Maternity planning and measles vaccination - when can you get pregnant after vaccination?

When can you get a measles vaccine when planning a pregnancy?

It is recommended to donate blood before vaccination. Laboratory tests will help determine the level of protection of the body, reflecting the number of immunoglobins of class G. Special microorganisms appear in the blood after the administration of anti-measles serum, the disease is stored for life.

If serological test results reveal immunoglobin G:

1. In sufficient quantities, the woman does not need to be vaccinated.
2. In small quantities, protective microorganisms can be activated with a single injection of anti-measles serum.
3. Absent. A two-stage vaccination will be required. The interval between injections is a month.

Foreign and domestic drugs are equally effective. The introduction of a weakened anti-measles mixture in standard situations is carried out 4 months before conception. Doctors recommend taking precautions to avoid unpleasant consequences during this period. Immune protection will develop in 90 days.

Attention:

Foreign and domestic drugs are safe for adults, but harmful to the fetus.

Immunoglobins of class G, leaking through the placenta, enter the fetal blood, creating passive measles immunity. The protection gradually weakens and disappears by the age of one year. Vaccination of pregnant women is contraindicated. It is recommended that the expectant father also refrain from getting the injection, since the probability of the girl becoming infected is high, especially if there is no measles protection.

A newly vaccinated woman who finds out she is pregnant should immediately consult her doctor. New varieties of serums contain weakened microorganisms. The likelihood of their transmission to another person is almost zero. Parents choose to take risks or wait.

No special preparation is required before visiting the clinic if the woman is healthy. Since each case is individual, an appropriate approach is needed. Medical offers all types of clinical studies with modern equipment, experienced doctors, and attentive staff.

You can reduce the risk of unwanted effects:

• taking anti-allergy medications for a couple of days;
• use therapeutic methods to prevent exacerbation of chronic diseases;
• drink body-strengthening remedies;
• Avoid crowded places and hospitals for 2 weeks after vaccination.

Indications for vaccination "Measles"

Planned and emergency prevention of measles:

Routine vaccinations are carried out twice at the ages of 12 months and 6 years for children who have not had measles. Children born from mothers seronegative for the measles virus are vaccinated at the age of 8 months and then at 14-15 months and 6 years. The interval between vaccination and re-vaccination must be at least 6 months.

Children aged 1 year to 18 years inclusive and adults up to 35 years old inclusive, who have not been vaccinated previously, who do not have information about vaccinations against measles, who have not previously had measles, are vaccinated in accordance with the instructions for use twice with an interval of at least 3 months between vaccinations.

Persons previously vaccinated once are subject to a single immunization with an interval of at least 3 months between vaccinations.

When and to whom are vaccinations contraindicated?

The Russian-made measles vaccine is made on the basis of quail embryos, while foreign mixtures are based on chicken embryos. Individual intolerance to egg white of one type or another should be accompanied by a change in the manufacturer of the injections.

Measles vaccination when planning pregnancy is not administered if a woman:

• does not tolerate aminoglycoside antibiotics well;
• suffers from active tuberculosis;
• has malignant diseases, blood pathologies;
• has AIDS;
• has malignant tumors.

It is strongly recommended to refuse protection for people who have suffered severely from the previous anti-measles serum. Vaccination should be postponed in the following cases:

1. Acute respiratory diseases. You need to wait for a complete recovery, restoration of the immune system while taking strong antibiotics.
2. Exacerbation of chronic diseases. The recommended time of administration is remission.
3. Risk of spontaneous abortion. The attending physician will suggest a more convenient time.
4. Use of blood products. The injection should be postponed for 90 days.
5. Taking corticosteroids. They are incompatible with measles vaccinations. After cancellation and completion of the course of treatment, you need to wait a month.
6. Taking immunosuppressive pills. After completing therapy, wait 4-6 months.

Infection with the measles virus is not an indication for termination of pregnancy, but the risks of carrying a defective child increase. Your doctor's recommendations should be followed to minimize side effects.

In Russia the following drugs are used:

• French "Ruvax";
• American combined "MMR";
• Russian Mumps-measles;
• British "Priorix";
• LCV monovaccine.

Ruwax

The vaccine produced by Aventis Pasteur provides 100% protection and contains the Schwarz strain virus. Medical institutions have been using the substance since 1968. Compliance with technology allows the laboratory to produce a drug that meets Russian and international standards and requirements. Independent purchase is almost impossible, since Ruvax is not available in retail stores.

Monovaccine

A drug for one disease, the effectiveness is on par with combined mixtures. For comprehensive protection, the monovaccine is inconvenient, but is publicly available and inexpensive. Contains virus strain Leningrad-16, Moscow-5.

Combined

The timing of the administration of vaccines against three common diseases (measles, mumps, rubella) coincides, so combined mixtures are an alternative to mono-vaccines. They can be purchased exclusively independently or in paid clinics.

Mumps and measles

A mixture of viruses is produced by the Federal State Unitary Enterprise NPO Microgen. The manufacturing technology fully complies with WHO requirements. Most often recommended in clinics as a vaccine that has been proven over the years.

Priorix

Smithkline Beecham Biologicals produces mixtures of attenuated viruses. The drug gained popularity for its high efficiency, minimization of symptoms, and lack of complaints.

Measles and pregnancy

Since cases of measles have begun to increase among the population of post-Soviet countries, where a huge number of children and adults are not vaccinated, vaccination certificates are purchased, where the diagnosis of measles is often made incorrectly, the exact statistics are untrue, I receive a lot of questions from women planning pregnancy and those already pregnant about how to protect yourself from measles, whether this infection is dangerous for a pregnant woman, how you can avoid it, what to do if you come into contact with a sick person. Since the questions are repeated, I have collected them together.

GENERAL ISSUES

Is measles a viral or bacterial disease? Measles is a viral disease. The causative agent is an RNA virus from the Paramyxoviridae family.

What is the difference between measles and rubella? Rubella is caused by a completely different type of virus. It is sometimes called German measles or 3-day measles, which can cause confusion regarding the correct interpretation of the infectious disease. The clinical picture for measles and rubella is also different.

How long is the incubation period when you may not even know about the disease? On average, 10-12 days. The rash most often appears on the 14th day after infection, although it can occur earlier or later (7-21 days). This is a very contagious disease - 90% of people get measles after infection.

How long is a person contagious if he has measles? A person can be contagious even in the absence of complaints and symptoms: 4 days before the appearance of the rash and the subsequent 4 days of rashes on the skin and mucous membranes.

How dangerous is it to be in a room where a person with measles has been? The measles virus can survive on smooth surfaces and in the air for up to 2 hours. Therefore, the possibility of infection also exists when a sick person is not in the room for a short period of time.

How does measles manifest itself? In the classic course of the disease, there is a triad: cough, runny nose, conjunctivitis (in English 3 Cs cough, coryza, conjunctivitis) against a background of fever and general weakness. The rash appears on days 2-3, in particular in the form of specific white spots with a red base (Koplik spots) on the mucous membrane of the soft and hard palate. Following them, spots appear on the scalp and body. Gradually the rashes fade (usually from top to bottom).

How is measles diagnosed? The most reliable methods for diagnosing measles is the determination of IgM antibodies and RNA of the virus by PCR in the blood and secretions from the oral cavity (mucosal scrapings).

How is measles treated? There is no cure for measles. In severe cases, therapy is supportive. When a bacterial infection occurs, treatment is carried out with antibiotics.

Is it true that adults suffer from measles worse than children? Yes, measles is more severe in adults and can be accompanied by more serious complications than in children. Measles is very dangerous for older people, as well as patients with serious chronic diseases and suppressed immunity.

What are the most common complications of measles? Relatively mild complications include bronchitis and pneumonia. Serious: encephalitis, subacute sclerosing panencephalitis, damage to the nervous system, death.

How common is measles? In countries where vaccination has been regularly carried out for several years (mainly in developed countries), 3-11 cases of measles per 100,000 population occur per year. In countries where vaccination levels are low, the incidence of measles can increase severalfold.

IMPACT OF MEASLES ON A PREGNANT WOMAN

How dangerous is measles for a pregnant woman? Pregnant women are more likely to experience complications in the form of pneumonia, which also increases the mortality rate from complications of measles, and indeed pregnancy itself. Such women are more likely to end up in hospital.

Although there are many publications on the topic of measles during pregnancy, most of them contain inaccurate data without taking into account many factors that determine the reliability of the information. Also, the socioeconomic status of pregnant women infected with measles affects the rate of pregnancy complications. In developed countries, the number of pregnant women infected with measles is extremely small, which does not allow drawing conclusions characterizing the level of danger of this disease for the mother and fetus.

Should a pregnant woman be hospitalized if she contracts measles? No, if her condition is satisfactory. However, the woman should be isolated from other family members and people who are not immune to measles, that is, be in a separate room.

If a pregnant woman gets measles before giving birth, what measures should be taken for her baby? If the infection occurred 10 days before birth, then it is advisable for the newborn to administer immunoglobulins (intramuscularly) during the first 5 days of life. Also, a protective dose of immunoglobulins is recommended for children under 12 months of age if their mothers are infected with measles.

Is it necessary to isolate a newborn if a postpartum mother has measles? There is very little evidence to support child isolation. Typically, the issue of isolation for 4 days after birth is decided on a case-by-case basis, taking into account the protection of other newborns.

EFFECT OF MEASLES ON THE FETUS

Is the measles virus transmitted to the fetus? Transmission of measles virus to the fetus has been described in several cases where women became infected with the infection just days before giving birth. Such children were born with congenital measles - they had a rash on the skin and mucous membranes, characteristic of measles, during the first 10 days of life. Of course, such children have an increased risk of developing other complications, but there is not enough information on this topic.

How dangerous is measles to the fetus? Data on the effects of measles on the fetus in most publications were collected retrospectively by analyzing pregnancy histories from many years ago, when vaccination was not carried out or was carried out irregularly. The most common complication is low baby weight (less than 2500 g) and premature birth.

Does the rate of pregnancy loss increase when infected with measles? Evidence that women who contract measles have increased rates of miscarriage is controversial, as is evidence of higher rates of fetal death and stillbirth. The level of losses depends on the stage of pregnancy at which the infection occurred. According to some publications, if the infection occurred in the first trimester, then the probability of pregnancy loss is 50%, if in the second - 20%. But whether the cause is the direct effect of the virus on the fetus, or the serious condition of the mother, is unknown.

Does measles cause birth defects in the fetus? The measles virus does not increase the rate of birth defects. Several publications with isolated cases of measles in pregnant women do not deny the occurrence of malformations in the fetus. But high body temperature is a teratogenic factor and can lead to the death of the embryo or the development of defects, especially cardiovascular ones. A reliable connection between cases of measles and developmental defects has not yet been confirmed.

What is the chance of fetal survival in a multiple pregnancy for a woman with measles? Nobody knows the answer to this question. The medical literature describes only one case in which one of the two fetuses of a woman who contracted measles at 19 weeks died in utero, and the other was born healthy at term. Changes characteristic of intrauterine infection were found in the placenta.

IMMUNOLOGICAL STATUS

How to find out whether a woman has immunological protection against measles or not before planning a pregnancy if there is no data on vaccination? As American statistics have shown, for example, more than 16% of pregnant women are seronegative (without protection) for measles. Many of them do not remember whether they were vaccinated as children, whether they had one dose of vaccination or two. But even among vaccinated women (documented), the protective level of antibodies was only in 85-88% of cases. Therefore, many doctors recommend checking the level of IgG antibodies to the measles virus before planning a pregnancy and, if they are absent or insufficient, re-vaccination.

Is there a way to prevent this disease? Yes, at 12-15 months, vaccination is carried out with a vaccine that also protects against rubella and viral mumps, and in some countries, against chickenpox. Repeated vaccination is carried out at 4-6 years.

How effective is the measles vaccine? The effectiveness of the vaccine depends on compliance with the vaccination regimen: after the first dose - 93%, after the second dose - 97%. However, with age, the protective response of the vaccine may decrease. In 80% of adults, immunity persists into old age.

Is it possible to get vaccinated against measles during pregnancy? The measles vaccine also includes suppressed rubella and mumps viruses. Although there is no evidence that the vaccine is harmful to the embryo or fetus, it is still contraindicated during pregnancy.

When can you plan pregnancy after measles vaccination? In 3-4 weeks. This time is enough to develop immunity and deactivate viruses.

What to do if a woman did not know that she was pregnant at the time of the measles vaccination? Is it necessary to terminate such a pregnancy? No, a woman can safely carry a pregnancy to term. There is only a theoretical risk of possible harm from the vaccine, but there have not been any reported cases of pregnancy complications as a result of the measles vaccine, including pregnancy loss. On the contrary, there is a lot of data on the safety of this vaccination during pregnancy, when vaccination was carried out without taking into account the presence of pregnancy. But traditionally, doctors do not recommend such vaccination for pregnant women.

Is it possible to vaccinate after childbirth? If yes, then when? Is it necessary to interrupt breastfeeding in this case? Measles vaccination is recommended for women after childbirth, at almost any time. Most often it is carried out at the time of discharge from the hospital. There is no need to interrupt breastfeeding. On the contrary, the antibodies produced will be transferred through breast milk, which will provide some protection for the newborn.

If a pregnant woman has had contact with someone with measles, what should she do? If a woman (regardless of whether she is pregnant or not) is vaccinated against measles or had this disease in childhood, she may not worry about the possible development of the disease.

If a woman does not have immunity from measles, it is advisable for her to be given intravenous IgG immunoglobulins within 5-6 days after infection. Antibodies will help neutralize the effects of the measles virus and protect the woman from developing the disease.

If a woman does not know her immunological status, she can either determine the level of IgG in the blood using a rapid method, or administer antibodies without prior analysis.

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Possible risks to the fetus

At 16 weeks of pregnancy, the placenta is fully formed, creating an impenetrable protective barrier around the baby, reducing the likelihood of infection. The last weeks are the most dangerous, since infection can occur in the birth canal. This is a period of increased frequency of premature births caused by the virus.

Measles affects the nervous system and the brain. The risks of administering measles vaccine during pregnancy are as follows:

• blindness, decreased visual acuity;
• underdevelopment of the limbs;
• intrauterine hypoxia;
• dropsy of the brain;
• deafness, hearing loss;
• stomatitis;
• heart failure;
• pneumonia;
• mental retardation.

Special studies of the effect of the measles virus on the intrauterine development of babies have not been conducted; the results are based on observations of women infected during pregnancy. Information about the increase in spontaneous abortions in patients is also important, which must be taken into account before planning.

Dementia of a child in a mother with measles appears in 40% of cases. Ultrasound examination cannot diagnose the initial stages of the disease. The most dangerous complication affecting children inside the mother is viral meningoencephalitis. Statistics show a 40% incidence.

Compatibility with other vaccines

Vaccination against measles can be carried out simultaneously (on the same day) with other vaccinations of the National Preventive Vaccination Calendar (against mumps, rubella, polio, hepatitis B, whooping cough, diphtheria, tetanus) or no earlier than 1 month after the previous vaccination. After the administration of human immunoglobulin preparations, vaccinations against measles are carried out no earlier than 3 months later. After the administration of measles vaccine, immunoglobulin preparations can be administered no earlier than 2 weeks later. If it is necessary to use immunoglobulin earlier than this period, measles vaccination should be repeated.

After immunosuppressive therapy, measles vaccination can be carried out 3-6 months after the end of treatment.

Contraindications

Only a doctor can decide whether Measles is suitable for vaccination

The Measles vaccine is contraindicated if there is a history of an allergic reaction to any component of the vaccine, and in the following cases:

• Severe forms of allergic reactions to aminoglycosides (gentamicin sulfate, etc.), chicken and/or quail eggs.
• Primary immunodeficiency conditions, malignant blood diseases and neoplasms.
• Severe reaction (temperature rise above 40 C, swelling, hyperemia more than 8 cm in diameter at the injection site) or complication to a previous administration of measles or mumps-measles vaccines.
• Pregnancy.

Possible side effects

• In most vaccinated people, the post-vaccination period is asymptomatic.
• In the period from 6 to 18 days after vaccination, temperature reactions, mild hyperemia of the pharynx, and rhinitis may be observed.
• Rarely, coughing and conjunctivitis are observed, lasting for 1-3 days, minor skin hyperemia and mild swelling, which disappear after 1-3 days without treatment.
• Very rarely, 6-10 days after vaccination, mild malaise and a measles-like rash and convulsive reactions occur, most often occurring against a background of high fever.
• In the first two days, allergic reactions may be observed in children with allergic altered reactivity.
• A history of febrile convulsions, as well as an increase in temperature above 38.5 ºC in the post-vaccination period, are an indication for the prescription of antipyretics.
• Considering the possibility of developing immediate allergic reactions (anaphylactic shock, Quincke's edema, urticaria) in particularly sensitive individuals, vaccinated persons must be provided with medical supervision for 30 minutes.

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