II. Class C: Small risk in controlled animal studies
-
Tdap (Tetanus Diptheria Acellular Pertussis Vaccine)
- Give Tdap at 27-36 weeks gestation in each pregnancy
- Allows time for maternal Pertussis antibodies to transfer to the newborn (passive Immunity)
- (2013) Ann Intern Med 158(3):191-9 [PubMed]
-
Hepatitis A Vaccine
- Give if travel to endemic area or IVDA in pregnancy
-
Hepatitis B Vaccine
- Administer in all pregnant patients if not previously immunized
-
Influenza Vaccine
- Indicated if pregnant in Influenza season
- Immunize after first trimester
-
Meningococcal Vaccine
- Standard indications (dormitory, barracks, travel)
- Plague Vaccine
-
Polyvalent pneumococcal Vaccine
- Vaccinate high risk women before pregnancy
- ACIP recommends avoiding during pregnancy
-
Polio Vaccine (live and inactivated)
- Avoid during pregnancy in most cases
- Use IPV in pregnancy if high risk Polio exposure
- Rabies Vaccine
- Tularemia Vaccine
- Typhoid Vaccine
III. Class D: Strong evidence of risk to the human fetus
IV. Class X: Very high risk to the human fetus
- BCG vaccine (Bacille Calmette-Guerin Vaccine)
-
MMR Vaccine (MeaslesVaccine, Mumps Vaccine, RubellaVaccine)
- Give MMR dose immediately post-delivery if Rubella non-immune
- Small Pox Vaccine
- TC-83 Venezuelan Equine EncephalitisVaccine
-
Varicella Vaccine (Varivax)
- Risk if vaccinated within 4 weeks of conception
- Theoretic risk only; not an indication for EAB
V. Resources
- CDC Guidelines for vaccinating pregnant women
VI. References
- Briggs (1998) Drugs in Pregnancy and Lactation, 5th ed
- Black (2003) Am Fam Physician 67(12):2517-24 [PubMed]
- Larimore (2000) Prim Care 27(1):35-53 [PubMed]
- Sur (2003) Am Fam Physician 68(2):299-304 [PubMed]