The American Society for Reproductive Medicine (ASRM) has issued new recommendations regarding vaccinations for women of reproductive ages to handle female infertility, updating previous guidelines issued in 2008.
The new guidelines offer the gynecologist a reminder that they can hang on their wall, according to, Dr. Samantha Pfeifer, MD, who led the study and is an associate professor of obstetrics and gynecology at the University of Pennsylvania School of Medicine in Philadelphia.
If possible, patients should receive vaccinations before conception, the guidelines say. However, most recommended adult vaccines can be administered even during pregnancy, the guidelines say.
| Influenza during pregnancy can increase the risk of miscarriage, and the high, sustained fever some women experience with the flu increase the risk of the birth defect spina bifida. |
The committee issued the following recommendations:
- MMR and varicella vaccines should not be administered during pregnancy, and women should avoid pregnancy for one month after vaccination. There are no documented cases of congenital malformation associated with MMR, but there are reports of congenital varicella after immunization. Other vaccines to be avoided are intranasal (but not injectable) influenza, and herpes zoster vaccines, which are live attenuated vaccines.
- Flu shots are recommended even during pregnancy. However, nasal influenza vaccine spray contains live attenuated virus and should not be given during pregnancy.
- Thimerosal, a mercury-based preservative, has been suggested as a possible health risk, but there is no evidence to back the fears. Pregnant women can receive shots with thimerosal, the committee says. (The Centers for Disease Control and Prevention came to the same conclusion in a study reported in 2010 in Pediatrics, in which it concluded that “prenatal and infant exposure to vaccines and immunoglobulins that contain thimerosal does not increase risk for autism spectrum disorder.”)
- Because of the recent upsurge in pertussis infection among infants, it is recommended that all adults aged between 19 and 64 years receive Tdap if they have not previously been immunized. Tetanus-Diphtheria-Pertussis (Tdap) vaccination is recommended to adults who are in contact with infants. If it is administered during pregnancy, it should be given after 20 weeks of gestation.
- Non-routine vaccinations should be administered to women who have risk factors for the respective diseases.
- Pneumococcus and hepatitis A and B vaccines pose no known risks to the fetus as they contain no live virus . The same holds for the meningococcus vaccine, but the literature on this one is limited, the committee says.
- Meningococcal vaccine should be administered before pregnancy, as experience during pregnancy is limited.
In summary, the authors recommend that physicians be aware of women’s immunization status before pregnancy and update her vaccine status as appropriate.
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