International Prenatal Infection Prevention Month: Dr. Maya Barsky Speaks about the Importance of Maternal Immunizations

For International Prenatal Infection Prevention Month, I wanted to take a moment and discuss maternal immunizations. It is important before getting pregnant to know your rubella and varicella status. If not immune, please get these vaccines prior to pregnancy and wait one month after getting the recommended regimen before trying to conceive. These infections can cause fetal malformations. This includes cataracts, deafness, heart defects and developmental delay for Congenital Rubella Syndrome, and eye, limb, skin, or brain abnormalities with Congenital Varicella Syndrome. The good news is that the chance of these infections is so rare because of widespread immunization. However, the less people vaccinate the more of a threat this becomes. Given that they are live vaccines it is not safe to be vaccinated with rubella or varicella when pregnant— This means that knowing if you need the vaccine before pregnancy is key.

All other vaccines should be up to date and pregnancy does not preclude you from receiving them, including the flu vaccine during flu season (making sure it is not the nasal live vaccine). TDAP is especially important when pregnant and with each pregnancy at around 28 weeks gestation, because you can confer passive immunity to your newborn against pertussis (or whooping cough) through your own antibodies.

Finally, and probably most pertinent right now, is the COVID vaccine. Currently the two vaccines available are mRNA based and are not live vaccines, therefore are not contraindicated in pregnancy.  While data is lacking in patients who are pregnant or those trying to conceive current studies are on the way regarding safety data of vaccination in these populations. The American Society for Reproductive Medicine (ASRM), the CDC, the Society for Maternal-Fetal Medicine (SMFM), and the American College of Obstetricians and Gynecologists (ACOG) indicate that the COVID vaccine should not be withheld from patients who are planning to conceive, who are currently pregnant, or who are lactating.  Importantly, infection with COVID-19 during pregnancy can potentially increase risk of preterm delivery, ICU admission, and mechanical ventilation. So, this is definitely worth a conversation with your doctor. Regarding fertility specifically, biologically there is no evidence that these vaccines should at all interfere with fertility, and any claim to this is baseless.