From the Guidelines
A pregnant woman who discovers she is not immune to varicella should not receive the varicella vaccine during pregnancy, but rather wait until after delivery to get vaccinated. The varicella vaccine is a live attenuated vaccine, which means it contains weakened but still living virus particles, and is contraindicated during pregnancy due to theoretical risks to the developing fetus 1.
The recommended approach is to avoid exposure to chickenpox during pregnancy and get vaccinated in the immediate postpartum period, ideally before discharge from the hospital. According to the most recent guidelines, after pregnancy, the woman should receive 1 dose of the varicella vaccine if she has previously received 1 dose of a varicella-containing vaccine, or 1 dose of a 2-dose series (with the second dose given 4 weeks later) if she has not received any varicella-containing vaccine previously 1.
Key considerations for vaccination include:
- The varicella vaccine is contraindicated during pregnancy due to theoretical risks to the developing fetus
- Women should be counseled to avoid conception for 1 month after each dose of varicella vaccine
- The complete vaccination schedule involves two doses of the varicella vaccine given 4-8 weeks apart
- Vaccination after pregnancy is important because chickenpox infection in adults can be more severe than in children and can lead to serious complications.
It is essential to follow the recommended vaccination schedule to ensure optimal protection against varicella, as outlined in the most recent guidelines 1.
From the Research
Varicella Vaccine Administration in Pregnant Women
- The varicella vaccine is recommended for women with no history of varicella who are planning to become pregnant, as well as for post-pregnancy women, to prevent the occurrence of this illness and its severe complications 2.
- If a pregnant woman finds out she is not immune to varicella, the vaccine should not be administered during pregnancy, nor in the month preceding it 2.
- However, if a woman is inadvertently vaccinated during pregnancy, the data collected on the outcomes of exposed pregnancies allow for reassurance, as no congenital varicella syndrome has been reported to date following accidental vaccination in early pregnancy 2.
Post-Pregnancy Vaccination
- The varicella vaccine can be administered to women post-pregnancy, and it is recommended for women who are not immune to varicella 2.
- During breastfeeding, a woman may be vaccinated if there is an expected short- or medium-term benefit, such as varicella exposure or planned pregnancy 2.
Alternative Prevention Methods
- For pregnant women who are not immune to varicella and are exposed to the virus, varicella zoster immune globulin (VARIZIG) can be administered to prevent or attenuate varicella-zoster virus infection 3, 4.
- VARIZIG can be administered up to 10 days after varicella exposure, and it has been shown to be effective in reducing the incidence of varicella in high-risk individuals, including pregnant women 3.