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Key Clinical Updates in Travel & Immunizations During Pregnancy

Vaccination against COVID-19 is recommended for women who are pregnant, trying to get pregnant or may become pregnant, and who are breastfeeding. The CDC has determined that the benefits of vaccination outweigh any risks. There is no evidence that vaccination causes problems with fertility in men or women. Pregnant women who have been vaccinated may receive the COVID-19 booster shot. There have been rare reports of thrombosis with thrombocytopenia syndrome in women younger than 50 years old who received the Johnson and Johnson’s Janssen vaccine. This risk has not been found with the Pfizer-BioNTech and Moderna vaccines; women younger than 50 years old with access to multiple vaccines may want to factor this into their decision-making process.

CDC. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

During an otherwise normal low-risk pregnancy, travel can be planned most safely up to the 32nd week. Commercial flying in pressurized cabins does not pose a threat to the fetus. An aisle seat will allow frequent walks. Adequate fluids should be taken during the flight. Travel can also increase women’s chances of exposure to SARS-CoV-2, the virus that causes COVID-19. Pregnant women infected with SARS-CoV-2 are believed to be at increased risk for preterm birth and for serious illness compared with women who are not pregnant. Pregnant women should limit their exposure to people outside their household, wear a mask while outside the home, practice frequent hand washing, and social distance.

Vaccination against COVID-19 is recommended for women who are pregnant, trying to get pregnant, or may become pregnant, and who are breastfeeding. The CDC has determined that the benefits of vaccination outweigh any risks. There is no evidence that vaccination causes problems with fertility in men or women. Pregnant women who have been vaccinated may receive the COVID-19 booster shot. There have been rare reports of thrombosis with thrombocytopenia syndrome in women younger than 50 years old who received the Johnson and Johnson’s Janssen vaccine. This risk has not been found with the Pfizer-BioNTech and Moderna vaccines; women younger than 50 years old with access to multiple vaccines may want to factor this into their decision-making process.

Traveling to endemic areas of yellow fever (Africa or Latin America) or of Zika virus (Latin America) is not advisable; since Zika virus can be sexually transmitted, partner travel should also be discussed (see Chapter 32). Similarly, it is inadvisable to travel to areas of Africa or Asia where chloroquine-resistant falciparum malaria is a hazard, since complications of malaria are more common in pregnancy.

Ideally, all immunizations should precede pregnancy. Live virus products are contraindicated during pregnancy (measles, rubella, yellow fever, and smallpox). Inactivated polio vaccine should be given subcutaneously instead of the oral live-attenuated vaccine. The varicella vaccine should be given 1–3 months before becoming pregnant. It is not recommended in pregnancy. Vaccines against pneumococcal pneumonia, meningococcal meningitis, and hepatitis A can be used as indicated. Pregnant ...

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