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In this summary

  • This summary contains advice for clinicians on pregnant women who are inadvertently vaccinated against:
    • measles, mumps, and rubella (MMR)
    • chicken pox (varicella)
    • human papillomavirus (HPV).

Notify PHE

  • If you have patients who have had MMR, varicella, or HPV vaccine administered during their pregnancy or shortly before conception, notify PHE, which runs UK-wide surveillance on the safety of vaccines given in pregnancy
  • PHE tracks women who are immunised, and then become pregnant within a specific time frame, with the following vaccines:
    • MMR vaccine: immunisation from 30 days before last menstrual period to anytime during pregnancy
    • varicella vaccine (chickenpox): immunisation from 90 days before last menstrual period to anytime during pregnancy
    • HPV vaccine: immunisation from 60 days before last menstrual period to anytime during pregnancy

Vaccination during pregnancy

  • There are no known risks for women who are vaccinated against measles, mumps, rubella, chickenpox, or HPV during any stage of pregnancy

Women who get pregnant soon after vaccination

Shingles vaccine administration in pregnancy

  • Shingles vaccine (Zostavax®; generic name: varicella zoster virus (VZV), marketed by Sanofi Pasteur MSD) is a live viral vaccine that is not recommended for use in pregnancy
  • Most women of child-bearing age in the UK are known to be immune to chickenpox
  • You can reassure a pregnant woman immunised with Zostavax that she is protected from infection if she both:
    • has a past history of chickenpox or shingles, or two doses of a varicella-containing vaccine
    • is not immunosuppressed
  • This is the same advice you would give a woman with the same history if she was exposed to natural disease (chickenpox or shingles) while pregnant—see Viral rash in pregnancy
  • If a pregnant woman has an uncertain history with regard to chickenpox, or is not known to be immune, and receives Zostavax while pregnant, offer her testing to establish her immunity as early as possible
  • Laboratory diagnosis of past infection is by VZV immunoglobulin G (IgG) antibody in serum
  • If a woman with an uncertain or negative history of chickenpox is found susceptible (VZV IgG negative): contact immunisationlead@phe.gov.uk as soon as you have the result, to discuss the individual case
  • The immunisation team may recommend varicella zoster immunoglobulin, given within 10 days of the Zostavax immunisation
  • The virus in both varicella (chickenpox) and shingles vaccines has been weakened: it is safer in humans than infection by the wild virus—there is no known risk to the pregnancy or to the fetus from these vaccines
  • Shingles vaccine contains a higher dose of the same varicella zoster virus that is in the varicella vaccine
  • As with varicella vaccine in pregnancy, report inadvertent immunisation with Zostavax to the PHE Vaccination in Pregnancy surveillance programme, to monitor the safety of such exposures
  • While consent does not need to be obtained, it is recommended that details of this surveillance are discussed with the patient by any health professional reporting a case in one of their patients
  • The Health Service Regulation 2002 stipulates that confidential patient information may be processed with a view to monitor and manage the delivery, efficacy, and safety of immunisation campaigns
  • The Regulation states that the processing of confidential patient information for the purposes specified above may be undertaken by the Public Health Laboratory Service, since superseded by the Health Protection Agency and subsequently PHE

For any questions, contact Helen Campbell at PHE on 07824 551803

Infectious diseases during pregnancy

  • This guidance gives an overview of risks to pregnant women from infections—it provides information on current screening, vaccination, treatment, and prevention programmes

full guideline available from…

https://www.gov.uk/guidance/vaccination-in-pregnancy-vip

Public Health England. Vaccination in pregnancy (VIP). PHE, 2010 (last updated 2015).

Contains public sector information licensed under the Open Government Licence v3.0.

First included: March 2019.