Vaccines for Pregnant Women in the Philippines

On June 9, 2021, the Philippines Foundation for Vaccination (PFV) aired a special webinar, “Vaccination for Expectant Mothers: Current Practices, Challenges, and Gains.” The webinar covered which vaccines for pregnant women are safe, as well as which are not recommended. It aimed to provide resources and information not only to healthcare professionals but to everyday people as well.

The speakers included a number of distinguished doctors with specializations in the fields of obstetrics, gynecology, and public health, as well as pro-bakuna mothers.

In case you missed it or would like a recap, this article will cover the highlights and key takeaways from the webinar.

How Do Vaccines Work?

Are vaccines for pregnant women safe?

Yes! As mentioned by the speakers, vaccination is not only safe during pregnancy but encouraged. Being immunized reduces the risk of disease in the mother and offers benefits for children in the womb.

Additionally, the mother’s immunity temporarily protects her child after birth. This is important because the first few months are critical for growth and development.

However, it is important to note that not all vaccines can be given during pregnancy. Certain vaccines

What are the recommended vaccines for pregnant women?

Dr. Desiree Valles-Pampolina outlined the recommended vaccines for pregnant women. For extra precaution, most OB-GYNs prefer to administer any vaccine during the second and third trimester.

Highly recommended vaccines include the annual influenza vaccine and the combination tetanus-diphtheria-pertussis vaccines (Td/TDaP). While other vaccines can be given, depending on the mother’s immunization history and current risk factors.

Dr. Daphne Policarpo added that pregnant women should only receive the inactivated vaccines, not live vaccines. She also explained that the two highly recommended vaccines (influenza and Td) are available for free in government health centers.

Influenza vaccine

The flu vaccine is not only recommended for pregnant women but for everyone, especially those who are at risk of exposure. Because there are different prevalent strains of influenza in each season and year, the vaccine requires yearly doses.

Td/TDap vaccines

Another important vaccine for pregnant women is the tetanus-diphtheria vaccine (Td) and the tetanus-diphtheria-pertussis vaccine (TDaP). While DTaP is already part of the National Immunization Program for children, women should get a dose of TDaP every time she gets pregnant.

Ideally, it should be given during the 27th week of pregnancy to the 36th week. However, mothers can still receive the dose before being discharged from the hospital.

Everyone should receive a booster shot of the Td vaccine every 10 years.

Additional vaccines for pregnant

Hepatitis A and B

For mothers who have a high risk of exposure to hepatitis A (HAV) or hepatitis B (HBV) viruses, they should also get vaccinated.

The hepatitis A (HepA) vaccine is an inactivated vaccine that is safe for pregnant women. High-risk exposure includes traveling to countries where the virus is endemic, having chronic liver disease, and being a healthcare worker. Get the vaccine in 2 separate doses, 6 to 18 months apart.

The hepatitis B (HepB) vaccine is given to pregnant women if she has not been previously immunized or her antibody (anti-HBs) count is low. Get the vaccine in 3 doses; 1 to 2 months for the second dose and 4 to 6 months for the third dose.

Rabies

Rabies vaccines are not routine. However, in case a pregnant mother has been bitten by a dog, cat, or other infected animals, she can safely receive a shot of this vaccine. It should be given as soon as possible because a rabies infection progresses quickly and is life-threatening.

How about the COVID-19 vaccines?

There is limited data on the safety of the vaccine during the first trimester of pregnancy, however, pregnant women can still get vaccinated. The mRNA-type COVID vaccines can be offered to pregnant and breastfeeding women. You can avail of the vaccine if you are part of the current priority group (e.g. A3, A4).

Like with other vaccines, it is best to get it after the first trimester. Additionally, if you get the COVID vaccine, wait at least 14 days before and after getting another vaccine.

Which vaccines should pregnant women avoid?

Aside from the vaccines that were recommended above, women should take note of the vaccines to avoid while pregnant. Most of these vaccines are live vaccines that can potentially harm a growing fetus, that is why they are contraindicated during pregnancy.

Here is a list of the vaccines to avoid during pregnancy:

• Chickenpox (varicella zoster, VZV)*
• Pneumococcal (PCV, PPSV)
• Measles, mumps, rubella (MMR)*
• Human papillomavirus (HPV)
• Polio (OPV*, IPV)
• Dengue*
• Yellow Fever*

(*) = live virus vaccine

Are vaccines safe while breastfeeding?

Yes, most vaccines are safe for lactating and breastfeeding women. Because the baby is already born, there is less risk of harm than getting vaccinated during pregnancy. In addition, many vaccines can benefit a nursing child because the antibodies within breastmilk confer passive immunity.

Interestingly, some studies have shown that women who have received an mRNA COVID-19 vaccine while breastfeeding offered some immunity against the virus to their children.

Double-check with your doctor before getting any vaccine or taking medications.

Question & Answer Portion

Can the COVID vaccine (or any vaccine) cause fertility problems in women?

Answer: Dr. Rosalina Roque-Tan covered this information in her presentation, stating that so far, there is no evidence that any vaccine, including the COVID-19 vaccine, can prevent or harm a pregnancy. As of now, pregnancy testing is not a prerequisite before receiving a vaccine.

If a pregnant woman did not complete her Td vaccine in her previous pregnancy, what should she receive in her present pregnancy? Td or TDaP?

Answer: In private clinics and hospitals, doctors prefer to give TDaP, as it offers more coverage. In some cases, Td can be given for the first two doses in the series, while TDaP can be given in the last dose. In public clinics and hospitals, some doctors will give the tetanus toxoid (TT) vaccine in two doses instead, especially if supplies of the other vaccines are limited.

Alternatively, if only one or two doses were completed during the first pregnancy, the remaining doses can be continued in the current pregnancy.

Can a mother who recovered from a COVID-19 infection still be vaccinated?

Answer: Yes, it is possible and recommended. However, based on current guidelines, she should wait until she has fully recovered or becomes asymptomatic. This is typically 10 to 14 days after first being diagnosed.

Can hypertensive pregnant women receive COVID-19 vaccines?

Answer: Yes, women with known hypertension or preeclampsia (high blood pressure during pregnancy) would definitely benefit from receiving the COVID-19 vaccine. Hypertension is one of the comorbidities that can increase the risk and severity of COVID infection.

What happens if a woman gets a vaccine but she did not know she was pregnant?

Answer: There is no need to worry. The majority of vaccines have no known risk during pregnancy, even the first trimester. However, most doctors prefer to give any vaccines during the second or third trimester as an added precaution. A woman can wait until the second trimester to receive the succeeding doses of her vaccine. She may also opt to hold off until after delivery.

Are there any studies on adverse effects on babies when a mother receives a vaccine?

Answer: There is a lack of studies done regarding the effects of vaccines on pregnant mothers and their children. Much of the recommendations are made based on theoretical knowledge. But so far, there are no major adverse effects reported in these cases.

Can pregnant women get HPV vaccines?

Answer: No, this vaccine is contraindicated in both pregnant and breastfeeding women. If a woman got pregnant before completing all of the doses, she should wait until after delivery to receive the vaccine.

Although the HPV vaccine is not a live vaccine, it is not ideal for pregnant women. This is because the vaccine works best before the first sexual contact (coitarche). Therefore, the HPV vaccine does not provide much protection for pregnant women.

If a woman has an abortion or miscarriage, should she still continue her Td/TDaP vaccines?

Answer: She may if she chooses to. The main purpose of receiving Td/TDaP during pregnancy is to offer protection to newborn babies who cannot receive these vaccines until 2 months of age. If she chooses not to complete all of the doses, there is also no harm.

Key Takeaways

In summary, vaccines for pregnant women are available and encouraged. Two of the most important shots to get during pregnancy are the influenza vaccine and the Td or TDaP vaccines. Additionally, they can safely receive the mRNA-type COVID-19 vaccines while pregnant and breastfeeding. Under most circumstances, pregnant women should not receive live vaccines.

For more information on vaccines, talk to your doctor and visit Philippine Foundation for Vaccination at http://www.philvaccine.org/.

Learn more about Other Mothercare Topics here.