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

Hepatitis A

Not routinely recommended. Pregnant women can receive hepatitis A vaccine if:

• they are travelling to areas of moderate to high endemicity
• they have increased risk of exposure through lifestyle factors or exposure to a person known to have acute hepatitis A
• severe outcomes may be expected (eg women with pre-existing liver disease)

Limited data are available. Only pregnant women who are non-immune and at increased risk for hepatitis A should receive hepatitis A vaccine.²⁰

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. Only women who are non-immune and at increased risk for hepatitis B should receive hepatitis B vaccine.²¹

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).²²

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.¹⁹Pregnant 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.^23-26 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.^27,28