Table 1.
Vaccines Recommended Routinely and in Special Circumstances, and Vaccines Currently in Development
| Vaccine | Timing | Immunogenicity in Pregnancy | Safety in Pregnancy Documented | Placental Transfer Efficiency | Antibody Duration in Infant |
|---|---|---|---|---|---|
| Routinely recommended | |||||
| Inactivated influenza virus | Annually during influenza season | Yes [13] | Yes | 95% | 2–3 mo |
| Tetanus, diphtheria, and acellular pertussis | 27–36 wk gestation of every pregnancya | Yes [14] | Yes | >100% for tetanus >100% for pertussis |
2 mo for pertussis |
| In special circumstances (travel to endemic areas, exposure, and during outbreaks) | |||||
| PPSV23 or conjugate PCV13 | Studies performed in third trimester | Yes [15, 16] | Yes | 30%–44% for polysaccharide | 5 mo |
| Haemophilus influenzae type b conjugate and polysaccharide | Studies performed in third trimester | Yes [8] | Yes | 82%–92%; IgG1 > IgG2 | 2 mo |
| Meningococcus conjugate and polysaccharide | Studies performed in third trimester | Yes for polysaccharide [17] | Yes for polysaccharide, ND for conjugate | 30%–44% for polysaccharide [18] | 2–4 mo |
| Inactivated poliovirus | Prior to travel, during outbreaks | Yes [10] | Yes | ND | ND |
| Typhoid | Prior to travel | ND | ND | ND | ND |
| Cholera | Prior to travel | ND | ND | ND | ND |
| Hepatitis A | Prior to travel | Yes | Yesb | ND | ND |
| Hepatitis B | Prior to travel | Yes | Yesb | ND | ND |
| Rabies | Prior to travel and after exposure | Yes | Yesb | ND | ND |
| Japanese encephalitis | Prior to travel | ND | ND | ND | ND |
| Yellow fever | Prior to travel | Yes [19] | Unclearc | ND | ND |
| Oral poliovirus | During outbreaks | Yes [20] | Yesb | Yes | ND |
| Contraindicated in pregnancy [9] | |||||
| Measles, mumps | … | No | Yesd | >100% for measles [21] | 9–12 mo for measles |
| Rubella | … | Yes | Yesb | ND | ND |
| Varicella | … | No | Yesd | ND | ND |
| Zoster | … | No | Yes | ND | ND |
| LAIV | … | No | Yesd | ND | ND |
| Vaccines under development | |||||
| Herpes simplex virus | ND | ND | ND | ND | ND |
| Cytomegaloviruse | ND | ND | ND | ND | ND |
| Respiratory syncytial virus | Third trimester | ND | ND | ND | ND |
| Group B Streptococcus | Third trimester | Yes [22] | Yes | 77% | 2 mo |
Adapted from Munoz and Englund [12].
Abbreviations: IgG, immunoglobulin G; LAIV, live attenuated influenza vaccine; ND, no data; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccine.
a Recommendations by the Centers for Disease Control for United States populations.
b No adverse events have been identified in registry programs of infants born to women inadvertently vaccinated during pregnancy.
c One of 81 infants of mothers vaccinated with yellow fever vaccine had evidence of yellow fever immunoglobulin M antibody in cord blood.
d Contraindicated due to live vaccine. However, no adverse events have been identified in registry programs of infants born to women inadvertently vaccinated during pregnancy.
e Target population for cytomegalovirus (CMV) vaccine would be adolescent or adult females prior to pregnancy to prevent primary CMV infection during pregnancy.