Table 1.
Vaccines recommended, contraindicated, and available in special circumstances during pregnancy.
| Vaccine | Type | Comments | References |
|---|---|---|---|
| Recommended | |||
| IIV (Inactivated Influenza Vaccine) | Inactivated | For all pregnant women at any time of gestation, as well as for all women planning to get pregnant or in the postpartum phase/breastfeeding during flu season. | (114) |
| Tdap (Tetanus, Diphtheria, Pertussis) vaccine | Inactivated | For all pregnant women during each pregnancy, regardless of personal history of previous vaccine, at 27–36 weeks of gestation (although it could be given at any time during pregnancy). Women who were not vaccinated during pregnancy should receive Tdap vaccine at postpartum. | (132) |
| Available in special circumstances | |||
| Hepatitis A | Inactivated | In case of high-risk of infection (i.e., due to permanence in highly or intermediately endemic regions) the risk-benefit ratio should be considered. | (144) |
| Hepatitis B | Subunit | If case of high risk of infection (among risk factors: sexual promiscuity in the past 6 months, HbsAg-positive partner, intravenous drug abuse) to protect both mother and fetus. | (145) |
| Meningococcal ACWY | Inactivated | In case of high-risk of infection (i.e., due to close contact to affected patients, in addition to chemoprophylaxis, and to permanence in endemic/hyperendemic regions in specific immunocompromised hosts) the risk-benefit ratio should be considered. | (145) |
| Meningococcal B | Inactivated | In case of high-risk of infection (i.e., due to close contact to affected patients) the risk-benefit ratio should be considered. Main role of chemoprophylaxis. |
(146) |
| Pneumococcal (PPSV23) | Inactivated | In case of high-risk of infection for women with certain chronic health conditions | (145) |
| Pneumococcal (PCV13) | Inactivated | In case of high-risk of infection, only when benefits outweigh risks (after consultation with patient's health care provider) | (145) |
| Japanese encephalitis | Inactivated | In case of high-risk of infection (i.e., before traveling to endemic regions, during outbreak) the risk-benefit ratio should be considered. Data on the safety, immunogenicity, and efficacy are scarce. | (147) |
| Tick- borne encephalitis | Inactivated | In case of high-risk of infection during outbreaks in endemic regions | (148) |
| Rabies | Inactivated | Post-exposure prophylaxis and pre-exposure in case of high-risk | (149) |
| Anthrax | Adsorbed | Post-exposure prophylaxis (plus 60 days of antimicrobial treatment) | (150) |
| Polio | Inactivated | In case of high-risk of infection (during outbreaks or before traveling in endemic regions) when the benefits outweigh the risks. | (151) |
| Cholera | Inactivated | In case of high-risk of infection (during cholera outbreaks and traveling in endemic regions) | (152) |
| Yellow fever | Live attenuated | Generally not recommended; in case of high-risk of infection (during outbreaks and for traveling in endemic regions) the risk-benefit ratio should be considered. | (153) |
| Typhoid | Inactivated | In case of high-risk of infection (during outbreaks, high exposure risk) | (146) |
| Small pox | Live attenuated | Fetus could be exposed to small but serious potential risk. The vaccine should not be administered in pregnant or periconceptual women except in case of high risk of contracting the disease, when the benefits outweigh the risks. |
(146) |
| Contraindicated | |||
| Measles-mumps-rubella | Live attenuated | Contraindicated during pregnancy. It could be administered during post-partum in rubella seronegative women. No case of Congenital Rubella Syndrome (CRS) has been detected after accidental vaccination in pregnant women. | (146) |
| Varicella | Live attenuated | Contraindicated during pregnancy. It could be administered during post-partum in varicella seronegative women. No case of Congenital Varicella Syndrome (CVS) has been detected after accidental vaccination in pregnant women. | (146) |
| Bacillus Calmette- Guèrin (BCG) vaccine | Live attenuated | Contraindicated during pregnancy. | (146) |
| Live zoster vaccine | Live attenuated | Contraindicated during pregnancy. | (146) |
| Live Attenuated Influenza Vaccine (LAIV) | Live attenuated | Inactivated vaccine available and recommended in pregnant women | (146) |
| Oral poliovirus vaccine | Live attenuated | Inactivated vaccine available | (146) |
| Typhoid live oral vaccine | Live attenuated | Inactivated vaccine available | (146) |
| HPV vaccine | Inactivated | Non-recommended. In case of incomplete immunization before pregnancy, it could be completed after delivery. | (146) |