Advice for GPs on pregnant women who are inadvertently vaccinated against measles, mumps, rubella, chicken pox (varicella) or human papilloma virus.
The Immunisation department at Public Health England (PHE) follows up women who have been given certain vaccines in pregnancy (VIP).
It analyses the details submitted by GPs and surgeries to better inform:
- pregnant women who are inadvertently immunised
- their families
- health professionals who are responsible for their care
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:
- measles, mumps and rubella (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
- human papilloma virus (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
There are no risks to women who conceive a baby soon after vaccination against measles, mumps, rubella, chickenpox or HPV.
Shingles vaccine administration in pregnancy
Shingles vaccine (Zostavax®, Generic Name: Varicella Zoster Virus, 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 2 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) whilst pregnant. See Viral rash in pregnancy.
If a pregnant woman has an uncertain history to chickenpox, or is not known to be immune, and receives Zostavax whilst pregnant, offer her testing to establish her immunity as early as possible.
Laboratory diagnosis of past infection is by VZV IgG antibody in serum.
If a woman with an uncertain or negative history of chickenpox is found susceptible (VZV IgG negative): contact firstname.lastname@example.org 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.
Whilst 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.
The UK Teratology information service (UKTIS) publishes information on the toxicity of drugs and chemicals in pregnancy.
The European Medicines Agency’s Electronic Medicines Compendium (EMC) publishes summaries of product characteristics (SPCs) and patient information leaflets (PILs).
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.