Table. Vaccines that are routinely recommended in pregnancy: inactivated vaccines
See also the disease-specific chapters in this Handbook for more details.
| Vaccine | Recommendation | Comments |
|---|---|---|
| Influenza (inactivated) | Recommended as a single dose for all pregnant women at any stage of pregnancy, particularly those who will be in the 2nd or 3rd trimester during the influenza season | Clinical trial data and observational studies show no increased risk of congenital defects or adverse effects in the fetuses of women who received influenza vaccine during pregnancy. Pregnancy increases the risk of severe influenza. Influenza immunisation protects the mother, and also protects her newborn baby in the first few months after birth.2 Inactivated influenza vaccines should be given in pregnancy instead of live attenuated influenza vaccines (LAIV). See Influenza. |
| dTpa (diphtheria-tetanus-acellular pertussis) | Recommended as a single dose between mid 2nd trimester and early 3rd trimester of each pregnancy (ideally at 20–32 weeks) | Vaccination during pregnancy reduces the risk of pertussis in pregnant women and their young infants by 90%.2,3 Studies have found no evidence of an increased risk of adverse pregnancy outcomes related to pertussis vaccination during pregnancy.4-9 Optimal protection is provided when the vaccine is given soon after 20 weeks and protection is lower if given within 2 weeks of birth. See Pertussis for more details. |
| Respiratory syncytial virus (Abrysvo only) | Recommended as a single dose from 28 weeks gestation (preferably between 28 and the end of 36 weeks gestation) in each pregnancy. |
A clinical trial found vaccine efficacy of 57% in infants born to mothers who received Abrysvo, against hospitalisation from RSV for up to 6 months.10 Post-licensure effectiveness data from the UK and Argentina, show a 72% to 82% reduction in the incidence of RSV-related lower respiratory tract infection hospitalisation, among infants during their first 6 months of life.11-14 There was no conclusive evidence of a significant difference in preterm births or other adverse pregnancy outcomes in the Abrysvo trials. Vaccination before 28 weeks is not recommended, as a precautionary approach due to an imbalance in the number of preterm births and neonatal deaths seen in low- and middle-income countries during another discontinued maternal RSV vaccine trial.15 Vaccination beyond 36 weeks is permitted; however, protection is lower if given within 2 weeks of birth. The recommendation for revaccination in subsequent pregnancies is based on immunologic principles and experience with other vaccines recommended in pregnancy as there is currently limited evidence. See respiratory syncytial virus (RSV) for more details. |