From the Guidelines
Pregnant patients in the Philippines are recommended to receive the influenza vaccine and the Tdap vaccine, as per the Philippine Obstetrical and Gynecological Society (POGS) guidelines. The inactivated influenza vaccine should be administered during any trimester of pregnancy to protect both mother and baby from flu complications 1. The Tdap vaccine is recommended between 27-36 weeks of gestation during each pregnancy, regardless of prior vaccination history, to provide passive antibody transfer to the newborn against pertussis 1.
Key Vaccines Recommended for Pregnant Patients
- Influenza vaccine: administered during any trimester of pregnancy
- Tdap vaccine: administered between 27-36 weeks of gestation during each pregnancy
- COVID-19 vaccination: also recommended for pregnant women, with mRNA vaccines preferred
Special Considerations
- Live attenuated vaccines such as MMR (measles, mumps, rubella) and varicella are contraindicated during pregnancy and should be given at least one month before conception or postpartum
- Pregnant women who have not received tetanus vaccination previously or have an incomplete series should receive Td (tetanus and diphtheria) or Tdap according to the recommended schedule 1
Rationale for Recommendations
Vaccination during pregnancy serves dual purposes: protecting the mother from infections that may cause more severe illness during pregnancy and providing passive immunity to the newborn through maternal antibodies that cross the placenta. The recommended vaccines are based on the latest guidelines and evidence, including those from the Advisory Committee on Immunization Practices (ACIP) 1.
From the Research
Vaccines for Pregnant Patients per Philippines POGS Guideline
The Philippines POGS (Philippine Obstetrical and Gynecological Society) guideline recommends the following vaccines for pregnant patients:
- Influenza vaccine: Women who are or will be pregnant during influenza season should receive an annual influenza vaccine 2
- Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine: All pregnant women should receive a Tdap vaccine during each pregnancy, as early in the 27-36-weeks-of-gestation window as possible 2, 3
- Pneumococcal vaccine: Although not specifically mentioned in the provided studies, pneumococcal vaccine uptake was low and unchanged in a study examining vaccine uptake during pregnancy 4
Safety of Vaccines during Pregnancy
There is no evidence of adverse fetal effects from vaccinating pregnant women with inactivated virus, bacterial vaccines, or toxoids 2, 3, 5 A study examining the risk of major birth defects in offspring found no evidence of appreciable risks associated with Tdap vaccine exposure during early or late pregnancy 5
Vaccine Uptake during Pregnancy
A study found that Tdap vaccine uptake and timing improved after the release of new guidelines, with 86.1% of pregnant women receiving the Tdap vaccine after the guidelines, compared to 47.4% before 4 Influenza vaccine uptake also improved during the study period, while pneumococcal vaccine uptake remained low 4 Factors associated with receiving the Tdap and influenza vaccines during pregnancy included an increased number of prenatal visits, while non-Hispanic Black individuals were less likely to receive both vaccines 4