Vaccination in pregnancy

What it is

Vaccination during pregnancy is a short list, and the exam turns on which vaccine is on it and which is not:

• Influenza
• Tdap (Tetanus, Diphtheria, and Acellular Pertussis)
• COVID-19 vaccine
• Tetanus toxoid

And if indicated only: hepatitis A, hepatitis B, or inactivated typhoid vaccine; and meningococcal polysaccharide vaccine.

Why the list exists at all is worth holding, because it explains two of the entries. Immunization of pregnant women can protect them directly against vaccine-preventable infections, and in so doing potentially protect the fetus; it can also directly protect the fetus and infant via specific antibodies transferred from the mother during the pregnancy. That second route carries the weight, because the immature adaptive immune systems of neonates and premature infants make them particularly vulnerable to morbidity and mortality due to infection.

How it is diagnosed

Two items from booking screening sit next to vaccination. Rubella immunity is one of them. The other: tetanus vaccination may be given, but tetanus antibody testing is not routine - the page marks it Exam Q.