Vaccines In Pregnancy

Are they safe and what are the benefits?

Contracting certain diseases, infections and viruses in pregnancy can lead to serious health complications for mother and baby. Healthcare providers do recommend vaccines for expectant moms, to help lower the risk for serious illness with specific diseases. Not all vaccines are advocated. Those that contain inactivated viruses or bacteria (pathogens) are considered safe, while those that contain live pathogens aren’t recommended.

The Immune System and Vaccines

Pathogens can invade the body and cause disease – they include viruses, bacteria, fungi and parasites. Your immune system is your defence team against these pathogens. It’s a group of organs and cells that work together to fight off an infection.

When an unknown pathogen first enters the body, the immune system may not initially recognise it as an invader. The pathogen starts reproducing and infection begins. Once the immune system recognises the pathogen as  a threat, it starts producing antibodies against it. Antibodies are special proteins the body uses to fight disease causing pathogens. Chills and/or a fever are signs of an immune response. The immune system ‘remembers’ the pathogen and will react quicker should a future infection occur.

A vaccine is given to stimulate the immune system to recognise the invader more quickly and begin fighting it at a much earlier stage. Vaccines are effective at producing an immune response, in a safe way, and without the complications of an actual illness. Scientists have developed a number of different types of vaccines that work in different ways. Three types are safe in pregnancy.

• Inactivated vaccines contain a dead or inactivated version of a virus or bacteria that causes a specific disease. Examples are the flu or Tdap vaccine. These vaccines need periodic booster shots to be effective.
• mRNA vaccines are the latest in vaccine technology. The vaccine contains mRNA (messenger nucleic acid) which gives the body’s cells an instruction to make a small part of the virus’s protein. The immune system will recognise this protein as an invader and start to produce antibodies to fight it. Should the immune system encounter the actual virus in the future, it remembers the protein and quickly starts an immune response. Some COVID-19 vaccines work this way.
• Viral vector vaccines are produced using a modified version of a similar, common virus that causes a minor infection. The virus is modified so it can’t cause illness, but instead, delivers a protein from the targeted virus into the body. This triggers the immune response. Some of the COVID-19 vaccines are produced this way. The vaccine uses a modified version of the adenovirus.

Live attenuated vaccines contain weakened forms of live viruses or bacteria and are not advocated during pregnancy. Examples are smallpox, chickenpox and the measles, mumps and rubella (MMR) vaccine.

To further boost your defence against viruses and diseases, read our article on “Strengthening Your Immune System During Pregnancy”.

Recommended Vaccines

Three vaccines are recommended for pregnant women. Some moms may be offered other vaccines, including a vaccine for hepatitis B but this depends on your individual working environment or travel plans you may have. Your healthcare provider will advise you. Find out from your medical insurance if they cover vaccines and is part of your preventative benefits.

Flu Vaccine

Pregnant moms are at risk for more severe illness and possible complications that may require hospitalisation. Getting the flu shot doesn’t mean you won’t get sick with the flu, but because your immune system reacts quicker, you are much less likely to get seriously ill. The flu vaccine should be taken annually, from March to April in South Africa. It’s safe in any trimester of your pregnancy. You can have your flu vaccine at your healthcare provider or a local pharmacy clinic.

What to expect:

You’ll get the jab in your upper arm. It may feel a little sore, with redness and swelling the following day. Some people also experience mild cold-like symptoms. This is a normal reaction from your immune system.

For more benefits and reasons why you should get the jab, read our article “Benefits Of Getting The Flu Vaccine”.

COVID-19 Vaccine

Pregnant women are at greater risk for more severe disease with COVID-19 which may require treatment in hospital. Research has proven that the vaccine decreases the risk for severe disease. You can have the COVID-19 vaccine anytime in pregnancy or while breastfeeding. If you have questions, speak to your healthcare provider. You can have the vaccine at a local pharmacy clinic or government vaccination site. Enquire with your medical insurance if they will cover the cost of your vaccine.

What to expect:

Both viral vector (J&J) or mRNA (Pfizer) vaccines are safe in pregnancy. You will need two doses of the Pfizer vaccine, with at least 42 days between doses, or one dose of the J&J vaccine. The vaccine is given in the upper arm muscle. Your arm may be sore for a few days and you may notice swelling, redness or pain at the vaccine site. Some people also experience fatigue, chills, fever, muscle pain or nausea. Side-effects usually resolve in one to two days. Boosters are required for both vaccines – six months after the second dose of Pfizer and two months after the single J&J dose. If you had your first shots before your pregnancy, you can have the booster when you’re eligible.

Tdap Vaccine                                                                                                                   

Tdap is a vaccine for tetanus (lockjaw caused by a bacteria that affects the nerves), diphtheria (bacterial infection of the nose and throat that effects breathing) and acellular pertussis (whooping cough). After the vaccine, your body will produce antibodies and you will pass these to your growing baby. Whooping cough can be very serious for a newborn, so by getting the vaccine, you protect your baby until he or she can receive the Tdap vaccine at six weeks. Although rare today, becoming infected with tetanus or diphtheria in pregnancy can be fatal for mother and baby. One dose of the Tdap vaccine is recommended in each pregnancy regardless of when you had your last vaccine.

What to expect:

The Tdap vaccine can be given at any stage but is best administered between 27 and 36 weeks. The vaccine is given in the upper arm. Side effects can be mild to moderate. There may be redness, pain and swelling at the vaccine site. Body pain, fatigue and fever may also occur but these resolve in a few days.

If you experience symptoms that concern you after receiving any vaccine, let your healthcare provider know.

Getting a safe vaccine in pregnancy can help protect you and your baby. Antibodies in your blood cross the placenta and strengthen baby’s developing immune system. The flu vaccine protects baby for up to six months after the birth. Early research suggests COVID-19 antibody protection for baby from the vaccine before birth and through your breastmilk if you breastfeed.

If you still have questions about the safety or benefits of vaccines, contact your midwife or healthcare provider.

Resources:  https://www.mayoclinic.org/; https://www.cdc.gov/; https://www.sitcancer.org/; https://www.healthline.com/; https://sacoronavirus.co.za/; https://www.whattoexpect.com/; https://www.enca.com/; https://raisingchildren.net.au/; https://www.cdc.gov/; https://www.nicd.ac.za/