Pregnancy

About

Immunisation can protect a pregnant woman and her unborn baby from infectious diseases. Some infectious diseases can cause serious harm to pregnant women or their unborn babies. Ideally, women should be up to date with their immunisations before they become pregnant and all women should receive influenza, whooping cough and Pfizer/Moderna COVID-19 vaccines during every pregnancy.

Vaccines can protect against many infectious diseases such as chickenpox, influenza, measles, mumps, rubella (German measles), diphtheria, tetanus, whooping cough (pertussis), pneumococcal disease, hepatitis B, and now COVID-19. Serious side effects or allergic reactions to vaccines are rare.

Planning a pregnancy

Have a discussion with your doctor about whether you are up-to-date with your vaccinations before you become pregnant. If you are unsure if you have had any of the vaccines below, your doctor can order a blood test which can check whether you have antibodies^[1] that can fight that virus:

• Hepatitis B
• Measles
• Chicken pox
• Rubella

If you have not already had the seasonal influenza vaccine, then it is also recommended.

Avoid pregnancy within 28 days of having a live vaccine. Measles, chicken pox and rubella vaccines are live vaccines.

COVID-19 vaccine is also now recommended for women planning to become pregnant.

Recommended vaccines for pregnant women

In Australia, the following vaccines are recommended in each pregnancy:

• Whooping cough – given mid 2nd trimester and early 3rd trimester (ideally at 20-32 weeks) as a single dose
• Influenza – given at any time during pregnancy as a single dose
• Pfizer or Moderna COVID-19 vaccines – given at any stage of pregnancy as 2 doses 3-6 weeks apart for Pfizer and 2 doses 4-6 weeks apart for Moderna

Risk of infectious diseases during pregnancy

If a pregnant woman becomes infected with some diseases, her unborn baby can be harmed. Newborn children can also be harmed if their mothers have an infection.

Examples of infections that are harmful to babies include:

• Rubella – can cause defects in the brain, heart, eyes and ears of the baby and increases the risk of miscarriage and stillbirth.
• Chickenpox – can cause defects in the brain, eyes, skin and limbs of the baby.
• Measles – increases the risk of miscarriage, premature birth or stillbirth.
• Mumps – increases the risk of miscarriage.
• Hepatitis B – can cause acute hepatitis B infection that can be passed on to the baby during birth, and both mother and baby have the potential to become ‘carriers’ of hepatitis B (the virus is not cleared from the body).
• Influenza – increases the risk of miscarriage, premature birth or stillbirth and increases the risk of severe illness and death in the mother.
• Whooping cough – can cause pneumonia (infection causing inflammation of air sacs in the lungs), seizures, encephalopathy (damage to the brain) and the death of the baby.
• COVID-19 – increases the chance of the unborn baby being born prematurely (before 37 weeks of pregnancy) and having to go to hospital for care. The baby is also more likely to show distress during birth or to be still born.

COVID-19 vaccination and pregnancy

Pregnant women who get COVID-19 have a higher chance of being hospitalised and ending up in the Intensive Care Unit.

There is evidence from other countries to show that the Pfizer COVID-19 and the Moderna COVID-19 vaccines are safe in pregnant women.

A US study of more than 35,000 pregnant women showed that the side effects after vaccination in pregnant and non-pregnant women were similar. The Pfizer/Moderna vaccines are the preferred vaccines for pregnant women.

If Pfizer or Moderna are not available, AstraZeneca can be considered if the benefits to the individual outweigh the potential risks.

Breastfeeding and vaccinations

Breast feeding women can safely receive most vaccines.

The seasonal influenza vaccine is recommended if not already received.

Research shows that the Pfizer COVID-19 or the Moderna COVID-19 vaccine can be given safely to breastfeeding women.