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Although no adverse effects of IPV have been documented among pregnant women or their fetuses, vaccination of pregnant women should be avoided on theoretical grounds. However, if a pregnant woman is at increased risk for infection and requires immediate protection against polio, IPV can be administered in accordance with the recommended schedules for adults. Paralytic disease can occur with greater frequency when infection develops during pregnancy. Damage to the unborn baby has also been reported, with up to 50 percent mortality in neonatal infection.
The hepatitis B vaccine may be administered during pregnancy. On the basis of limited experience, there is no apparent risk of adverse effects to developing fetuses when hepatitis B vaccine is administered to pregnant women (CDC, unpublished data).
Because of the increased risk for influenza-related complications, women who will be beyond the first trimester of pregnancy (greater than 14 weeks' gestation) during the flu season should be vaccinated. Pregnant women who have medical conditions that increase their risk for complications from influenza should be vaccinated before the flu season -- regardless of the stage of pregnancy.
Travel-Related Immunization During Pregnancy
The yellow fever vaccine should not be given to a pregnant woman unless travel to an endemic or epidemic area is unavoidable. In these instances, the vaccine can be administered. Although concerns exist, no congenital abnormalities have been reported after administration of this vaccine to pregnant women.
If traveling to or transiting regions within a country where the disease is not a current threat but where policy requires a yellow fever vaccination certificate, pregnant travelers should be advised to carry a physician's waiver, along with documentation (of the waiver) on the immunization record.
In general, pregnant women should be advised to postpone until after delivery (when vaccine can be administered without concern of fetal toxicity) travel to areas where yellow fever is a risk. However, a nursing mother should also delay travel because the neonate cannot be immunized due to the risk of vaccine-associated encephalitis.