Vaccinations During Pregnancy and When Breastfeeding

Key Points

1. Pregnant women should not halt vaccinations due to changes in immune function
2. Vaccinations serve a dual purpose by safeguarding both the mother and the unborn baby
3. Vaccination involves receiving a vaccine, while immunisation refers to developing immunity to a disease post-vaccination
4. Vaccines contain weakened viruses, killed bacteria or viruses, or modified toxins, facilitating immunity development in the recipient

Pregnancy is not a time when women need to stop having vaccinations. In fact, during pregnancy there are a range of changes to a woman’s immune function, making them more vulnerable to severe infections from illnesses like influenza and whooping cough.

As well as protecting the pregnant mother, vaccinations also provide protective antibodies for the unborn baby which extend to their first few months of life.

Vaccinations are rarely not advisable for women who are planning to conceive, are already pregnant or are breastfeeding.  Breastfed, as well as formula fed babies, need to be vaccinated.

What’s the Difference Between Immunisation and Vaccination?

Most of us switch between using the words vaccination and immunisation, although they don’t mean exactly the same thing.

Vaccination means actually having a vaccine. This can be an injection (needle) or taken in via the mouth.

Vaccines contain small doses of either:

1. a live but weakened virus;
2. a killed bacteria or virus, or small parts of bacteria; or
3. a modified toxin produced by bacteria.

Immunisation means having a vaccine and then developing immunity to a disease.  This timeframe varies. There is generally a few weeks between having a vaccination, the immune system responding and then developing antibodies (resistance) to the disease.

What You Need to do Before You Conceive

If possible, start thinking about your vaccination cover before you conceive.  If you are planning a baby, checking your immunisation status is as important as any other aspect of your pre-conception health.

1. Have a check-up with your doctor or healthcare provider.
2. Find your vaccination record book, if you have one, and take it along with you.
3. Ask your doctor about having blood tests to check your immunity to vaccine preventable diseases. If, as a child, you did not complete the full primary course of your immunisations, you may need to have “catch-up” doses. If there’s any doubt, the general recommendation is to be immunised again.
4. Most importantly, check if you are fully immunised against these diseases: chickenpox, influenza, COVID-19, measles, mumps, rubella, diphtheria, tetanus and whooping cough.
5. Check with other people who live with you, your partner and who you’ll be having close contact with, about their own vaccination cover.
6. Aim to wait at least one month before conceiving after having vaccines which contain live viruses. These include measles, mumps and rubella (MMR) vaccine and the chickenpox vaccine.

But I’m Already Pregnant – Is it Safe For Me to be Vaccinated?

Many pregnant women worry about the safety of vaccinations during pregnancy. Though they know on one hand that some are recommended, many still have lingering doubts about the safety.

Immunisation during pregnancy serves a dual purpose – it helps to protect both the mother and her developing baby.

Read on to understand more about vaccinations and what you can do to protect yourself and your unborn baby.

Ideally, vaccination is avoided during pregnancy unless there is a risk to the woman and her unborn baby.

But there are a couple of exceptions to this rule.

It is recommended that all women should receive vaccinations for influenza, COVID-19 and whooping cough* during every pregnancy.

^*A whooping cough combination vaccine including tetanus and diphtheria protection - the adult dTpa  - Diphtheria-Tetanus-acellular Pertussis vaccine - is  recommended to be given in the third trimester of every pregnancy, ideally between 28 and 32 weeks gestation, but it can be given up until delivery. (Reference).

Serious side effects and allergic reactions to vaccinations are rare. The diseases themselves and the complications which vaccines protect against are far more common.

Remember too …

If pregnant women catch “the flu” they can become very sick and there is a higher risk of them developing complications. The influenza vaccine is protective for women and their baby for the first six months of life.

Influenza vaccine, otherwise known as “the flu shot” is free for pregnant women though you may need to pay a consultation fee to see your GP.  It can be given at any time during pregnancy. Autumn is generally the time when new flu vaccine strains are released for the community.

Research into vaccine preventable diseases is constantly evolving. As new findings are released, recommendations change. Always check reliable resources which use science to guide their advice.  

Is it safe to be vaccinated against COVID-19 when I’m pregnant?

The current advice from healthcare experts is that pregnant women receive the COVID-19 Pfizer vaccine. Research has demonstrated that this vaccine is safe for pregnant (and breastfeeding women) to have at any stage of their pregnancy.  Women who get COVID-19 during pregnancy are at a higher risk of developing complications and having a premature baby.

The COVID-19 vaccination during pregnancy is protective because it causes the mother to create antibodies against the virus. These protective agents cross the placenta and may help the baby to be protected from getting COVID-19 in their first few months of life.

Two doses of vaccine are recommended, 3-6 weeks apart.  Side effects from the COVID-19 vaccination are very similar for pregnant and non-pregnant women. There are no specific reactions which are unique to pregnancy.  Check here for more information.

What’s the Risk with Infectious Diseases During Pregnancy?

Depending on the particular disease, the unborn baby could be affected.  And in the newborn period, before they’ve had a chance to build their own immunity and have their own vaccinations, very young children can also be harmed if their mother has an infection.

Some of the diseases which are particularly harmful to babies include rubella, chickenpox, measles, mumps and influenza. Whooping cough and influenza are also risky. It’s not just the diseases which are dangerous, but their complications as well.

What Else Can I do to Prevent Getting Sick?

1. Hand washing goes a long way in protecting all of us from disease. Get into the habit of washing your hands regularly, especially before eating, after toileting and handling animals.
2. Use hand sanitiser if you don’t have access to water and soap.
3. Follow the government guidelines about wearing a mask when out in public and social distancing.
4. Avoid putting your hands to your face and touch your eyes, mouth or nose. Mucous membranes are a perfect entry point for microbes.
5. Try to stay away from people who are sick.
6. Avoid international travel, if possible, when you’re pregnant.
7. Eat healthy foods which support your immunity. Drink lots of water, aim for at least eight hours sleep a night and exercise regularly.

Where to go for Your Vaccinations

A tip
Vaccinations may be free under The National Immunisation Program Schedule (NIPS).

1. Speak with your GP or healthcare practitioner.
2. Ask your maternity care provider and/or the hospital where you plan to give birth.
3. Ask at your local community health centre.
4. Check with your local council about where immunisation clinics are held.

About the Author:

Jane Barry has qualifications in general, paediatric, immunisation, midwifery and child health nursing. She holds a Bachelor Degree in Applied Science (Nursing) and has almost 30 years specialist experience in child health nursing. She is a member of a number of professionally affiliated organisations including AHPRA, The Australasian Medical Writer’s Association, Health Writer Hub and Australian College of Children and Young People’s Nurses.

References:

Immunisation and pregnancy - Better Health Channel

Immunisation for pregnancy | Australian Government Department of Health

Immunise Australia Program

Better Health Channel

Vaccination for women who are planning pregnancy, pregnant or breastfeeding | The Australian Immunisation Handbook (health.gov.au)

Whooping cough (pertussis) vaccine in pregnancy (healthywa.wa.gov.au)