Are you planning to become pregnant?
Will you have contact with an infant this year?
Are you attending college?
Have you reached age 60?
Are you planning foreign travel?
Most of us are very aware that children need immunizations to protect them from contagious diseases and to enroll them in school. Each summer, moms plan visits to the pediatrician to update the important blue slip, the Alabama Certificate of Immunization. But our need for vaccinations extends beyond childhood. The questions above are reminders of just some of the situations for which adult women need to consider their immunizations.
We know and are happy that many women rely on us, their Ob-Gyn physicians, for primary care. Since preventive care is an important aspect of that role, we want to assist you to be well-informed about immunizations, especially about certain considerations that apply uniquely to women.
Note: Making sure your routine adult immunizations are up-to-date is a very important part of pre-conception planning. Be sure, at a pre-conception visit, to inform your physician if your occupation, travel, or other circumstances may expose you to communicable illnesses while you are pregnant. Many immunizations cannot be given during pregnancy.
The following are general recommendations. Your individual medical history and risk factors may change the recommendation or timing for certain vaccines. Before receiving any immunization, inform your physician of allergies, previous reactions to vaccines, possibility of pregnancy, or symptoms of current illness.
With few exceptions, nearly all of our patients—including pregnant women—should be vaccinated against the flu. We will have the 2013-2014 flu vaccine available for our patients beginning in September. Pregnant women are especially at risk for serious complications from the flu. When the vaccine is given during pregnancy, it also provides protection for your baby who cannot receive the vaccine directly until he or she is 6 months old. Women who are breastfeeding may also be vaccinated. Pregnant women should not receive the live-attenuated vaccine (the nasal spray vaccine).
TETANUS, DIPTHERIA, AND PERTUSSIS (WHOOPING COUGH)
Tetanus, diphtheria, and pertussis are three serious but preventable bacterial illnesses. Any adult 19 years of age and older who has not received a dose of Tdap should get one as soon as feasible – to protect themselves and infants. Adults get Tdap in place of one of their regular tetanus boosters (Td). However, the dose of Tdap can be given no matter when the last Td shot was received. Adults continue to need the tetanus booster (Td) every ten years throughout their lives.
Whooping cough is especially dangerous for babies and young children and can even cause death, especially in infants under 1 year. The most important weapon against whooping cough is the pertussis vaccine (Tdap). But infants cannot receive the vaccine until they are 2 months old and do not have maximum protection until after their third shot at about 6 months. During these early months, you can protect your baby from whooping cough by maintaining your own immunity and by avoiding contact with people who may not have been vaccinated.
ALL pregnant women should receive the Tdap vaccine with EACH PREGNANCY, regardless of their history of receiving the Tdap vaccine before. Mothers should receive the Tdap shot late in pregnancy (between 27 and 36 weeks) to maximize the immunity passed to the newborn. If you did not get vaccinated while you were pregnant, you should be vaccinated immediately after your baby is born, even if you are breastfeeding.
If you are a caregiver or family member, it is important to get your Tdap booster vaccine at least two weeks before you will be in contact with an infant under the age of 1 year, to allow time for immunity to develop.
An infection with human papilloma virus (HPV) can lead to cervical cancer. All women age 26 and under should receive 3 doses of the HPV vaccine. HPV vaccination is not recommended for pregnant women.
HERPES ZOSTER (SHINGLES)
Shingles is a very painful skin rash often with blisters that is caused by the chicken pox virus. Anyone who has had chicken pox can develop shingles because the virus can remain dormant in the body for many years. Typically the outbreaks occur later in life. If you have reached age 60 we recommend that you receive immunization against shingles. Pregnant women should not receive this immunization.
Streptococcus pneumoniae bacteria or pneumococcus can cause many types of illnesses, especially in the elderly. Some of these illnesses can be life-threatening. Adults age 65 and over and other persons with certain risk factors should be vaccinated against pneumococcal disease. Inadequate data exist for specific recommendations regarding use in pregnant women.
VARICELLA VACCINE (CHICKEN POX)
Because chicken pox can be a serious illness in adults, the chicken pox vaccine is recommended for most people age 13 or older who have never had chicken pox or been vaccinated. Pregnant women should not receive the chicken pox vaccine. Women should not get pregnant for one month after receiving the chicken pox vaccine.
This dangerous bacterial infection causes meningitis, most often in babies, children and young adults. College freshman living in dormitories, military recruits, (because they live in close quarters with others), and other individuals with certain risk factors, should be immunized against meningococcal disease. Consult your obstetrician regarding recommendations for pregnant women.
MEASLES, MUMPS, RUBELLA (GERMAN MEASLES)
From the CDC: Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases. Pregnant women should not receive this immunization.
Vaccines are available to protect against other communicable diseases. Discuss your individual risk factors with your physician. If you are travelling abroad we recommend that you make an appointment with UAB’s travel medicine clinic where you can obtain information about infectious diseases in other parts of the world, individualized to your particular travel plans. http://www.uabmedicine.org/location/travelers-health-clinic