Pregnancy is a period when the immune system is weakened, so the susceptibility to infectious diseases increases. Vaccination of expectant mothers plays an important role in immunizing the fetus in the womb and the newborn after birth against preventable infections.
The main purpose of vaccines is to protect expectant mothers against infectious diseases for which they are at high risk. Thanks to vaccination, severe conditions such as miscarriage, developmental delay in the baby and mental retardation can also be prevented. Although ideally, vaccinations are completed before pregnancy, vaccinations are also carried out during pregnancy. Acıbadem Dr. Şinasi Can (Kadıköy) Hospital Gynecology and Obstetrics Specialist Assoc. Dr. Şafak Yılmaz Baran stated that each vaccine has its own specific application schedule and said, “Except for live vaccines, all vaccines that can be administered during pregnancy can be administered at any week of pregnancy, including the first trimester of pregnancy. However, since the first 3 months of pregnancy cover the period of organ development, it is preferred to apply the vaccines after 3 months, if possible. Noting that the vaccines that should be administered according to the standard vaccination schedule during pregnancy are administered in insufficient doses and for a period of time, their effectiveness will decrease. Dr. Şafak Yılmaz Baran said, “For example, in the tetanus vaccine, the vaccine dose must be completed at least 2 weeks before the birth. If sufficient time is not provided, the mother and baby with a single dose of tetanus vaccine are at risk for this disease. gives the information.
WHICH VACCINE SHOULD BE DONE WHEN?
The American Society of Obstetrics and Gynecology (ACOG) routinely recommends tetanus, diphtheria, pertussis, hepatitis B and influenza vaccines for all pregnant women. These vaccines, which have a good safety profile in pregnancy, can provide passive protection to the newborn and do not cause abortion. Gynecology and Obstetrics Specialist Assoc. Dr. Şafak Yılmaz Baran explains the vital importance of vaccinations during pregnancy as follows:
INFLUENZA
Influenza vaccine is another important vaccine recommended during pregnancy. Assoc. Dr. Şafak Yılmaz Baran draws attention to the fact that influenza infection has a different feature than hepatitis B infection, as it can progress more severely during pregnancy, and says, “Because influenza can cause an increase in lung and heart problems, hospitalization and miscarriage in the mother.” In addition, antibodies from the influenza vaccine during pregnancy protect the baby by crossing the placenta. In this way, influenza vaccine provides protection not only to expectant mothers but also to newborns under 6 months old.
When should it be done?
The General Directorate of Primary Health Care Services of the Ministry of Health recommends influenza vaccination to pregnant women after the 14th week of pregnancy, during the influenza season (in September-April).
COVID – 19 VACCINE
In studies conducted during the Covid-19 pandemic, it was observed that this infection was more severe in expectant mothers than in non-pregnant women. As a result of the studies; It has been determined that inactive Covid-19 vaccine applications are effective and safe for expectant mothers and newborns at every stage of pregnancy. For this reason, Covid-19 vaccine is recommended to expectant mothers in line with the recommendation of the Turkish Ministry of Health and Obstetrics and Gynecology Associations.
When should it be done?
There is no evidence that it is necessary to delay the Covid-19 vaccine until after the first 12 weeks of pregnancy. Therefore, the vaccine can be administered at any stage of pregnancy. One dose of Covid-19 vaccine provides good protection against the original alpha variant, but two doses are required to maintain good immunity with the delta variant of the virus. The second dose is administered 8 weeks after the first dose. A dose booster (third dose) is recommended to provide the best protection against the Omicron variant.
TETANOS – DIPHTHERIA VACCINE
Tetanus infection; It can develop as a result of cutting or dressing the umbilical cord of the baby (especially in home births) with an unhygienic tool such as a knife, in cases such as injuries, bites, traffic accidents and burns during pregnancy. Thanks to vaccination, the severity of tetanus infection that can occur during pregnancy decreases, and the risk of premature birth and stillbirth that may develop due to this decreases. In addition to these, neurological problems that may develop in the baby can also be prevented.
Diphtheria is a disease that can lead to fatal consequences in the respiratory tract. The diphtheria toxoid vaccine is administered together with the tetanus vaccine in the vaccination calendar since childhood. With the widespread vaccination program, it has started to be seen very rarely around the world. However, since life-long immunity cannot be provided by vaccination in childhood, the application is repeated with tetanus vaccine in case of pregnancy.
When should it be done?
According to the tetanus-diphtheria vaccine calendar; The first dose of the vaccine is administered at the 4th month of pregnancy or, if not yet, at the first examination after the 4th month. The second dose is administered at least 4 weeks after the first dose, thus providing 1-3 years of protection. With this; 5 years after the third dose administered at least 6 months after the second dose, and 10 years with the vaccine administered at least one year after the third dose or in the next pregnancy. Again, according to the vaccination calendar; Protection is provided throughout the childbearing age with the vaccine administered at least one year after the 4th dose or in the next pregnancy. In women who have been vaccinated with five full doses before, if no additional dose has been given in the last 10 years, a single dose vaccination is sufficient, preferably between 20-36 weeks of pregnancy.
HEPATITIS B VACCINE
Hepatitis B vaccine can be given if the mother-to-be has no previous immunity. Hepatitis B infection during pregnancy is not expected to be more serious than in the normal population. However, there is a risk of transmission of infection to the newborn. Therefore, vaccination of expectant mothers who have not previously been immune to hepatitis B infection during pregnancy reduces the risk of transmission of hepatitis B virus, which can cause serious problems in the newborn.
When should it be done?
The vaccine administered at 0, 1 and 6 months of pregnancy protects both the mother and the baby after birth.
whooping cough vaccine
The pertussis vaccine is included in the childhood immunization schedule, but it does not provide lifelong immunity. Therefore, additional doses are recommended for the high-risk patient group (healthcare workers, people living with immunocompromised people, living or working with young children).
When should it be done?
After the 6th month of pregnancy, it is recommended to apply the pertussis vaccine to protect the unborn baby. In this way, the baby can be provided with passive protection in the early stages.
Source: (BYZHA) – Beyaz News Agency
