Things to consider during your delivery, and ways to prepare.
Vaccines are an important topic for pregnant and non-pregnant women alike. When the body is exposed to a new bacteria or virus a primary immune response occurs. It takes times for the body to identify the new attacker, create the appropriate antibody to respond and then manufacture enough copies of the antibody to fight off the attack. Once the new virus or bacteria has been defeated, the body stores copies of the antibody to save for future reference. If the same virus or bacteria invades the body in the future, the appropriate antibody is already present and only needs to be replicated. This is known as the “secondary immune response.” The secondary immune response occurs more quickly and more robustly as the body already has the blueprints so to speak.
Vaccines are basically weakened or inactivated parts of bacteria or viruses. When they are given the body goes through the primary immune response and creates the corresponding antibodies. Because of this sometimes you will feel a very short course of fatigue or mild fever as the body’s immune system is activated to create the antibodies. If the body is exposed to these viruses or bacteria in the future it will then be able to mount a secondary immune response and prevent infection. Some of the more commonly recommended vaccines include varicella, MMR, hepatitis A and B, polio, flu, Tdap and HPV.
Varicella: Varicella zoster virus is more commonly referred to as chicken pox. It is characterized by a blister-like rash that itches and is accompanied by a fever. The vaccine, which prevents 90% of cases, is recommended at age 12-15 months and then again at four to six years. The 10% of people who still get chicken pox after having the vaccine have milder cases with only a few pox and no fevers. It is recommended to have the vaccine prior to attempting conception as chicken pox in pregnancy can lead to fetal anomalies or miscarriage and because the vaccine is a live attenuated vaccine, it is contraindicated in pregnancy.
MMR: MMR is a combination vaccine that prompts the body to create antibodies against the viral diseases measles, mumps and rubella.
Hepatitis A: Hepatitis A is a viral disease that affects the liver. It is spread by fecal contamination of food or water and is characterized by fever, fatigue, nausea, vomiting, diarrhea and jaundice or a yellowing of the skin. Affected people typically recover with no long-lasting sequelae. The vaccine is inactivated, not alive, and is recommended for anyone over one year of age who lives in or is traveling to an endemic area. Starting in 2018 there has actually been a dramatic increase in Hepatitis A infections throughout Florida and was declared a statewide public health emergency in August of 2019. Vaccination is recommended for everybody.
Hepatitis B: Hepatitis B is another viral disease that affects the liver. In its acute form is causes fever, fatigue, nausea, vomiting and jaundice. Most people recover completely without complications, but some develop chronic hepatitis B. The chronic form is usually asymptomatic however it can lead to liver scarring, cirrhosis, liver cancer and death. Hep B as it is commonly known is spread by bodily fluids including blood, semen, and amniotic fluid. Every pregnant woman is screened for immunity and carrier status. If found to be carrier the baby can be properly treated at birth to reduce the risk of transmission. The recombinant vaccine comes in three doses which are recommended at birth, one to two months and at 6-18 months.
Polio: Polio is a viral illness spread by respiratory droplets or by fecal contamination of food or water. The majority of people who become infected have no symptoms however 1 in 4 develop headaches, nausea, fatigue and fevers. Most of these people will recover without complication however 1 in 25 people develop swelling around the brain and 1 in 200 people develop paralysis. Post-polio syndrome is rare but can develop 15-40 years after the initial infection and presents as weakness or paralysis. The inactivated vaccine is recommended as 4 doses administered at 2 months, 4 months, 6-18 months and a booster at 4-6 years. The development of the polio vaccine by Jonas Salk has been credited as one of the greatest achievements in the history of mankind. Due to this vaccine, polio has been eliminated from most of the world but is still present in portions of Asia and Africa. A booster is available for those traveling to these regions.
Influenza: The flu is a seasonal, respiratory virus that typically presents with a fever, cough, headaches, body aches, fatigue and in children, nausea, vomiting and diarrhea. Most people recover without complications however infants, pregnant women and the elderly are at higher risk from complications including death. There are two versions of the vaccine, an inactivated injection that is safe for anyone over six months of age, and a nasal spray. The nasal spray, because it is live, is contraindicated in pregnancy. The inactivated injection is safe and recommended for every pregnant woman because it decreases the risk of influenza pneumonia by half and the risk of hospitalization by 40%. The antibodies a pregnant woman makes after receiving the vaccine can cross the placenta and be shared with the baby which will help protet the baby after birth. If a pregnant woman comes in contact with a person known to have a positive flu test, she should immediately contact her OBGYN because Oseltamivir, TamiFlu, can decrease her risk of contracting the flu.
Tdap: Tdap is a combination vaccine that protects against tetanus, diphtheria and pertussis. Tetanus is caused by the bacteria Clostridium tetani and causes muscle contractions so severe it can become difficult to open one’s mouth or swallow. Diphtheria is caused by the bacteria Corynebacterium diphtheriae and causes fever, sore throat and swelling the glands which makes breathing difficult. Pertussis, also called whooping cough, is caused by the bacteria Bordetella pertussis. It commonly causes fever, fatigue and a cough so severe ribs can break. 61% of people with pertussis, especially children, develop irregular breathing which can lead to death. The vaccine comes in different forms targeted at different age groups. Those under seven years are encouraged to get the DTaP or DT and whose over age seven get the Tdap or Td. Pregnant women are encouraged to get the Tdap in the third trimester of every pregnancy to help protect their babies as infants cannot be vaccinated until 2 months. When the pregnant woman is vaccinated, her body produces an increased number of antibodies which cross the placenta and are shared with the baby.
HPV: The human papilloma virus is the most common sexually transmitted infection. For more information please see the blog post, HPV Explained. https://www.obgyncareorlando.com/blog/hpv-explained
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