Vaccines during pregnancy: which can and which can not be taken | Drauzio Varella

Some immunizers are advisable to protect the mother and baby, but there are also contraindications. Know the recommendations.

Vaccination is an important protection tool for pregnant women and their babies. This is because the pregnant woman during pregnancy is more prone to contamination with infectious agents as her immune system undergoes several changes.

If the mother is contaminated, the health of the fetus can also be compromised, which in some cases leads to malformations, premature birth, abortion and even fetal death. After birth, the baby’s immunity is still quite early; therefore, their greatest defenses come from breastfeeding and vaccinations.

If you intend to become pregnant, it is ideal that the pregnant woman can anticipate and take the immunizations off Adult vaccination calendar. If this is not possible, it is necessary to be aware of the vaccines that may or may not be used at this stage.

Vaccines that pregnant women should take

Currently, the Brazilian Society of Immunizations (SBIm) recommends three vaccines during pregnancy. Are they:

Influenza (influenza)

Due to low immunity, pregnant and postpartum women are more susceptible to severe forms of flu, and is even considered a risk group for the disease. Therefore, it is important to get the flu vaccine at any time during pregnancy.

Even if the pregnant woman has already taken the immunizer in a previous pregnancy, it needs to be reapplied. If you can not get the vaccine during the nine months, you can still get it within 45 days of birth.

Hepatitis B

If the mother is infected with Hepatitis B for a period close to birth, the baby is at risk of developing chronic liver infection. Therefore, this is another vaccine that can not be omitted by pregnant women.

The immunizer should be applied from the second trimester of pregnancy in a 3-dose regimen. There is an interval of 1 month (30 days) between the first and second dose; and between the first and third 6 months (180 days). If the woman has already been immunized before, a new booster dose is not necessary.

Bacterial triple (dTpa)

This vaccine protects against diphtheria, tetanus and pertussis. The application is essential to prevent transmission to the newborn and protect him in the first months of life until he is old enough to also be immunized.

The administration of dTpa depends on each situation:

  • For pregnant women who have previously been vaccinated with all three doses: a dose of dTpa from the 20th week of pregnancy;
  • For pregnant women who have already received a dose: a dose of dTpa from the 20th week of pregnancy and a dose of the adult couple (dT) with a minimum interval of 1 month between them;
  • For pregnant women who have already received two doses: a dose of dTpa from the 20th week of pregnancy;
  • For pregnant women who have not been vaccinated with any dose: one dose of dTpa from the 20th week of pregnancy and two doses of dT with a minimum interval of 1 month between them.

dT also protects against tetanus and diphtheria. If it is not immunized during pregnancy, a woman should be vaccinated as soon as possible after giving birth.

Covid-19

Pregnant and postpartum women are more susceptible to developing severe forms of Covid-19. Given the situation of the pandemic in Brazil and the circulation of Sars-CoV-2, the Ministry of Health therefore recommends the primary vaccination plan for this group: two doses plus a booster dose after an interval of 4 months.

Ideally, the immunizer should not contain the viral vector, as is the case with CoronaVac, manufactured by the Butantan Institute, and Pfizer. For pregnant women who received the first dose of AstraZeneca, the Ministry of Health indicates the continuation of the vaccination plan with Pfizer.

Although these vaccines have not been tested in pregnant and postpartum women during the clinical trial phase, evidence shows that pregnant women who were already immunized had no complications and had a satisfactory course of pregnancy.

See also: Doctors insist pregnant women be vaccinated against covid-19

Vaccines that pregnant women can take in special situations

There are also recommended vaccinations for pregnant women on specific occasions:

Hepatitis A and Hepatitis A and B

In Brazil, the circulation of the transmitting agent of hepatitis A it is frequent. Therefore, pregnant women who live or travel to places with a high incidence of the disease should consider taking the vaccine. There are no risks as the immunizer contains the inactivated virus.

In the case of the hepatitis A vaccine, there are two doses at 6-month intervals. Combination vaccination against hepatitis A and B is performed in the same regimen for children under 16 years and in three doses from that age, with intervals of 1 month between the first and second dose and 6 months between the first and third.

pneumococcus

Pneumococcal diseases are caused by the bacteria Streptococcus pneumoniae. This is the case with pneumonia, meningitis and otitis. When the bacteria invade parts of the body that are normally free of microorganisms, such as the bloodstream or the tissues around the spinal cord, it results in invasive pneumococcal disease (IPD).

If the pregnant woman is at risk for IPD, it is recommended that she take the pneumococcal conjugate vaccines: VPC13 or VPP23. The doctor sets the dosing regimen.

Meningococcal conjugate ACWY and meningococcus B

THAT meningococcal meningitisis in turn caused by the bacteria neisseria meningitidis and causes inflammation of the membranes that cover the brain. The indication of the vaccine against the disease depends on the epidemiological situation in the region and the presence of risk comorbidities.

The meningococcal ACWY conjugate vaccine is given in a single dose and the meningococcal B vaccine in two doses with an interval of 1 to 2 months. Both contain the inactivated virus, so there is no contraindication.

Yellow fever

Usually the vaccine yellow fever is contraindicated in pregnant women. However, when the risk of infection is high, it can be used depending on medical assessment.

Dosage is single, but another application may be considered depending on the epidemiological situation. After birth, it is contraindicated for the mother until the baby is 6 months old. If this is not possible, she should stop breast-feeding for ten days.

See also: What prenatal examinations should pregnant women perform?

Vaccines that pregnant women can not take

Immunizers made with attenuated but still living viruses or bacteria should not be taken by pregnant women. If a woman happens to be vaccinated without knowing she is pregnant, there is no need to take special precautions, but medical follow-up is recommended.

Dengue

One of them is the vaccine dengue, contraindicated during pregnancy and lactation. Women who are seronegative (without previous contact with the virus), immunosuppressed or allergic to any of the components of the vaccine should not take it either.

triple viral

MMR is the vaccine that protects against measles, mumps and rubella. It should not be administered during pregnancy, only during childbirth and during breastfeeding.

HPV

The vaccine mod HPV It is responsible for preventing the development of some cancers, such as uterus, vulva and vagina. It can only be taken during childbirth and during breastfeeding, but not during pregnancy. If the woman has started the vaccination plan before pregnancy, she should suspend it until the postpartum period.

chickenpox (chickenpox)

This is another immunizer that is only allowed during the postpartum period and during breastfeeding as it is contraindicated during pregnancy. If the woman is not immune to chickenpoxshe should be vaccinated as soon as possible immediately after giving birth.

See also: Services available in SUS for a good birth experience

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