Which infectious disease should be avoided by a pregnant HCP who is not immune?

• A. Measles or rubella
• B. COVID-19
• C. Hepatitis B
• D. Influenza

Answer: (A)

In pregnancy, the fetus is highly vulnerable to infections that can cross the placenta and cause serious birth defects. Rubella is a classic example: if a pregnant person who is not immune contracts rubella, it can lead to congenital rubella syndrome with eye, heart, hearing, and developmental problems. The rubella vaccine (MMR) is a live attenuated vaccine and is not given during pregnancy, so you cannot rely on vaccination to provide protection at this time. That’s why avoiding exposure is the best course for a pregnant HCP who isn’t immune—prevention is essential, and immunization should occur after delivery to protect future pregnancies.

Other infections, while they can be harmful, do not carry the same combination of fetal risk and vaccine timing during pregnancy. For example, while COVID-19 and influenza can be serious during pregnancy, vaccines exist and guidance emphasizes vaccination and protective precautions rather than a blanket avoidance. Hepatitis B is primarily a concern of occupational exposure via blood and bodily fluids, managed with standard precautions, not a need to avoid exposure overall.