Introduction
Pregnancy is a time when the female body is in a state of emergency, which is why different rules than usual apply to many drugs and medical procedures. For example, there are also some guidelines regarding vaccinations that should be followed in order not to endanger the health of the mother and the unborn baby.
Vaccination
Complete vaccination protection during pregnancy is particularly important for two reasons: There are some infections that can be transmitted from the woman to her unborn child, as these pathogens can pass into the placenta via the blood and thus also infect the unborn child. In addition, antibodies can also be transmitted in this way. If the mother has a protection against a certain disease in the form of antibodies against the pathogens, she can also transmit them to her child, who then also has a protection in the first three to six months of life.
This phenomenon is also called “nest protection”. It slowly fades away as the child’s own immune system develops accordingly. It is best for a woman to see a doctor if she already has a desire for children.
The doctor can then use her vaccination card to determine whether all vaccinations are up to date or whether any booster vaccinations are necessary. If the vaccination protection is incomplete, it is advisable to update it. If it is necessary to administer a live vaccine such as measles, mumps and rubella, the woman should wait at least three months afterwards to become pregnant.
The costs of all vaccinations recommended by the Permanent Vaccination Commission (STIKO) of the Roland Koch Institute are also covered by the statutory health insurance companies. If you take precautions in this way, you can avoid getting into the situation of having to worry about the vaccination status during a pregnancy. If a pregnancy already exists and there are gaps in the vaccination protection, the further procedure should definitely be discussed with a specialist.
Together with the woman, the doctor can weigh up the advantages and risks of any upcoming vaccinations against each other and finally decide together with her which step is appropriate next. Most vaccinations are not given, unless there is an acute urgent reason, because the consequences during pregnancy are difficult to assess. Pregnant women are advised to stay away from people with infectious diseases or fever to prevent infection.
In general, it is not recommended to carry out any vaccinations in the first trimester (i.e. in the first 3 months) of pregnancy, as there is a potential risk of endangering the embryo, both through the vaccination itself and through the side effects it may cause. During this period, special care should be taken with the administration of any medication, as this is when the child’s organs are formed. Otherwise, a distinction is made between recommended, permitted and critical vaccinations during pregnancy.
There are many vaccinations that are completely harmless even during pregnancy. These include vaccinations against influenza, diphtheria, tetanus, whooping cough, hepatitis A and B, meningococcus and poliomyelitis. Other vaccinations should be avoided during pregnancy if possible.
In this group mumps, measles, rubella and chickenpox (varicella) are particularly important. These are so-called “live vaccines”. This means that with these vaccinations, weakened but still living organisms enter the body, which thereby simulate a disease and cause the body to react with a defensive reaction.
However, these living viruses can enter the organism of the unborn child via the blood and thus infect it. This is extremely feared, especially with rubella. While the disease in adults is usually mild and the symptoms are often limited to mild respiratory problems and a skin rash, a fetus can be life-threatened by an infection with rubella virus.
More than half of the children who are infected with rubella unborn develop a so-called “rubella embryopathy”, which can be accompanied by severe brain damage, heart defects, eye damage and/or deafness. For these reasons it is important to ensure that a pregnant woman is not infected with rubella and that she is not vaccinated during pregnancy. Other vaccinations, such as cholera, Japanese encephalitis or yellow fever, should not be administered during an existing pregnancy.However, these do not belong to the routine vaccinations in Germany and are actually only recommended in principle if a journey is made to an area in which the pathogens occur even more frequently.
If, however, such a vaccination should have been given during pregnancy, when it was not yet known, it is not necessarily a reason for concern, as complications do not always occur. (An exception to this is the vaccination against rubella. If this vaccination has been administered accidentally during an existing pregnancy, it is advisable to carry out additional ultrasound checks on the baby during pregnancy.
In fact, many of the recommendations made are not based on sound medical knowledge, but rather on assumptions. This is because it is extremely difficult (for understandable reasons) to conduct studies with pregnant women that could provide more precise information about the influence of certain vaccinations. The only vaccination that is even explicitly recommended during pregnancy is the flu vaccination (against the seasonal influenza A viruses).
This recommendation also applies initially to the period from the second trimester of pregnancy. In certain cases, for example in the case of some underlying chronic diseases of pregnant women, vaccination is even recommended in the first trimester. It has been proven that the benefits of this vaccination clearly outweigh the risks.
