Before and during pregnancy, the topic of vaccination is particularly important to optimally protect both the mother and the unborn child. Even when planning a pregnancy, the vaccination status for certain infectious diseases should be reviewed. Rubella and varicella (chickenpox) are particularly important in this context. Immunity to these diseases is ensured if two vaccinations are documented in the vaccination record or if the respective illness has already been contracted. If the vaccination status is unclear, for example due to the absence of a vaccination record, immunity can be determined by checking antibody levels. If no protection exists, immunisation with two vaccine doses should be completed before pregnancy. It is important to know that pregnancy should be avoided for at least one month after receiving a rubella or varicella vaccine, as both are live vaccines.

During pregnancy, two approaches are considered with regard to vaccination: vaccinations that protect the pregnant woman, and those where the antibodies produced by the mother pass through the placenta to the baby and protect the newborn.

To protect the mother, a seasonal influenza vaccination is recommended from October to mid-December, as pregnancy significantly increases the risk of severe illness and complications from the flu. Close contacts of the pregnant woman should also be vaccinated.

To protect the newborn, a pertussis (whooping cough) vaccination is recommended at the end of the second or the beginning of the third trimester. In this case, the maternal antibodies are intended to protect the newborn until the child can be vaccinated. According to the Swiss vaccination schedule, the immunisation of the infant starts at two months of age with a paediatrician. Since sufficient protection is only achieved after the second dose, the child is not fully protected until the fourth month of life. In Switzerland, there is no vaccine that protects solely against pertussis; therefore, a combination vaccine against diphtheria, tetanus, and pertussis is used. Household members and close contacts in the first weeks of life (father, grandparents, siblings) should also be adequately protected against pertussis.

Since November 2024, a vaccine against the respiratory syncytial virus (RSV) has been approved for use during pregnancy. The FOPH (Federal Office of Public Health) and the Swiss Federal Commission for Vaccination Issues (FCVI) recommend vaccination with one dose of the RSV vaccine Abrysvo® for pregnant women aged 18 and older. Abrysvo® should be offered and administered between the 32nd and 36th week of pregnancy from October to February if the expected due date is before the end of March. The vaccine should be administered at least 14 days prior to delivery. Currently, the cost of this vaccination is not covered by the compulsory health insurance (OKP; basic insurance).

As an alternative, the Swiss vaccination recommendation since mid-October 2024 suggests immunisation of the newborn with the monoclonal antibody Nirsevimab (Beyfortus®). For births between early October and the end of March, the newborn receives a single dose of the antibody within the first week of life. The costs are covered by the compulsory health insurance (OKP; basic insurance).

Each strategy has its advantages and disadvantages, which the pregnant woman should understand and discuss with her gynaecologist in order to determine the most suitable approach. Maternal immunisation protects both mother and child. It has been shown to reduce RSV infection rates by 80% in the first three months of life and by 70% between the fourth and sixth month. However, if the vaccine is administered less than 14 days before delivery or if the baby is born before the 34th week of gestation, maternal immunisation does not provide sufficient protection. Timely vaccinated, full-term newborns are protected from the first minute of life. Aside from mild local reactions at the injection site, no significant side effects were observed in pregnant women.

Passive immunisation of the newborn has shown to reduce the infection rate during the entire RSV season by 80–90%. This protection strategy is also suitable for preterm infants. Possible vaccine reactions include fever, rash, and, in extremely rare cases, allergic reactions.

According to current scientific knowledge, vaccination during pregnancy is safe and has no negative impact on pregnancy progression, delivery, or fetal development. In addition to the recommendations mentioned above, further vaccinations (e.g. for travel) may be appropriate and should be discussed individually with a gynaecologist.

For any questions regarding vaccinations during pregnancy, the competent medical team at GynHealth is available to support you at any time.