Which vaccines are contraindicated during pregnancy?

Which vaccines are contraindicated during pregnancy?

• A. Intranasal influenza, MMR, and varicella
• B. None; all vaccines are safe
• C. Tdap during pregnancy
• D. HPV vaccine

Answer: (A)

The key idea is that vaccines containing live, replicating organisms are not given during pregnancy because of potential risk to the fetus and the limited safety data in pregnancy. Among common vaccines, the intranasal influenza vaccine is a live attenuated vaccine given as a spray, so it is contraindicated in pregnancy. Measles, mumps, and rubella (MMR) and varicella vaccines are also live vaccines and are not administered during pregnancy for the same reason; they’re typically given after delivery if vaccination is needed, with pregnancy deferred for a period after vaccination. In contrast, vaccines that are inactivated or specifically recommended during pregnancy are considered safe and appropriate. For example, Tdap is recommended during pregnancy to protect the newborn against pertussis, so it is not contraindicated. HPV vaccine is not given during pregnancy, but it’s not treated as a strict contraindication; it’s generally deferred until after pregnancy if possible.

The key idea is that vaccines containing live, replicating organisms are not given during pregnancy because of potential risk to the fetus and the limited safety data in pregnancy. Among common vaccines, the intranasal influenza vaccine is a live attenuated vaccine given as a spray, so it is contraindicated in pregnancy. Measles, mumps, and rubella (MMR) and varicella vaccines are also live vaccines and are not administered during pregnancy for the same reason; they’re typically given after delivery if vaccination is needed, with pregnancy deferred for a period after vaccination.

In contrast, vaccines that are inactivated or specifically recommended during pregnancy are considered safe and appropriate. For example, Tdap is recommended during pregnancy to protect the newborn against pertussis, so it is not contraindicated. HPV vaccine is not given during pregnancy, but it’s not treated as a strict contraindication; it’s generally deferred until after pregnancy if possible.