A 24-year-old primigravid woman at 28 weeks gestation presents to the obstetric clinic in mid-October for a routine prenatal visit. She has no significant past medical history and her pregnancy has been uncomplicated to date. Her vaccination records from childhood are unavailable, and she states she has not received any immunizations since graduating high school. Physical examination shows a fundal height consistent with dates and normal fetal heart tones. Which of the following immunizations should be administered to this patient today? (Select all that apply)
- Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccineCevap
- Inactivated influenza vaccineCevap
- CMeasles, mumps, and rubella (MMR) vaccine
- DVaricella vaccine
- ELive attenuated influenza vaccine (LAIV)
Cevap
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine AND Inactivated influenza vaccine
The administration of both the Tdap vaccine and the inactivated influenza vaccine is the standard of care for this patient. Tdap is universally recommended during every pregnancy, optimally between 27 and 36 weeks of gestation, to maximize the transplacental transfer of protective maternal pertussis antibodies to the fetus. The inactivated influenza vaccine is recommended for all pregnant women who are pregnant during the influenza season (typically October through May) to prevent severe maternal morbidity and mortality associated with influenza infections during pregnancy.
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Routine immunization during pregnancy includes the Tdap vaccine (optimally at 27-36 weeks) and the inactivated influenza vaccine (during flu season), while all live-attenuated vaccines are strictly contraindicated.