Pregnancy is avulnerable and severely risk-prone period for both mother and child; travellingwhilst being so further exposes both mother and child to foreign pathogens dueto a weakened immune system which is characteristic of pregnancy. Potential contraindications totravelling whilst pregnant included obstetrical risk factors (history ofmiscarriage, previous cervix/labour/delivery complications, etc.
) and medicalrisk factors (hypertension, diabetes, chronic organ system dysfunction, etc.).1Vaccines are usuallyinactive or weakened forms of pathogens given to stimulate an immune response –identifying its foreign, attacking it and then remember it to prevent futureinfection, therefore, developing immunity to the particular disease. Duringpregnancy, there is a ‘theoretical risk of perinatal infection’2,posed to both the mother and infant via a process called vertical transmissionwhich is the passage of a pathogen from mother to infant via either theplacenta, breast milk or direct contact during or after birth causing disease.3For Influenza, itwas found that ‘immunization was the best strategy for flu prevention’2 thusin a randomized study the administering of the inactivated influenza vaccine (IIV)revealed a 70% reduction in flu illness.2 For the Tdap vaccine,’passive infant immunity’2 had been documented followingimmunization of the mother, with the optimal timing for immunizationbeing recommended within the third trimester to allow for a substantial antibodyresponse to be formed. Rubella cases also declined over time as the MMR vaccinewas more recognised, leading to the ‘elimination of rubella virustransmission.
‘2 Similarly, as the Varicella vaccine becameroutinely administered, ‘disease incidence dropped by 90%’.2Hepatitis A virus (HAV)cases decreased from 2,979 to 1,3982 after the widespread ofthe HAV vaccination. Hepatitis B virus (HBV) vaccine was found toresult in a ‘protective antibody response greater than 90%’2 deemingit the best preventative measure, however, should only be consideredfor those at a high risk of developing the infection. Pneumococcal vaccinessaw a 47% reduction in disease development following vaccination, withmeningococcal demonstrating an ‘appropriate maternal antibody response’2 aswell as ‘transplacental antibody transfer’2 leading to thedevelopment of infant immunity. Yellow fevervaccines, when given during an outbreak, found no adverse effects for bothmother and child.
Japanese encephalitis is seen as the most common’vaccine-preventable disease cause of encephalitis’ 2 howeverdue to the lack of adequate studies within pregnancy, the effectiveness was notestablished. Similarly, with Typhoid vaccine, despite consisting of two typesof vaccines, there was ‘no supporting data on the efficacy and safetyof either during pregnancy’.2 Both Anthrax and Rabies vaccineswere recommended as post-exposure prophylaxis. The results from limited studiesimplied no associated between the rabies vaccination and adverse effects withinpregnancy, regardless pre-exposure vaccines were only to be consideredif the ‘risk was deemed high’.2To summarize,immunization prior to conception would be ideal for theprevention of vaccine-preventable diseases, however, Influenza and Tdap vaccines arerecommended whereas MMR and Varicella are recommended postpartumand others such as Hepatitis A and B, Pneumococcal and meningococcalare to be administered dependent upon risk factors.2 Inactivatedvaccines are deemed somewhat safe for use during pregnancy however regarding otherforms of vaccines, it should be considered whether the severityof the repercussions of infection during pregnancy outweighs the risksassociated with the vaccination when administering the vaccine.