acteria and viruses can infect a person and cause serious diseases. Some diseases can be prevented with immunizations or vaccines. It is better to protect yourself against these diseases than to treat them. Most vaccines are given to children, but adolescents and adults also need them. This pamphlet will explain:
- Diseases that can be prevented with immunizations
- Which immunizations a woman may need
- Vaccines recommended during pregnancy
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| Vaccines are an important part of your preventive health care. Talk with your doctor about which ones you need. |
Vaccines
When bacteria or a virus invades a person's body, it triggers their immune system—the body's natural defense against disease—to produce antibodies to fight the infection. In many cases, once your immune system has produced antibodies, you become immune to the disease—that is, you can no longer get it. Just as having a disease may make a person immune to getting it again, a vaccine also can cause immunity. The vaccine mimics the disease (without signs and symptoms) and causes your body to produce antibodies.
A vaccine usually is made up of an altered form of the infection that you will be protected against. In most cases, vaccines are given as shots and are safe and effective. Most people have no problems after having a vaccine. As with any medication, however, there may be some mild side effects. Soreness or swelling may occur where the shot was given. Your doctor may suggest that you take a mild pain medication or use an ice pack on the sore area. Other side effects, such as a fever or a rash, usually are very mild and go away in a few days. There is much more danger to you from the diseases than from the vaccines. Serious side effects are rare.
To protect against some diseases, you need only one dose or, in some cases, a series of doses of the vaccine to be immune for life. For other diseases, you will need booster shots to remain immune.
Which Vaccines Do You Need?
If you have not been vaccinated for the common childhood diseases, or if you are not sure, talk with your doctor—it may be important for you to get them now. These vaccines usually are given during childhood:
- Hepatitis A
- Hepatitis B
- Diphtheria–tetanus–pertussis
- Haemophilus influenzae type B
- Human papillomavirus
- Influenza
- Measles, mumps, and rubella
- Meningococcal
- Pneumococcal
- Polio
- Rotavirus
- Varicella
There are nine main vaccines adolescents and adults may need to receive. Some of these are required for all women, some for only high-risk women, and some for only women of a certain age (see table "Recommended Vaccines"). Women who work in jobs where they may be exposed to certain infections, such as teachers and health care workers, also should be vaccinated.
| Recommended Vaccines |
Routine for All Women
(When) |
High-Risk Groups (When) |
| Ages 13–18 years |
Tetanus-diphtheria-pertussis booster (once between
ages 11 and 18 years)
Hepatitis B (if not already immunized)
Human papillomavirus (if not already immunized)
Meningococcal (once before entry into high school if not already immunized) |
Influenza (annually)
Hepatitis A virus (one series if not already immunized)
Pneumococcal pneumonia (once if not already immunized)*
Measles, mumps, and rubella (one series if not already immunized)
Varicella (one series if not already immunized) |
| Ages 19–39 years |
Tetanus-diphtheria-pertussis booster (every 10 years)
Human papillomavirus (once if aged 26 years or younger and not already immunized) |
Measles, mumps, and rubella (once)
Varicella (one series)
Influenza (annually)
Hepatitis A (one series)
Hepatitis B (one series)
Pneumococcal pneumonia (once)*
Meningococcal (once)
|
| Ages 40–64 years |
Tetanus-diphtheria-pertussis booster (every 10 years)
Herpes zoster (once for women aged 60 years and older if not already immunized)
Influenza (annually beginning at age 50 years) |
Measles, mumps, and rubella (once)
Varicella (one series)
Hepatitis A (one series)
Hepatitis B (one series)
Pneumococcal pneumonia (once)*
Meningococcal (once)
Influenza (annually)
|
| Ages 65 years and older |
Tetanus-diphtheria booster (every 10 years)
Herpes zoster (once if not already immunized)
Influenza (annually)
Pneumococcal (once) |
Hepatitis A (one series)
Hepatitis B (one series)
Meningococcal (once)
Pneumococcal (once)* |
| *Based on risk factors, some women may need to have the vaccination repeated after 5 years. |
In some cases, a woman's personal or family health history can cause her to be in a high-risk group. This means that she is at increased risk for certain diseases and may need vaccines other than those routinely recommended. Check the Centers for Disease Control and Prevention web site (http://www.cdc.gov/vaccines/) or talk to your doctor to find out which vaccines you may need.
Tetanus, Diphtheria, and Pertussis
Tetanus, diphtheria, and pertussis are serious diseases caused by bacteria. Tetanus is an infection that can enter the body through a puncture wound or cut like those made by nail or knife. It is sometimes called "lockjaw" because it can cause the jaw to "lock" so that you cannot open your mouth or swallow.
Diphtheria can cause the growth of a membrane, usually in the throat, that can block air passages from the lungs. This can cause permanent damage to the heart and lungs and can be life-threatening.
Pertussis, also called whooping cough, causes severe coughing that occurs without a fever. It is most harmful to babies younger than 3 months, but adolescents and adults also can get the disease.
Tetanus, diphtheria, and pertussis are prevented by a vaccine that protects you against all three diseases. The vaccine—known as the Tdap vaccine—is given as one shot. Adults should have a booster shot every 10 years. Those who have never had the vaccine, or cannot remember, will need a series of three shots (two of Td and one of Tdap). Adults who have been vaccinated against tetanus and diphtheria, will need a one shot dose of the Tdap vaccine to prevent pertussis.
Measles, Mumps, and Rubella
Measles, mumps, and rubella are infections caused by viruses. Measles can cause a rash, high fever, and cough. Mumps can cause a painful swelling of the glands near the ears. Rubella (German measles) causes cold symptoms, sore throat, fever, and a rash. In pregnant women, rubella can cause birth defects or death of the fetus.
If you have never had or are not sure if you have had the measles, mumps, or rubella, or if you have not been vaccinated against them, you should be immunized. The measles, mumps, and rubella shot protects against all three diseases.
Hepatitis B Virus
Hepatitis B virus (HBV) attacks and can damage the liver. It is spread by contact with bodily fluids and causes the disease hepatitis. Symptoms include fatigue, loss of appetite, nausea, jaundice, and muscle aches.
Most people who get HBV become immune to it after the disease runs its course. They can no longer pass it on to someone else. For some (10–20%) who are infected, the disease is chronic. It can lead to problems such as cirrhosis (scarring) of the liver, liver failure, or liver cancer later in life. If a pregnant woman has HBV, she can pass it to her fetus. If a child gets HBV at birth, he or she has up to a 90% chance of becoming a chronic carrier. Someone who carries the virus can spread the disease throughout his or her life. He or she also is at increased risk for cirrhosis of the liver or cancer of the liver.
The vaccine for HBV is given in a series of three shots over a period of 6 months. To be protected, all of the shots must be taken. The vaccine is safe during pregnancy and is encouraged for all pregnant women who have not been vaccinated.
Hepatitis A Virus
Hepatitis A virus also attacks and can damage the liver. It is most often spread by contact with feces in food or water. It also can be spread through contact with infected blood. Symptoms include fatigue, loss of appetite, fever, diarrhea, and jaundice.
Most people who have hepatitis A get well on their own after a few weeks. Once a person recovers, he or she is immune and will not get hepatitis A again.
The vaccine for hepatitis A virus is given in a series of two or three shots over a period of 6 months. All of the shots are needed in order to be protected.
Varicella
Varicella—chickenpox—is a very contagious disease caused by a virus. People who have never had varicella can get infected just by being in the room with someone who has the disease.
Although varicella is a mild disease in children, adults usually get very sick. This is even more true for women who are pregnant. Varicella causes an itchy rash with blisters that may spread over most of the body, including inside the mouth or eyes.
The vaccine to protect against varicella is given in two doses for adults. To be protected, both doses must be taken.
Although the rash caused by varicella goes away in days or weeks, the virus does not leave your body. As a person ages, the virus can reappear in the form of shingles. Shingles is a painful skin rash that is caused by the varicella-zoster virus, the same type of virus that causes chickenpox. There is a vaccine called herpes zoster available for women aged 60 years and older to prevent shingles.
Human Papillomavirus
Human papillomavirus is a very common infection that can be passed from person to person. Many types of HPV are spread through sexual contact. Studies suggest that at least three out of every four people who have sex will get a genital HPV infection at some time during their lives. Sexually transmitted HPV can spread through vaginal, anal, or oral sex.
About 40 types of HPV can infect the genital areas of a woman or a man. There often are no signs of genital HPV; however, a few types of HPV cause warts. Some types of HPV cause cancer of the cervix. HPV also may be linked to cancer of the anus, vulva, vagina, and penis. Genital warts usually are not linked with cancer.
A vaccine is available that protects against the two types of HPV that cause the most cases of cervical cancer and the two types that cause the most cases of genital warts. The HPV vaccine is given in three doses over a 6-month period and is recommended as a routine vaccination for all girls aged 11–12 years. However, it can be given to girls as young as 9 years. To be protected, all shots must be taken. Girls and young women aged 13–26 years who have either not yet received the vaccine or have not completed all doses also should be vaccinated. The vaccine is most effective when it is given before a woman has sex for the first time.
Meningococcal
Meningococcal disease is a bacterial infection that can cause meningitis. Meningitis is an infection of the spinal cord fluid and the fluid that surrounds the brain. It can be severe and, in some cases, life threatening. It can cause brain damage, hearing loss, blindness, or learning problems. Meningitis is spread through contact with bodily fluids from the lungs and throat, such as during coughing or kissing.
The vaccine is recommended for all adolescents aged 11–18 years or before they enter high school. Although the meningococcal vaccine cannot prevent all types of meningitis, it does prevent four types of the disease, including two of the three most common types in the United States.
Influenza
Influenza—the flu—is a very contagious infection of the nose, throat, and lungs. The symptoms of influenza include high fever, chills, a dry cough, headache, and muscle and joint pain. It can cause extreme fatigue that lasts several days.
A new flu vaccine is made each year because the influenza virus is always changing. For this reason, you must get the vaccine (flu shot or, in some cases, a nasal spray) once a year. The shot is given anytime between October and May to protect you throughout fall and winter when the illness is most common. In general, anyone who wants to reduce his or her risk of getting the flu can be vaccinated.
Pneumococcal Pneumonia
Pneumococcal pneumonia is caused by bacteria that infect the lungs. The symptoms include high fever, cough with chest pain, shaking chills, and wheezing.
The vaccine to protect against pneumococcal pneumonia is very effective. It is recommended for women aged 65 years and older and may be considered for others based on their risk. One shot lasts most people a lifetime.
Concerns During Pregnancy
It is best for a woman to have all of her vaccinations before she becomes pregnant—especially the varicella vaccine. This is because the infection can cause serious illness during pregnancy and may harm the fetus.
Like all medications, a vaccine should be used during pregnancy only when it is needed and safe. All women who will be pregnant during the flu season (October through May) can and should be vaccinated for the flu at any time during pregnancy with the flu shot. Pregnant women should not get the nasal spray form of the flu vaccine. Some other vaccines are not given routinely to pregnant women, but are safe to be used if a woman is likely to come in contact with the infections:
- Hepatitis A
- Hepatitis B
- Tetanus, diphtheria, and pertussis
- Pneumococcal
- Meningococcal
Certain vaccines should be avoided during
pregnancy:
- Human papillomavirus
- Measles, mumps, and rubella
- Varicella
- Lyme disease
If you plan to become pregnant, you should be vaccinated for measles, mumps, rubella, or varicella, at least 1 month in advance. If you are already pregnant but not vaccinated, you should get vaccinated right after you have your baby. However, if you received the vaccines while you were pregnant, do not worry. Many women have been exposed to the vaccines during pregnancy and have healthy babies. If the reason you need certain vaccines is because of travel, talk to your doctor. In some cases, it may be better to postpone the trip until the baby is born.
You may wish to schedule a visit with your doctor to plan your pregnancy. As part of your visit, talk with your doctor about the routine vaccinations that are needed to protect you and your fetus from possible problems.
Finally...
Vaccines are an important part of your preventive health care. Talk with your doctor about which ones you need. Keep a record of the vaccines you have had. Getting the recommended vaccinations is one of the easiest and most important things you can do to increase your chances of staying healthy.
Glossary
Antibodies: Proteins in the blood produced in reaction to foreign substances (in this case, vaccines).
Cirrhosis: A disease caused by loss of liver cells, which are replaced by scar tissue that impairs liver function.
Jaundice: A buildup of bilirubin that causes a yellowish appearance.
This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.
Copyright ©March 2008 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
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Bacteria and viruses can infect a person and cause serious diseases. Some diseases can be prevented with immunizations or vaccines. It is better to protect yourself against these diseases than to treat them. Most vaccines are given to children, but adolescents and adults also need them. This pamphlet will explain:
