Pocket Guide for Immunizers

 

Videos for Immunizers on How to Recommend Vaccines in Pregnancy

 

 

 

 

Toolkit: Improving vaccine confidence and uptake in pregnant Canadians

 

Factsheets and Infographic on Vaccines in Pregnancy 

**A COVID-19 vaccine is recommended in pregnancy and particularly for those with additional risk factors for severe COVID-19 disease. Administration should consider the timing of last dose provided. We encourage pregnant individuals to speak with their healthcare professional for more information.

Vaccines in Pregnancy factsheet in multiple languages

 

Video Shorts about Vaccines in Pregnancy

 

 

Posters on Vaccines in Pregnancy 

Additional Resources 

• Vaccines in Pregnancy Canada - Cumming School of Medicine at the University of Calgary, the Alberta Children’s Hospital Research Institute, BC Children’s Hospital Research Institute, and the Faculty of Medicine at the University of British Columbia.

 

Is immunization safe during pregnancy?

Yes! There are three vaccines recommended during every pregnancy, and all three vaccines have a good safety record. There is no evidence that these vaccines harm the pregnant parent or baby. These vaccines are:

• 1. the influenza (flu) vaccine (see our factsheet on influenza vaccines in pregnancy)
• 2. the pertussis (whooping cough) vaccine, given as the tetanus, diphtheria, and pertussis (Tdap) combination vaccine (see our infographic on the pertussis vaccine in pregnancy)
• 3. the COVID-19 vaccine

 

In addition, if you are pregnant, you can typically receive any of the non-live vaccines approved for use in Canada. Non-live vaccines use a killed (inactivated) version of a virus or bacteria, or parts/by-products of viruses or bacteria. Because non-live vaccines do not use a live virus or bacteria in the vaccine, it is impossible to become infected with said virus or bacteria if you receive one of these vaccines. As such, they are considered safe to receive if you are pregnant.

I am planning a pregnancy. What vaccines should I consider before getting pregnant?

In general, if you are planning a pregnancy, you should consider getting any vaccines you have never received in the past or that you are not up to date on.

However, before becoming pregnant, there are two main vaccines that you should consider getting if you have never received these vaccines in the past. These vaccines are:

• 1. the varicella (chickenpox) vaccine
• 2. the measles, mumps, and rubella (MMR) vaccine – to specifically protect against rubella

 

You cannot receive these vaccines during pregnancy as they are live vaccines and, as a result, pose a potential risk to your developing baby.

The reason it is recommended that you receive the varicella and MMR vaccines before you become pregnant is that if you catch varicella or rubella while pregnant, it may cause your baby to be born with conditions that will affect them for the rest of their life.

Why is immunization important before and during pregnancy?

Pregnancy causes certain changes to take place within your body that can affect your immune system, heart, and lungs. These changes can leave you more susceptible to catching some diseases, and to experiencing severe infection. If you catch certain communicable diseases while pregnant, such as rubella, the infection can be passed on to your baby, who may be born with conditions that will affect them for life. As well, there are other vaccine-preventable diseases, such as pertussis (whooping cough), that are most severe in children too young to be immunized.

Therefore, getting vaccinated with recommended vaccines both before and during pregnancy will help give yourself and your baby the best protection possible against harmful vaccine-preventable diseases, such as rubella, varicella (chickenpox), influenza (flu), and pertussis, to name a few.

How does getting vaccinated while pregnant protect my baby?

When you get vaccinated, your body creates protective proteins called antibodies that specifically protect against the disease you are being immunized against. When you get vaccinated while pregnant, you pass on some of these antibodies to your baby in the womb (in utero). Once your baby is born, these antibodies provide them with some short-term protection (a couple of months or so) against the disease you were immunized against while pregnant.

What about the respiratory syncytial virus (RSV) vaccine? Can I get that vaccine if I am pregnant?

Yes! You can safely get the RSV vaccine if you are pregnant.

As of December 2023, a vaccine that protects against RSV was approved for use in Canada for people 32 to 36 weeks pregnant. Getting immunized against RSV while pregnant gives your baby some short-term protection against severe RSV infection for up to six months after they have been born. Talk to your healthcare professional to see if you can get immunized against RSV while pregnant.

Can I get vaccinated if I am breastfeeding?

Yes, you can safely receive any of the routinely recommended vaccines in Canada if you are breastfeeding. There is no evidence that receiving any of these vaccines while you are breastfeeding will harm you or your baby.

However, the following vaccines are not recommended for people who are breastfeeding:

• 1. the yellow fever vaccine
• 2. the oral typhoid vaccine
• 3. the Bacille Calmette-Guérin vaccine
• 4. the Ebola vaccine
• 5. the live replicating smallpox vaccine

 

In extenuating circumstances, your healthcare professional may recommend you receive one or more of the vaccines listed above.

If I am planning to travel while pregnant, are there certain vaccines I should receive?

Depending on where you are travelling to, your healthcare professional may recommend you receive a vaccine to protect against one or more of the following diseases, especially if you are likely to become severely infected with one of them:

• 1. typhoid
• 2. cholera
• 3. enterotoxigenic Escherichia coli (travellers' diarrhea)

 

The yellow fever vaccine is not recommended for pregnant people (it is a live vaccine). However, if you absolutely must travel to a place where yellow fever is very common/active and you will not be well protected against mosquito bites, your healthcare professional may recommend you receive the yellow fever vaccine.

It is also highly recommended that you visit a travel health clinic at least six weeks before you plan to travel outside of Canada if you are pregnant. Travel clinics can provide you with up-to-date information – such as which vaccines you may need depending on your travel destination – on how best to protect yourself and your developing baby from certain diseases found only in other countries that can be very serious if caught during pregnancy.

Why are non-live vaccines considered safe to receive while pregnant, while live vaccines are not generally recommended?

Live vaccines use a weakened (attenuated) version of a virus or bacteria. Non-live vaccines use a killed (inactivated) version of a virus or bacteria, or parts/by-products of viruses or bacteria.

Because non-live vaccines do not use a live virus or bacteria in the vaccine, it is impossible to become infected with said virus or bacteria if you receive one of these vaccines. As live vaccines use a weakened version of a virus or bacteria, they can be used safely in people with healthy immune systems without causing infection.

However, live vaccines are generally not recommended for people who have a severely weakened immune system – or for pregnant people. If you are pregnant, there is the possibility that even the weakened form of a virus or bacteria in a live vaccine could infect your unborn baby. This is why non-live vaccines are recommended, and live vaccines are normally not recommended, during pregnancy.