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Maternal Immunization

ACOG Committee Opinion Summary, Number 741

doi: 10.1097/AOG.0000000000002665
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ABSTRACT: Immunization is an essential part of care for adults, including pregnant women. Influenza vaccination for pregnant women is especially important because pregnant women who contract influenza are at greater risk of maternal morbidity and mortality in addition to fetal morbidity, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. Other vaccines provide maternal protection from severe morbidity related to specific pathogens such as pneumococcus, meningococcus, and hepatitis for at-risk pregnant women. Obstetrician–gynecologists and other obstetric care providers should routinely assess their pregnant patients' vaccination status. Based on this assessment they should recommend and, when possible, administer needed vaccines to their pregnant patients. There is no evidence of adverse fetal effects from vaccinating pregnant women with inactivated virus, bacterial vaccines, or toxoids, and a growing body of data demonstrate the safety of such use. Women who are or will be pregnant during influenza season should receive an annual influenza vaccine. All pregnant women should receive a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during each pregnancy, as early in the 27–36-weeks-of-gestation window as possible.

Number 741, June 2018

For a comprehensive overview of these recommendations, the full-text version of this Committee Opinion is available at http://dx.doi.org/10.1097/AOG.0000000000002662.

Scan this QR code with your smartphone to view the full-text version of this Committee Opinion.

Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group

This Committee Opinion was developed by the American College of Obstetricians and Gynecologists' Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, in collaboration with member Kevin A. Ault, MD and Laura E. Riley, MD.

This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org or by calling the ACOG Resource Center.

While ACOG makes every effort to present accurate and reliable information, this publication is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.

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Recommendations

The American College of Obstetricians and Gynecologists makes the following recommendations:

  • Obstetrician–gynecologists and other obstetric care providers should routinely assess their pregnant patients' vaccination status.
  • Obstetrician–gynecologists and other obstetric care providers should recommend and, when possible, administer needed vaccines to their pregnant patients.
  • Women who are or will be pregnant during influenza season should receive an annual influenza vaccine.
  • All pregnant women should receive a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine during each pregnancy, as early in the 27–36-weeks-of-gestation window as possible.
  • Other vaccines may be recommended during pregnancy depending on the patient's age, prior immunizations, comorbidities, or disease risk factors.

Copyright June 2018 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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Maternal immunization. ACOG Committee Opinion No. 741. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;131:e214–7.

© 2018 by American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.