Vaccination in pregnancy

Key content Live attenuated viral and bacterial vaccines are generally contraindicated during pregnancy because of the theoretical risks to the fetus. No evidence exists of fetal risks from vaccinating pregnant women with inactivated virus or bacterial vaccines or toxoids. Inactivated, recombinant, subunit, polysaccharide, conjugate vaccines and toxoids pose no risk for breastfeeding mothers or their infants. Learning objectives To provide an overview of the principles of vaccination in pregnancy. To improve confidence of healthcare professionals in discussing aspects of vaccination in pregnancy. To provide a quick reference guide regarding the indications, contraindications and safety of vaccines in pregnancy. Ethical issues Is the use of a mother as a vehicle to protect her fetus ethically justified? Is compulsory vaccination of healthcare professionals ethically debatable?