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Table. Vaccines that are contraindicated in pregnancy: live attenuated vaccines

Vaccine Recommendation Comments
BCG (bacille Calmette–Guérin) (live attenuated bacterial vaccine) Contraindicated The risk is only hypothetical. BCG vaccine has not been shown to cause fetal damage.2,35
Oral typhoid (live attenuated bacterial vaccine) Contraindicated No data are available on the safety of oral typhoid vaccine in pregnant women. However, because of the theoretical risk of using a live attenuated vaccine, pregnant women should receive inactivated typhoid Vi polysaccharide vaccine instead36 (see Table. Vaccines that are not routinely recommended in pregnancy: inactivated bacterial vaccines).
Japanese encephalitis (Imojev) (live attenuated viral vaccine) Contraindicated No data are available about using Imojev vaccine in pregnant or breastfeeding women. However, because of the theoretical risk of using a live attenuated vaccine, pregnant women should receive inactivated Japanese encephalitis (JEpect) instead. Women of child-bearing age should avoid pregnancy for 28 days after vaccination with Imojev.
MMR (measles-mumps-rubella) or MMRV (measles-mumps-rubella-varicella) (live attenuated viral vaccines) Contraindicated
  • The risk is only hypothetical. Despite concerns that live attenuated rubella vaccine virus might cause congenital abnormalities, pregnant women have received rubella vaccine (either monovalent or as MMR, and usually inadvertently) without harm to the fetus.37,38 Even though rubella vaccine virus can infect the fetus, there is no evidence that it causes congenital rubella syndrome in infants.39 Women who receive rubella vaccine during pregnancy do not need to consider terminating the pregnancy.38
  • As a precautionary measure women of child-bearing age should avoid pregnancy for 28 days after vaccination.
  • All pregnant women are recommended to be tested for immunity to rubella. Susceptible women should receive rubella vaccine as soon as possible after delivery and have their serological status checked after vaccination.
Rotavirus (live attenuated viral vaccine) Contraindicated Rotavirus vaccines are not registered or recommended for use in adolescents or adults.
Varicella (live attenuated viral vaccine) Contraindicated The risk of congenital varicella syndrome is only hypothetical. Newborns of women who have inadvertently been given varicella vaccine in early pregnancy have not had congenital varicella syndrome.40 Women of child-bearing age should avoid pregnancy for 28 days after vaccination.
Zoster (Zostavax) (live attenuated viral vaccine) Contraindicated The risk of disseminated zoster is only hypothetical. Women of child-bearing age are unlikely to be eligible for vaccination, because zoster vaccine is registered for use in people ≥50 years of age. If women of child-bearing age have inadvertently been given zoster vaccine, they should avoid pregnancy for 28 days afterwards.

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