Influenza |
Pregnancy-induced changes in immune response and cardiopulmonary adaption; lack of passive immunity |
Pneumonia with severe course in pregnancy (especially in the second and third trimester), increased risk of hospitalization, need of intensive care treatment, death |
Abortions, preterm births and stillbirths |
Increased complication, hospitalization and mortality rates among infants aged <6 months |
Inactivated split virus vaccines or subunit vaccines |
Vaccination with a quadrivalent IIV with current, WHO-recommended antigen combination for all pregnant women from second trimester, in case of increased health risk due to an underlying disease from first trimester |
Pertussis |
Missing or low passive immunity in infants |
Not influenced by pregnancy |
Dependent on the severity of the maternal disease |
Increased risk of serious complications, hospitalization, death in newborns and infants aged < 6 months |
Inactivated combination vaccine (Tdap, Tdap-IPV) |
Vaccination in each pregnancy between WG 28 and 32; if increased risk of preterm delivery, in the second trimester |
Measles |
First infection in pregnancy; lack of passive immunity |
Potentially increased complication rate in pregnancy (pneumonia, hepatitis, encephalitis; anecdotal case reports) |
Potentially increased risk of abortions and preterm births (anecdotal case reports) |
Neonatal measles, increased risk of complications and SSPE (especially with early postnatal disease) |
Live attenuated vaccine (MMR) |
Contraindicated in pregnancy |
Rubella |
Vertical transplacental transmission |
Not influenced by pregnancy |
Spontaneous abortion, preterm birth, stillbirth |
Congenital rubella syndrome (malformations), developmental disorders, late sequelae |
Live attenuated vaccine (MMR) |
Contraindicated in pregnancy |
Varicella |
First infection in pregnancy; vertical transplacental transmission |
Complicated by varicella pneumonia, severe course in pregnancy (anecdotal case reports) |
Spontaneous abortion, stillbirth (anecdotal case reports) |
Congenital varicella syndrome/embryofetopathy with skin changes, neurological, ocular and skeletal anomalies, as well as other malformations; neonatal varicella with severe course and high mortality in case of peripartum infection |
Live attenuated vaccine |
Contraindicated in pregnancy |