Table. Vaccines that are not routinely recommended in pregnancy: inactivated bacterial vaccines

dT (diphtheria-tetanus)

Not routinely recommended. Pregnant women can receive dT vaccine under certain circumstances, such as to manage a tetanus-prone wound.

Many pregnant women have received tetanus- and diphtheria-containing vaccines, with no increased risk of congenital abnormalities in their fetuses.^11-13 See Diphtheria and Tetanus for more details.

Cholera (oral)

Not routinely recommended

There are limited data on the safety of oral cholera vaccine in pregnancy.¹⁴

Hib (Haemophilus influenzae type b)

Not routinely recommended. Pregnant women can receive Hib vaccine if they are at increased risk of Hib disease (eg women with asplenia).

Limited data suggest that Hib vaccination during pregnancy is unlikely to harm the fetus.¹⁵

MenB (meningococcal B) or MenACWY (quadrivalent meningococcal conjugate)

Not routinely recommended. Pregnant women can receive meningococcal vaccines if they are at increased risk of the disease (see Meningococcal disease).

There are limited data on the safety of meningococcal conjugate vaccines in pregnancy.¹⁶ Where clinically indicated, pregnant women can receive these vaccines.¹⁷

PCV (pneumococcal conjugate vaccine) - 13vPCV, 15vPCV [if ≥18 years of age] or 20vPCV [if  ≥18 yearsof age]

Not routinely recommended. Pregnant women can receive a pneumococcal conjugate vaccine (13vPCV, 15vPCV [if ≥18 years of age] or 20vPCV [if ≥18 years of age]) if they have very high risk of invasive pneumococcal disease (IPD) (eg those who are asplenic or immunocompromised, or have cerebrospinal fluid leak) (see Pneumococcal disease).

No data are available. Vaccination with 13vPCV, 15vPCV or 20vPCV during pregnancy has not been evaluated, although it is unlikely to result in adverse effects. Women of child-bearing age with known risk factors for IPD (including smokers) can receive the vaccine before pregnancy or as soon as practicable after delivery (see Pneumococcal disease).

23vPPV (23-valent pneumococcal polysaccharide)

Not routinely recommended. Pregnant women can receive 23vPPV if they have very high risk of IPD (eg those who are asplenic or immunocompromised, or have cerebrospinal fluid leak) (see Pneumococcal disease).

Pregnant women have received 23vPPV during clinical trials¹⁸ with no evidence of adverse effects. However, data are limited. Women of child-bearing age with known risk factors for IPD (including smokers) can receive the vaccine before pregnancy or as soon as practicable after delivery (see Pneumococcal disease).

Q fever

Not routinely recommended

Safe use of Q fever vaccine in pregnancy has not been established.

Typhoid Vi polysaccharide

Not routinely recommended. Pregnant women can receive typhoid Vi polysaccharide vaccine if they are travelling to endemic countries where water quality and sanitation are poor.

No data are available.¹⁹ Vaccination with typhoid Vi polysaccharide vaccine during pregnancy has not been directly evaluated, although it is unlikely to result in adverse effects.