Pregnancy Testing Before Meningitis Vaccination
No, females do not need to undergo a pregnancy test before receiving meningitis vaccines (MenACWY or MenB). Pregnancy testing is not required or recommended prior to meningococcal vaccination, and pregnancy itself is not a contraindication to MenACWY vaccination.
MenACWY Vaccines (Serogroups A, C, W, Y)
Pregnant and lactating women should receive MenACWY vaccine if indicated, without requiring pregnancy testing beforehand. 1 The Advisory Committee on Immunization Practices (ACIP) explicitly states that pregnancy should not preclude vaccination with MenACWY when indicated. 1
Key Evidence Supporting Safety:
- No major safety concerns have been identified from Vaccine Adverse Event Reporting System (VAERS) reports of women who received MenACWY during pregnancy. 1
- A comprehensive VAERS review of 103 pregnant women who received MenACWY-D found no concerning patterns in maternal, infant, or fetal outcomes, with no maternal or infant deaths reported. 2
- A Kaiser Permanente study of 92 women inadvertently exposed to MenACWY-CRM during pregnancy showed prevalence rates of adverse outcomes comparable to U.S. background rates. 3
Clinical Approach:
- Administer MenACWY when indicated without pregnancy testing. 1
- If a woman discovers she was pregnant at the time of vaccination, she should contact her healthcare provider or vaccine manufacturer for registry documentation, but no intervention is needed. 1
- The only contraindications are severe allergic reactions to vaccine components or diphtheria/tetanus toxoid. 1
MenB Vaccines (Serogroup B)
For MenB vaccines, pregnancy testing is also not required, but the vaccination approach differs. MenB vaccination should generally be deferred in pregnant women unless they are at increased risk for serogroup B meningococcal disease. 1
Specific Guidance:
- Defer MenB vaccination in women known to be pregnant or lactating unless the woman is at increased risk. 1
- If at increased risk (e.g., complement deficiency, asplenia, outbreak exposure), vaccination may proceed after consultation with her healthcare provider when benefits outweigh potential risks. 1
- This deferral recommendation is based on limited data availability rather than documented safety concerns. 1
Important Distinctions
The guidance differs from HPV vaccination, where the 2016 ACIP schedule explicitly states: "HPV vaccines are not recommended for use in pregnant women. However, pregnancy testing is not needed before vaccination." 1 This same principle applies to meningococcal vaccines—pregnancy testing is unnecessary even though certain considerations exist for pregnant women.
Common Pitfalls to Avoid:
- Do not delay indicated MenACWY vaccination to perform pregnancy testing. 1
- Do not confuse "not recommended in pregnancy" with "requires pregnancy testing"—these are separate concepts. 1
- Do not terminate or consider terminating pregnancy if vaccination occurred during early pregnancy, as inactivated vaccines like meningococcal vaccines are generally safe. 4, 5