Drugs in Pregnancy

Do the Benefits Outweigh the Risks?

Anita T. Mosley, PhD, PharmD; Amy P. Witte, PharmD


US Pharmacist. 2013;38(9):43-46. 

In This Article


Women who are considering pregnancy or those already pregnant should be advised on the importance of receiving vaccines. Informing these patients of the benefits of receiving certain vaccinations can significantly reduce the occurrence of preventable diseases. With the many vaccines available, and pharmacists at the front lines as immunizers, it is important to discuss the agents utilized for specific groups of patients. The following are a few of the current recommendations for vaccine use during pregnancy.

The most current update to the immunization schedule was the recommendation to administer tetanus, diphtheria, and acellular pertussis (Tdap) vaccine with each pregnancy during the 27th to 36th week of gestation. This is different from prior recommendations that were dependent upon previous vaccination history. Waiting until the second trimester is reasonable to minimize concerns about possible adverse reactions.[25] Healy et al concluded that the infants of mothers immunized either before their pregnancy, or in early gestation, displayed insufficient antibodies to aid in infant protection from disease.[26] Furthermore, the antibodies that were transferred were lost within a 6-week period, which could possibly place the infant at risk of infection.[26]

Influenza vaccination should be recommended for all pregnant women for prevention of seasonal influenza and can be administered in any trimester. It is most beneficial when given as early as available in the flu season.[27] The immunizations contraindicated during pregnancy are live vaccinations, which include influenza (LAIV); measles, mumps, and rubella (MMR); varicella; and zoster.[25]