unsubsribe please > ---------- > From: Rien[SMTP:[EMAIL PROTECTED]] > Reply To: [EMAIL PROTECTED] > Sent: 09 Juni 2000 9:04 > To: [EMAIL PROTECTED] > Subject: [balita-anda] Imunisasi saat hamil - artikel panjang (was : > suntik tetanus ?? > > Rekan2, > menyambung diskusi soal imunisasi Tetanus saat hamil, ini ada artikel > dari www.cdc.gov (wah, bukan 'mania' CDC nih, tapi karena belakangan > surfing ke sana dan ketemu yg. menarik2...). > Pengalaman pribadi sih, dulu waktu hamil tidak diberi suntikan TT, tapi > sepulang dari RS sesudah kena campak dulu itu, DSOG saya menyarankan > untuk vaksin Rubella, karena dari cek darah, belum ada antibodi tsb. > Cuma saya harus tidak boleh hamil sampai 3 bulan sesudahnya. Jadi beliau > menyarankan divaksin saat menstruasi, supaya bener2 yakin sedang tidak > hamil. > Semoga artikel ini berguna. > Semoga juga belum 40 KB...:-) > -- > \\\ > ( o> Salam, > /U ) Rien. > ----oo--- > > > Vaccination of Pregnant Women > > "Risk from vaccination during pregnancy is largely theoretical. The > benefit of vaccination among pregnant women usually outweighs the > potential risk when a) the risk for disease exposure is high, b) > infection would pose a special risk to the mother or fetus, and c) > the vaccine is unlikely to cause harm." ACIP General > Recommendations on Immunization, p. 20 > > Generally, live-virus vaccines are contraindicated for pregnant > women because of the theoretical risk of transmission of the > vaccine virus to the fetus. If a live-virus vaccine is > inadvertently given to a pregnant woman, or if a woman becomes > pregnant within 3 months after vaccination, she should be counseled > about the potential effects on the fetus. But it is not ordinarily > an indication to terminate the pregnancy. > > Whether live or inactivated vaccines are used, vaccination of > pregnant women should be considered on the basis of risks vs. > benefits - i.e., the risk of the vaccination vs. the benefits of > protection in a particular circumstance. The following table may be > used as a general guide. > > ------------------------------------- > Passive Immunization during Pregnancy > > "There is no known risk to the fetus from passive immunization of > pregnant women with immune globulin preparations." ACIP General > Recommendations on Immunization, p. 21 > > In the following table, relevant passages from ACIP > recommendations are reprinted for each vaccine. > Material in quotation marks is taken verbatim from > ACIP (emphasis in bold type added); material not in > quotation marks is paraphrased. > > ---------------------------------------------------- > > Guidelines for Vaccinating Pregnant Women > Abstracted from recommendations of the > Advisory Committee on Immunization Practices (ACIP) > > > HEPATITIS A * "The safety of hepatitis A vaccination > during pregnancy has not been determined; > however, because hepatitis A vaccine is > produced from inactivated [hepatitis A > virus], the theoretical risk to the > developing fetus is expected to be low. The > risk associated with vaccination should be > weighed against the risk for hepatitis A in > women who may be at high risk for exposure > to [hepatitis A virus]." (1) > > HEPATITIS B * "On the basis of limited experience, there > is no apparent risk of adverse effects to > developing fetuses when hepatitis B vaccine > is administered to pregnant women (CDC, > unpublished data). The vaccine contains > noninfectious HBsAg particles and should > cause no risk to the fetus. [Hepatitis B > virus] infection affecting a pregnant woman > may result in severe disease for the mother > and chronic infection for the newborn. > Therefore, neither pregnancy nor lactation > should be considered a contraindication to > vaccination of women."(2) > > * "Hepatitis B vaccine is recommended for > women at risk for hepatitis B infection . . > ." (3) > > INFLUENZA * "On the basis of . . . data that suggest > that influenza infection may cause increased > morbidity in women during the second and > third trimesters of pregnancy, the [ACIP] > recommends that women who will be beyond the > first trimester of pregnancy (>14 weeks' > gestation) during the influenza season be > vaccinated." (4) > > * "Pregnant women who have medical > conditions that increase their risk for > complications from influenza should be > vaccinated before the influenza > season--regardless of the state of > pregnancy." (4) > > * "Studies of influenza immunization of more > than 2,000 pregnant women have demonstrated > no adverse fetal effects associated with > influenza vaccine; however, more data are > needed." (4) > > MEASLES * "MMR and its component vaccines should not > be administered to women known to be > pregnant. Because a risk to the fetus from > administration of these live virus vaccines > cannot be excluded for theoretical reasons, > women should be counseled to avoid becoming > pregnant for 30 days after vaccination with > measles or mumps containing vaccines and for > 3 months after administration of MMR or > other rubella-containing vaccines." (5) > > * "If a pregnant woman is vaccinated or if > she becomes pregnant within 3 months after > vaccination, she should be counseled about > the theoretical basis of concern for the > fetus, but MMR vaccination during pregnancy > should not ordinarily be a reason to > consider termination of pregnancy." (5) > > MUMPS * "MMR and its component vaccines should not > be administered to women known to be > pregnant. Because a risk to the fetus from > administration of these live virus vaccines > cannot be excluded for theoretical reasons, > women should be counseled to avoid becoming > pregnant for 30 days after vaccination with > measles or mumps containing vaccines and for > 3 months after administration of MMR or > other rubella-containing vaccines." (5) > > * "If a pregnant woman is vaccinated or if > she becomes pregnant within 3 months after > vaccination, she should be counseled about > the theoretical basis of concern for the > fetus, but MMR vaccination during pregnancy > should not ordinarily be a reason to > consider termination of pregnancy." (5) > > PNEUMOCOCCAL * "The safety of pneumococcal polysaccharide > vaccine during the first trimester of > pregnancy has not been evaluated, although > no adverse consequences have been reported > among newborns whose mothers were > inadvertently vaccinated during pregnancy." > (6) > > POLIO * "Although no adverse effects of OPV or IPV > have been documented among pregnant women or > their fetuses, vaccination of pregnant women > should be avoided. However, if a pregnant > woman requires immediate protection against > poliomyelitis, she may be administered OPV > or IPV in accordance with the recommended > schedules for adults." (7) > > RUBELLA * "MMR and its component vaccines should not > be administered to women known to be > pregnant. Because a risk to the fetus from > administration of these live virus vaccines > cannot be excluded for theoretical reasons, > women should be counseled to avoid becoming > pregnant for 30 days after vaccination with > measles or mumps containing vaccines and for > 3 months after administration of MMR or > other rubella-containing vaccines." (5) > > * "If a pregnant woman is vaccinated or if > she becomes pregnant within 3 months after > vaccination, she should be counseled about > the theoretical basis of concern for the > fetus, but MMR vaccination during pregnancy > should not ordinarily be a reason to > consider termination of pregnancy." (5) > > * "Rubella-susceptible women who are not > vaccinated because they state they are or > may be pregnant should be counseled about > the potential risk for CRS and the > importance of being vaccinated as soon as > they are no longer pregnant." (5) > > * A registry of susceptible women vaccinated > with rubella vaccine between 3 months before > and 3 months after conception - the "Vaccine > in Pregnancy (VIP) Registry" - was kept > between 1971 and 1989. No evidence of CRS > occurred in the offspring of the 226 women > who received the current RA 27/3 rubella > vaccine and continued their pregnancy to > term. (5) > > TETANUS & DIPHTHERIA * "Combined tetanus and diphtheria toxoids > are . . . routinely indicated for > susceptible pregnant women. Previously > vaccinated pregnant women who have not > received a Td vaccination within the last 10 > years should receive a booster dose." (8) > > * "Pregnant women who are unimmunized or > only partially immunized against tetanus > should complete the primary series." (8) > > * "Although no evidence exists that tetanus > and diphtheria toxoids are teratogenic, > waiting until the second trimester of > pregnancy to administer Td is a reasonable > precaution for minimizing any concern about > the theoretical possibility of such > reactions." (9) > > VARICELLA * "The effects of the varicella virus > vaccine on the fetus are unknown; therefore, > pregnant women should not be vaccinated. > Nonpregnant women who are vaccinated should > avoid becoming pregnant for 1 month > following each injection. For susceptible > persons, having a pregnant household member > is not a contraindication to vaccination." > (10) > > * "If a pregnant woman is vaccinated or > becomes pregnant within 1 month of > vaccination, she should be counseled about > potential effects on the fetus." (10) > > * "Because the virulence of the attenuated > virus used in the vaccine is less than that > of the wild-type virus, the risk to the > fetus, if any, should be even lower." (10) > > * "In most circumstances, the decision to > terminate a pregnancy should not be based on > whether vaccine was administered during > pregnancy." (10) > > * "VZIG [Varicella Zoster Immune Globulin] > should be strongly considered for > susceptible, pregnant women who have been > exposed." (10) > > * The manufacturer & CDC have established a > VARIVAX® Pregnancy Registry to monitor > outcomes of women who got the vaccine 3 > months before or any time during pregnancy. > Call 1-800-986-8999. > > BCG * "Although no harmful effects to the fetus > have been associated with BCG vaccine, its > use is not recommended during pregnancy." > (11) > > CHOLERA * "No specific information exists on the > safety of cholera vaccine during pregnancy. > Its use should be individualized to reflect > actual need." (12) > > JAPANESE * "No specific information is available on > ENCEPHALITIS the safety of JE vaccine in pregnancy. > Vaccination poses an unknown but theoretical > risk to the developing fetus, and the > vaccine should not be routinely administered > during pregnancy." (13) > > * "Pregnant women who must travel to an area > where risk of JE is high should be > vaccinated when the theoretical risks of > immunization are outweighed by the risk of > infection to the mother and developing > fetus." (13) > > MENINGOCOCCAL * Studies have shown the vaccine to be both > safe and efficacious when given to pregnant > women. While high antibody levels were found > in umbilical cord blood following > vaccination during pregnancy, antibody > levels in the infants decreased during the > first few months after birth. Subsequent > response to meningococcal vaccination was > not affected. > > * "Based on data from studies involving use > of meningococcal vaccines administered > during pregnancy, altering meningococcal > vaccination recommendations during pregnancy > is unnecessary." (14) > > PLAGUE * "The effects of plague vaccine on the > developing fetus. . . are unknown. Pregnant > women who cannot avoid high-risk situations > should be advised of risk-reduction > practices and should be vaccinated only if > the potential benefits of vaccination > outweigh potential risks to the fetus." (15) > > RABIES * "Because of the potential consequences of > inadequately treated rabies exposure, and > because there is no indication that fetal > abnormalities have been associated with > rabies vaccination, pregnancy is not > considered a contraindication to > postexposure prophylaxis." (16) > > * "If there is substantial risk of exposure > to rabies, preexposure prophylaxis may also > be indicated during pregnancy." (16) > > TYPHOID * "No data have been reported on the use of > any of the three typhoid vaccines among > pregnant women." (17) > > VACCINIA * "Vaccinia should not be administered to > pregnant women." (18) > > * "On rare occasions, almost always after > primary vaccination, vaccinia virus has been > reported to cause fetal infection. . . . > Vaccinia vaccine is not known to cause > congenital malformations." (18) > > YELLOW FEVER * "Although specific information is not > available concerning adverse effects of > yellow fever vaccine on the developing > fetus, pregnant women theoretically should > not be vaccinated, and travel to areas where > yellow fever is present should be postponed > until after delivery." (19) > > * "If international travel requirements > constitute the only reason to vaccinate a > pregnant woman, rather than an increased > risk of infection, efforts should be made to > obtain a waiver letter from the traveler's > physician." (19) > > * "Pregnant women who must travel to areas > where the risk of yellow fever is high > should be vaccinated. Under these > circumstances, for both mother and fetus, > the small theoretical risk from vaccination > is far outweighed by the risk of yellow > fever infection." (19) > > -------------------------------------------------- > > Prenatal Screening for Vaccine-Preventable Diseases > > The ACIP currently recommends prenatal screening for rubella and > hepatitis B: > > "Prenatal serologic screening . . . is indicated for all pregnant > women who lack acceptable evidence of rubella immunity. Upon > completion or termination of their pregnancies, women who do not > have serologic evidence of rubella immunity or documentation of > rubella vaccination should be vaccinated with MMR before discharge > from the hospital, birthing center, or abortion clinic." ACIP, > Measles, Mumps, and Rubella -- Vaccine Use and Strategies for > Elimination of Measles, Rubella, and Congenital Rubella Syndrome > and Control of Mumps, p. 18. > > "All pregnant women should be routinely tested for HBsAg during an > early prenatal visit in each pregnancy. . . . HBsAg-positive > mothers identified during screening may have HBV-related acute or > chronic liver disease and should be evaluated by their > physicians." ACIP, Protection Against Viral Hepatitis, p. 14. > > -------------------------------------------------- > > Vaccinating Women who are Breastfeeding > > "Neither killed nor live vaccines affect the safety of > breast-feeding for mothers or infants. Breast-feeding does not > adversely affect immunization and is not a contraindication for > any vaccine." ACIP, General Recommendations on Immunization, p. > 20. > > The following applies to varicella vaccine, which was licensed > after the ACIP General Recommendations were published: "Whether > attenuated vaccine VZV is excreted in human milk and, if so, > whether the infant could be infected are not known. Most live > vaccines have not been demonstrated to be secreted in breast milk. > Attenuated rubella vaccine virus has been detected in breast milk > but has produced only asymptomatic infection in the nursing > infant. Therefore, varicella vaccine may be considered for a > nursing mother." ACIP, Prevention of Varicella, pp. 19-20. > > > > > >> Pusing milih POP3 atau web mail? mail.telkom.net solusinya << > >> Belanja Info & Keperluan Balita? 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