Vaccinations and planning for pregnancy

During pregnancy, you are more likely to catch certain illnesses as your immune system is naturally weaker than usual. Therefore, it is important that before becoming pregnant, you protect yourself against diseases that can harm you or your unborn baby. All women should have their required standard vaccinations before becoming pregnant, as not all vaccines are recommended during pregnancy.

Which vaccines should I have when planning for pregnancy?

Talk to your doctor to check that your vaccinations are up-to-date and to see which ones you might need. If you are unsure about your vaccination history, blood tests can be done to determine your immunity status (except for varicella testing, which can be unreliable). An assessment of your immunity status is advised for hepatitis B, measles, mumps, rubella and varicella.

Influenza vaccine

The influenza vaccine is recommended every year for women planning pregnancy, as it can be a very serious illness during pregnancy due to natural changes in your immune system.  The decision on whether you have the flu vaccine before or during pregnancy should be based on the timing of your pregnancy in relation to the influenza season.

Influenza vaccines in Australia are generally first made available and offered from March or April (although the exact timing will vary from year to year). However, recent evidence suggests that the immune protection provided from a flu vaccination may begin to wear off after three to four months. As influenza season typically occurs between June and September in most places in Australia, it is important not to receive the flu vaccination too early (which may be the case when the vaccine first becomes available). For those living in the tropics, cases are more likely to occur all year round.

Pneumococcal vaccine

Smokers, Aboriginal and Torres Strait Islanders, and those with chronic heart, lung or kidney disease, and/or diabetes, are encouraged to talk with their doctor about pneumococcal vaccination.

Rubella and chickenpox: Birth defect-causing infections

Two vaccine-preventable diseases deserve a special mention: rubella and chickenpox can cause significant birth defects in your baby.

Rubella infection (caused by the rubella virus) during pregnancy can result in significant life-long health problems for your baby, including deafness, blindness, heart problems, brain damage, growth problems, and swelling of vital organs. About nine in every ten babies whose mothers become infected with rubella in the first ten weeks of pregnancy will develop at least one of these problems. All women who are old enough to become pregnant and who are not yet immune should have a rubella vaccination. It is also recommended that all women be screened for rubella antibodies shortly before every pregnancy, whether or not they have had a positive rubella antibody test in the past.

Chickenpox infection (caused by the varicella virus) during the early stages of pregnancy can result in birth defects. If you are infected with the varicella virus near to when your baby is born, it may also result in a severe infection in your baby. You should receive a chickenpox vaccination before becoming pregnant if you have not previously had the chickenpox disease or the vaccine.

How long should I wait between vaccination and falling pregnant?

Women who receive live attenuated viral vaccines should wait at least 28 days after the vaccination before falling pregnant. This includes the measles, mumps and rubella (MMR) vaccine, as well as the chickenpox (varicella) vaccine.

Vaccinations for close household contacts and carers

Everyone who is going to be around a baby (parents, siblings, grandparents, etc) should keep up to date with their age-appropriate vaccinations. Family members can prevent the spread of disease to the baby and mother by making sure they themselves are immunised.

Newborns are most likely to catch respiratory illness from someone at home, so all household contacts and carers should be vaccinated against whooping cough (pertussis) and influenza. Babies have an increased risk of developing life-threatening complications from both whooping cough and influenza, and making sure all relevant family members are immunised can provide important indirect protection. It is important to note, however, that this is not the only strategy for protecting both baby and mother from these two respiratory illnesses. Both of these vaccines are safe to be administered during pregnancy, allowing short-term immune protection to be passed from the mother to the baby in the form of antibodies.

More information

For more information about vaccinations in pregnancy and in children in Australia, see Vaccinations.

References

1. Immunisation and pregnancy [online]. Healthdirect Australia; 2017 [cited 5 June 2018]. Available from: [URL link]
2. Immunisation for pregnancy [online]. Australian Government Department of Health; 2018 [cited 5 June 2018]. Available from: [URL link]
3. The Australian Immunisation Handbook 10^th edition. Vaccination of women who are planning pregnancy, pregnant or breastfeeding, and preterm infants [online]. Australian Government Department of Health; 2017 [cited 5 June 2018]. Available from: [URL link]
4. Rubella (German measles) [online]. Australian Government Department of Health; 2018 [cited 5 June 2018]. Available from: [URL link]
5. Rubella immunisation service [online]. Australian Government Department of Health; 2017 [cited 5 June 2018]. Available from: [URL link]
6. Australian Immunisation Handbook 10^th edition. Rubella [online]. Australian Government Department of Health; 2017 [cited 5 June 2018]. Available from: [URL link]
7. Create a circle of protection around babies [online]. Centers for Disease Control and Prevention; 2016 [cited 5 June 2018]. Available from: [URL link]
8. Maternal vaccines: Part of a healthy pregnancy [online]. Centers for Disease Control and Prevention; 2016 [cited 5 June 2018]. Available from: [URL link]
9. The Australian Immunisation Handbook 10^th edition. Influenza [online]. Australian Government Department of Health; 2017 [cited 5 June 2018]. Available from: [URL link]
10. The Australian Immunisation Handbook 10^th edition. Pertussis [online]. Australian Government Department of Health; 2017 [cited 5 June 2018]. Available from: [URL link]
11. Timing of influenza vaccination critical to ensuring highest level of protection for Australian patients [online]. The Royal Australian College of General Practitioners; 2018 [cited 5 June 2018]. Available from: [URL link]