A healthcare worker declines the influenza vaccine because she is pregnant; she explains that she is concerned about the dangers associated with receiving the influenza vaccine during pregnancy. What information would the infection preventionist share with the pregnant healthcare worker?

• A. Live attenuated vaccines are contraindicated for pregnant women, but it is safe to receive inactivated vaccines at any time during pregnancy.
• B. All vaccines are contraindicated during pregnancy.
• C. Vaccines are mandatory, regardless of pregnancy status.
• D. Vaccination should wait until after delivery.

Answer: (A)

Vaccination during pregnancy hinges on whether the vaccine is inactivated or live. Inactivated vaccines, which cannot cause disease, are considered safe to administer during pregnancy and are often recommended when indicated—like the inactivated influenza vaccine. Live attenuated vaccines, on the other hand, are avoided in pregnancy because they contain a weakened form of the virus that could potentially affect the fetus, and safety data in pregnant people is limited.

So the best information to share is that live vaccines are contraindicated during pregnancy, but inactivated vaccines are safe to give at any time during pregnancy, including the influenza vaccine. This supports protecting both the pregnant healthcare worker and her future baby from influenza. The other options misstate vaccine safety and recommendations for pregnancy.