AFRO-NETS> RFI: Meningitis vaccination in pregnancy (2)

[Hanna Nohynek <hanna.nohynek@ktl.fi>]

RFI: Meningitis vaccination in pregnancy (2)
--------------------------------------------

Dear Mohamed Sherif,

I presume you mean to give the polysaccharide vaccine rather than the 
conjugate. It has been given safely to thousands of pregnant mothers 
both in Africa and elsewhere. A similarly engineered pneumococcal 
polysaccharide vaccine has been given to healthy as well as so called 
risk group mothers in clinical trials without evidence of terato-
genicity. CDC recommends it to pregnant mothers belonging to the risk 
groups. If you visit the CDC website, you'll find the American recom-
mendation:

Specific Recommendations for Pregnancy and Travel

Routine Immunizations
Because of the theoretical risks to the fetus from maternal vaccina-
tion, the risks and benefits of each immunization should be carefully 
reviewed. Ideally, all women who are pregnant should be up to date on 
their routine immunizations. In general, pregnant women should avoid 
live vaccines and women should avoid becoming pregnant within 3 
months of having received one; however, no harm to the fetus has been 
reported from the accidental administration of these vaccines during 
pregnancy.

Pneumococcal/Influenza
The pneumococcal and influenza vaccines should be given to all who 
would otherwise qualify for special protection against these dis-
eases: pregnant women with chronic diseases or pulmonary problems. In 
general, women with serious underlying illnesses should not travel to 
developing countries when pregnant.

Meningococcal Meningitis
The polyvalent meningococcal meningitis vaccine may be administered 
during pregnancy if the woman is entering an area where the disease 
is endemic. The vaccine's safety during pregnancy has not been con-
clusively determined.

As you can see, this text is more cautious for meningococcal vaccine 
because no one has performed large enough trials hypothesizing that 
vaccination is teratogenic. That is why the info states it with a 
negative undertone.

At the end of the day the decision to vaccinate or not is careful 
balancing with risks: theoretical risk from the vaccination contra 
theoretical/true risk of contracting meningococcal infection, and the 
demonstrated protective effect of the vaccination, and the chance of 
the specific individual to induce protective immunity to the given 
vaccine. Not an easy algorithm.

I hope you can find some of the above helpful in your decision-
making.

Good Luck,

Hanna Nohynek
Finland
mailto:hanna.nohynek@ktl.fi

--
Send mail for the `AFRO-NETS' conference to `afro-nets@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to:  `owner-afro-nets@usa.healthnet.org'.