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. 2011 May;57(5):555-7.

Vaccination during pregnancy

Pina Bozzo  1 , Andrea Narducci, Adrienne Einarson
Affiliations

Vaccination during pregnancy

Pina Bozzo et al. Can Fam Physician. 2011 May.

Abstract
in English, French

Question: One of my patients is studying to become a dental hygienist. Owing to the program requirements, she received several vaccinations last week, including measles-mumps-rubella, varicella, and hepatitis B (HB) vaccines, as well as a tetanus booster. However, today a blood test confirmed that she is currently 6 weeks pregnant. What is known about the safety of these vaccines during pregnancy, and are there any general recommendations for vaccines for women who are planning to become pregnant or who are currently pregnant?

Answer: The combination measles-mumps-rubella vaccine and the varicella vaccine are live attenuated vaccines, and are contraindicated during pregnancy owing to theoretical concerns. However, there is no evidence that there are increased risks of malformations, congenital rubella syndrome, or varicella syndrome attributable to these vaccines. The HB and tetanus vaccines are composed of noninfectious particles or toxoids, and theoretically should cause no increased risk to the developing fetus. In addition, limited observational data also support no increased risk of any adverse pregnancy outcomes; consequently, administration of the HB and tetanus vaccines might be, if indicated, considered during pregnancy.

Question Une de mes patientes étudie pour devenir hygiéniste dentaire. Pour répondre aux exigences du programme, elle a reçu divers vaccins la semaine dernière, notamment contre la rubéole, la rougeole et les oreillons, la varicelle, l’hépatite B (HB), ainsi qu’un vaccin de rappel contre le tétanos. Par ailleurs, aujourd’hui, une analyse sanguine a confirmé qu’elle était actuellement enceinte de 6 semaines. Que sait-on de l’innocuité de ces vaccins durant la grossesse et y a-t-il des recommandations concernant les vaccins pour les femmes qui planifient une grossesse ou sont actuellement enceintes?

Réponse Le vaccin combiné contre la rubéole, la rougeole et les oreillons et celui contre la varicelle sont des vaccins vivants atténués et ils sont contre-indiqués durant la grossesse en raison de préoccupations théoriques. Par ailleurs, il n’y a pas de données probantes à l’effet qu’il y ait des risques accrus de malformations, de syndrome congénital de la rubéole ou de syndrome de la varicelle attribuables à ces vaccins. Les vaccins contre l’HB et le tétanos se composent de particules non infectieuses ou toxicoïdes et, théoriquement, ils ne devraient pas accroître les risques pour le fœtus en développement. De plus, des données d’observation limitées corroborent aussi qu’il n’y a pas de risques accrus d’effets indésirables sur l’issue de la grossesse; par conséquent, l’administration des vaccins contre l’HB et le tétanos, si elle est indiquée, pourrait être envisagée durant la grossesse.

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