Table. Vaccines that are not routinely recommended in pregnancy: inactivated viral vaccines
| Vaccine | Recommendation | Comments |
|---|---|---|
| COVID-19 | Not routinely recommended in previously vaccinated women, but can be considered on an individual basis. Unvaccinated women are recommended to receive COVID-19 vaccine. Vaccine can be given at any stage of pregnancy. | Safe use of mRNA COVID-19 vaccines in pregnancy has been demonstrated.21 See COVID-19. |
| Hepatitis A |
Not routinely recommended. Pregnant women can receive hepatitis A vaccine if:
|
Limited data are available. Pregnant women who are non-immune and at increased risk for hepatitis A should receive hepatitis A vaccine.2,22 |
| Hepatitis B | Not routinely recommended. Susceptible pregnant women can receive hepatitis B vaccine if it would otherwise be recommended (eg as post-exposure prophylaxis in a non-immune pregnant woman after a significant exposure to hepatitis B). | Limited data are available. Women who are non-immune and at increased risk for hepatitis B should receive hepatitis B vaccine.23 |
| Mpox vaccine (JYNNEOS) | Not routinely recommended. Post-exposure preventive vaccination during pregnancy may be considered after a risk–benefit assessment. |
MVA-BN mpox vaccine has not been formally evaluated in pregnant or lactating women, but limited animal studies have identified no vaccine-related fetal malformations. No adverse events have been reported from use of MVA-BN in pregnant women, though data are limited to fewer than 300 pregnancies.24 Post-exposure preventive vaccination during pregnancy may be considered after a risk–benefit assessment. Any decision on the use of vaccine should take into account the likelihood of mpox disease in pregnancy, and the risks to both the mother and fetus. |
| Japanese encephalitis (JE) (JEspect inactivated vaccine) | Not routinely recommended. Pregnant women at high risk of acquiring JE can receive inactivated JE vaccine. | Limited data are available. JE infection is associated with miscarriage. Assess whether pregnant women who are at high risk of JE need vaccination. If the risk of JE is high, pregnant women should receive the inactivated vaccine, JEspect (not Imojev, which is a live attenuated vaccine).2,25 |
| IPV (inactivated poliovirus) | Not routinely recommended. Pregnant women at high risk of poliovirus exposure (eg travelling to endemic countries) can receive IPV vaccine. | Limited data suggest that polio vaccination during pregnancy is unlikely to harm the fetus.20 Pregnant women should receive IPV vaccine only when clearly indicated. |
| Rabies | Pregnant women can receive rabies vaccine if required, such as for post-exposure prophylaxis. | Limited data suggest that rabies vaccination during pregnancy is unlikely to harm the fetus.26-29 Pregnancy is never a contraindication to rabies vaccination if there is a significant risk of exposure (related to occupation or travel), or if there has been a potential exposure to rabies virus, Australian bat lyssavirus or another bat lyssavirus.2,30,31 |
| Zoster (recombinant zoster vaccine [Shingrix]) | Not routinely recommended. Pregnant women at high risk of severe outcomes from herpes zoster (eg severe immunocompromise) can receive Shingrix. | There are no data on the use of Shingrix in women who are pregnant or breastfeeding. As the vaccine is not preventing infection, but reactivation of endogenous virus, women of child-bearing age who are immunocompromised and assessed to benefit from zoster vaccination, are recommended to receive Shingrix vaccine either: before a planned pregnancy, or as soon as practicable after delivery. |
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