Get Yourself Immunized First to Immunize Your Baby!

Congratulations on your pregnancy! You're eating right, getting extra rest and taking your prenatal vitamins. After all, you want to do everything you can to ensure a healthy baby! But have you given any thought to protecting yourself and your baby against infection? 

The vaccines you get before and during pregnancy not only play an important role in protecting your health but safeguard your baby's health too. Your immunity is your baby's first line of defense against certain serious illnesses. So if you're pregnant or planning a pregnancy, now is the time to make sure your vaccinations are up to date.

But not all vaccines are safe to get during pregnancy. Vaccines come in three forms: live virus, dead virus, and toxoids (harmless, chemically altered proteins drawn from bacteria). Pregnant women shouldn't get live virus vaccines, such as the combined measles, mumps, and rubella vaccine (MMR), because there's a slight chance these will harm the unborn baby. Vaccines made from dead viruses, such as the flu shot, and toxoid vaccines, such as the tetanus/diphtheria/pertussis (Tdap) shot, are safe. Here's a rundown of what you need to know about vaccinations before, during, and after pregnancy.

The Shots which are Safe during Pregnancy?

The Tetanus Toxoid (TT) vaccine is given during your pregnancy to prevent the risk of tetanus to you as well as your unborn baby. Tetanus is a life-threatening bacterial disease that is caused by the toxin of a bacterium called Clostridium tetani.

Tetanus bacteria enter the body through an open wound. It affects a person's nervous system and can be fatal if left untreated. It is preventable through immunisation. Antibodies formed in your body, after the vaccination, are passed on to your baby and protect her as well for a few months after birth.

Pregnancy Recommendations

In your first pregnancy, your doctor will recommend at least two doses of the TT vaccine, the first dose in the third trimester, usually in the seventh month of pregnancy and the second dose is given at least four weeks after the first. Some doctors prefer to give three doses that are four weeks apart, starting at 28 weeks of pregnancy. If your second pregnancy is within two years of your first, your doctor will check your vaccination history. If you received both TT vaccines in your previous pregnancy, she will recommend only a booster dose. If there is a larger gap between your first and second pregnancy your doctor will assess your situation and decide the schedule for you.

Flu shot: Flu shot for all women who got pregnant during the flu season, which is November through March is highly recommended. The flu shot is made of dead viruses, so it's safe for both you and baby. But FluMist, a nasal-spray vaccine made from live viruses should be completely avoided.

The best time to get a flu shot is in October or November, before the flu season is in full swing. And because flu strains change every year, the vaccine does too -- so don't rely on last year's shot to get you through this year's season.

Moms-to-be who come down with the flu, especially during the second half of pregnancy, are more likely than other women to suffer severe symptoms or complications such as pneumonia. Even a moderate case of the flu can make you feel miserable, resulting in fever, headaches, muscle pain, sore throat, and coughing. Most of these symptoms last about four days, although coughing and fatigue can drag on for two weeks or longer.

If you do get the flu, contact your doctor, get plenty of rest, and drink lots of fluids. Tell your doctor if you're not feeling better after several days or if you have trouble breathing, as this can be a sign of more serious complications such as pneumonia.

Fortunately, although the flu can be a real drag for you, it's unlikely to harm your baby.

Tetanus/diphtheria/pertussis shot (Tdap) : Tdap can be given at any point during pregnancy, though the preferred time frame is between 27 and 36 weeks of gestation. The vaccine is made with toxoids, so it's safe to get during pregnancy.

Tetanus, also called lockjaw, is a disease of the central nervous system that causes painful muscle spasms and convulsions. The bacterium that causes tetanus can be found in soil and in animal waste. It can enter the bloodstream through a cut in the skin, so follow up with your doctor if you get a deep or dirty wound. If contracted during pregnancy, tetanus can cause fetal death.

Diphtheria is a respiratory infection that can cause breathing problems, paralysis, coma, and even death. It's now rare in today’s time, but you need a booster shot every 10 years; otherwise your immunity is likely to wane.

Pertussis, an extremely contagious bacterial disease, can be fatal in infants and is characterized by a deep, hacking cough and a high-pitched "whoop" sound.

What Other Vaccines Should You Consider Before or During Pregnancy?

Your job or lifestyle can make you more susceptible to specific illnesses, as can certain chronic health conditions, such as diabetes. If you fall into one of these categories, your doctor may recommend additional vaccinations before or during pregnancy.

Hepatitis B vaccine: It's safe to get this shot when you're pregnant, and if you're a healthcare worker or you live with someone who has the disease, consider vaccination.

Hepatitis B is a viral infection that causes liver inflammation, nausea, fatigue, and jaundice (yellowing of the skin and eyes). In some cases, it can cause chronic liver disease, liver cancer, and death. A pregnant woman with hepatitis B can pass the infection to her baby during delivery, and without prompt treatment, the baby has a high risk of contracting serious liver diseases as an adult.

“The CDC recommends that all pregnant women be screened for hepatitis B because it's possible to have it without knowing.”

Hepatitis A vaccine: This vaccine protects against a liver disease that spreads through contaminated food or water. Symptoms include fever, fatigue, and nausea. It isn't usually as serious as the B version of the disease, and the illness won't affect an unborn baby most of the time. In rare cases, hepatitis A may contribute to premature labor and infection in the newborn.

If you're traveling to a developing country or if you work with the virus in a laboratory setting, you should discuss vaccination with your doctor.

Pneumococcal vaccine: If you have a specific chronic condition, such as diabetes or kidney disease, your doctor may recommend the pneumococcal vaccine, which protects against some forms of pneumonia.

What Vaccines Should You Get Post-Pregnancy?

Now is the time to catch up on any vaccines you may have been unable to get during pregnancy or before becoming pregnant, such as the MMR and chickenpox vaccines. Moms who are breastfeeding can get vaccinated according to a normal adult vaccination schedule.

As mentioned above, if you're due for a Td booster and didn't get one during pregnancy, the latest recommendation is to get Tdap, which includes pertussis, also known as whooping cough.

What If you're Allergic to a Vaccine?

Serious reactions to vaccines are rare. However, your doctor may tell you to skip certain shots if you have an allergy to a substance they contain. Those who are allergic, for example, to baker's yeast (used in making bread) shouldn't get the hepatitis B vaccine; those with a severe egg allergy should avoid the flu shot; and people with a severe allergy to gelatin shouldn't get the measles, mumps, and rubella or varicella vaccine. If you're skipping any shots, you should discuss alternate ways to prevent illness with your doctor.

Anti D Vaccine

Most people are rhesus-D positive, which means the surface of their red blood cells contains a protein called the D antigen. But others might be rhesus negative or known as RhD negative.

If you are RhD negative but your baby has inherited a rhesus positive status from its father, then your blood and your baby's blood may be incompatible. If your blood then comes into contact, an immune response is triggered and you will develop antibodies that fight against your baby's blood as though it were a foreign invader. This process is called sensitisation. It's unusual for maternal and foetal blood to mix during pregnancy, and sensitisation does not normally occur until birth. But once the antibodies are created, they do not leave your blood system and so, if you have a second pregnancy where your baby is rhesus positive, the antibodies can cross the placenta and attack and destroy the baby's blood cells causing rhesus disease.

The good news is that there is a simple way to prevent sensitisation during pregnancy. Anti-D immunoglobulin can be given whenever there is a risk of sensitisation (such as after a fall, bump or invasive medical procedures). It can also be given routinely in the third trimester for all women who are RhD negative. Anti-D neutralises the D antigen in foetal blood so maternal blood (ie yours) does not detect it and produce antibodies to fight it.

After your baby is born, a blood sample from the umbilical cord can be taken and tested for the D antigen. If the baby is RhD positive, another anti-D injection should be given within 72 hours to minimise the risk of sensitisation.

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