen information specialist so you can rest assured that you and your baby can have a healthy and well-informed entry into America.

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