title: Immunization in pregnancy.
abstract: OBJECTIVE
  To review the evidence and provide recommendations on immunization in pregnancy.
  
  
  RESULTS
  Outcomes evaluated include effectiveness of immunization, and risks and benefits for mother and fetus.
  
  
  METHODS
  The Medline and Cochrane databases were searched for articles published up to June 2007 on the topic of immunization in pregnancy.
  
  
  METHODS
  The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC) under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care.
  
  
  RESULTS
  Implementation of the recommendations in this guideline should result in more appropriate immunization of pregnant and breastfeeding women, decreased risk of contraindicated immunization, and better disease prevention. Recommendations 1. All women of childbearing age should be evaluated for the possibility of pregnancy before immunization. (III-A) 2. Health care providers should obtain an immunization history from all women accessing prenatal care. (III-A) 3. In general, live and/or live-attenuated virus vaccines are contraindicated during pregnancy, as there is a, largely theoretical, risk to the fetus. (II-3) 4. Women who have inadvertently received immunization with live or live-attenuated vaccines during pregnancy should not be counselled to terminate the pregnancy because of a teratogenic risk. (II-2) 5. Non-pregnant women immunized with a live or live-attenuated vaccine should be counselled to delay pregnancy for at least four weeks. (III) 6. Inactivated viral vaccines, bacterial vaccines, and toxoids are considered safe in pregnancy. (II-1) 7. Women who are breastfeeding can still be immunized (passive-active immunization, live or killed vaccines). (II-1) 8. Pregnant women should be offered the influenza vaccine when pregnant during the influenza season. (II-1).
authors.affiliation: Ottawa, ON.
authors.forename: Andrée
authors.initials: A
authors.lastname: Gruslin
authors.forename: Marc
authors.initials: M
authors.lastname: Steben
authors.forename: Scott
authors.initials: S
authors.lastname: Halperin
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Money
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yudin
authors.forename: Marc
authors.initials: M
authors.lastname: Boucher
authors.forename: Beatrice
authors.initials: B
authors.lastname: Cormier
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.forename: Caroline
authors.initials: C
authors.lastname: Paquet
authors.forename: Audrey
authors.initials: A
authors.lastname: Steenbeek
authors.forename: Nancy
authors.initials: N
authors.lastname: Van Eyk
authors.forename: Julie
authors.initials: J
authors.lastname: van Schalkwyk
authors.forename: Thomas
authors.initials: T
authors.lastname: Wong
mesh_terms: D002170:Canada; D000075202:Contraindications; D005260:Female; D006801:Humans; D017589:Immunization Programs; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D014611:Vaccination / Q000592:standards*