Vaccination during pregnancy plays a vital role in safe pregnancy and childbirth, offering protection against circulating infections to both the mother and the fetus. Specific maternal immunisation helps both the mother and the developing infant ward off infections.
Maternal immunisation enables the transmission of disease-specific antibodies from the mother to the fetus, granting the baby crucial protection against highly susceptible infections in the initial months after birth.
Tetanus vaccination during pregnancy
Dr Sushruta Mokadam, senior consultant, obstetrics and gynecology, Motherhood Hospitals, Kharadi, Pune, says that vaccination against tetanus infection is a must during pregnancy. This is to prevent neonatal tetanus (tetanus infection in newborns) and tetanus in the pregnant woman.
Dr Mokadam says that though tetanus was common earlier and not so much now, one cannot afford to take a risk. “We usually give the first dose of tetanus vaccination after the anomaly scan in the 18th week, which confirms that the fetus is healthy.” The second dose of the tetanus vaccine is given between the 26th and 28th week of pregnancy.
Tetanus vaccination or TDAP covers immunisation against tetanus, diphtheria and pertussis. “The prevalence of adult diphtheria and whooping cough in children is rising and hence concerning,” she adds.
According to Dr Hema Divakar, obstetrician, gynaecologist and medical director, of Divakars Speciality Hospital, Bengaluru, people are more aware of the importance of vaccinations ever since the pandemic.
“Couples understand when we say that the baby can’t be given TDAP in the first three months and hence the passive immunity through the vaccinated mother is essential,” says Dr Divakar, the past president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI).
“The exact time of the tetanus vaccination varies. In a government hospital, it is given in the first trimester itself, whereas in private practice, it is mostly given in the second trimester,” says Dr Mokadam.
Flu shot or influenza vaccination
Dr Mokadam points out that in recent years, there has been a paradigm shift when it comes to preventing respiratory infections through vaccinations in the general population as well as in women who are pregnant.
The flu vaccine given during pregnancy offers the woman protection against influenza. “Flu shot is usually given at the 22nd week, a month after giving the first dose of the tetanus vaccine,” says Dr Mokadam. She further adds that post-pandemic, there have been concerns about respiratory illnesses and hence it is easy to explain and convince couples about the immunisation against flu during pregnancy.
During the pandemic, the Covid-19 vaccine was part of the vaccination calendar in pregnant women to protect both the mother and the fetus from the virus.
How vaccines given during pregnancy help the foetus
Specifying the importance of vaccination in pregnancy, Dr Divakar says that a woman undergoes immunological changes during pregnancy and becomes vulnerable to infections. The infections can affect her pregnancy, uterus and fetus too.
According to Centres for Disease Control and Prevention, US, the antibodies mothers develop in response to these vaccines not only protect them but also cross the placenta and help protect their babies from serious diseases early in life. “Vaccinating during pregnancy also helps protect a mother from getting a serious disease and then giving it to her newborn,” the CDC says.
“Newborn babies cannot be given these vaccines in the first three months of birth and hence vaccination during pregnancy offers passive protection to the baby,” points out Dr Divakar.
How safe is immunisation during pregnancy?
Doctors specify that certain vaccines such as tetanus toxoid, influenza and covid vaccination are safe during pregnancy. “We do not give any live vaccine during pregnancy and they are all inactivated germs,” says Dr Mookadam.
However, certain live vaccines such as MMR, varicella and BCG vaccine are contraindicated during pregnancy, according to the Federation of Obstetrics and Gynaecologists Society of India (FOGSI). Further, the FOGSI members note that vaccines against pneumonia, rabies, hepatitis and typhoid should be administered if the mother needs to be immunised against these infections, following the recommendation of the treating doctor, like in the case of a dog bite during pregnancy.
HPV vaccination for mothers after childbirth
Dr Divakar mentions the need for educating women below the age of 45 years to take three doses of HPV vaccination to ensure protection against cervical cancer. However, HPV vaccination is not given during pregnancy, and it is recommended only after childbirth or before pregnancy.
Daksha Gowda, a 28-year-old mom to a nine-month-old girl recalls that she took the tetanus and influenza shots as suggested by her gynaecologist, Dr Hema Divakar. “I just followed what the doctor suggested. My husband was very aware of the HPV vaccination and hence I took the first dose before the discharge and have now completed all three doses,” says Bengaluru-based Daksha, who firmly believes that prevention is better than cure.
“Though nine to 15 years is the primary age group for HPV vaccination, women till the age of 45 years can take it. We remind pregnant women and new moms to ensure they take HPV vaccination after childbirth, if not jabbed earlier,” says Dr Divakar.
Takeaways
Vaccination during pregnancy is key to providing passive protection to the fetus against certain circulating infections. The mother passes on disease-specific antibodies to the fetus so that the baby is protected against the most vulnerable infections during the first few months after birth. Maternal immunisation against tetanus and influenza is a must.
