Do You Need a Measles Vaccine Before Pregnancy? Key Insights

Is it necessary to receive the measles vaccine before pregnancy?

Hello, Doctor.
I am currently living in Germany.
I previously underwent a health check and learned that I have antibodies against rubella, so I do not need to receive the vaccine again.
A German doctor also suggested that I get tested for measles antibodies.
However, in Taiwan or online searches, most pre-pregnancy vaccine recommendations mention only varicella and rubella, without mentioning the measles vaccine.
I would like to ask you:
1.
If I have antibodies against rubella, do I also have antibodies against measles?
2.
Following up on the previous question, if I do not have measles antibodies, is it necessary to get tested for measles antibodies and receive the measles vaccine?
3.
Is the impact of measles on pregnant women relatively minor? Why do most websites only mention rubella and not measles?
4.
A German doctor also recommended that I receive the diphtheria, pertussis, and tetanus vaccine before pregnancy.
Is this absolutely necessary? What is the vaccination rate among pregnant women in Taiwan? Thank you!

KK, 30~39 year old female. Ask Date: 2018/04/20

Dr. Chen Liqin reply Obstetrics and Gynecology

1.
No.
2.
Due to the current expansion of the epidemic in Taiwan, it is recommended to visit a hospital to discuss with a physician whether to receive a booster vaccine.
3.
Measles does not cause abnormalities in the fetus; however, it can worsen the condition for pregnant women.
4.
In Taiwan, it is also recommended for women to receive the DPT vaccine before pregnancy, but it is not mandatory, and the vaccination rate varies by region.

Reply Date: 2018/04/20

More Info

When considering vaccinations before pregnancy, particularly for measles and rubella, it is essential to understand the implications for both maternal and fetal health. Here are some key insights based on your questions:
1. Measles and Rubella Antibodies: Having antibodies against rubella (German measles) does not automatically confer immunity to measles. These are two distinct viruses, and immunity to one does not imply immunity to the other. Therefore, if you have confirmed rubella immunity, it is still advisable to check for measles antibodies separately.
2. Need for Measles Antibody Testing: If you have not been vaccinated against measles or have no documented history of measles infection, it is prudent to undergo measles antibody testing. If you lack immunity, receiving the measles vaccine before pregnancy is highly recommended. The measles vaccine is a live attenuated vaccine, and it is advised to wait at least one month after vaccination before trying to conceive to ensure the vaccine does not affect the developing fetus.

3. Impact of Measles on Pregnant Women: Measles can have severe consequences for pregnant women, including an increased risk of complications such as pneumonia, encephalitis, and even death. Additionally, measles infection during pregnancy can lead to adverse outcomes such as preterm labor, low birth weight, and fetal loss. Therefore, it is not accurate to say that the impact of measles on pregnant women is minor; rather, it can be quite serious.

4. Focus on Rubella Over Measles: Many health resources emphasize rubella vaccination because rubella poses a significant risk during pregnancy, particularly in the first trimester, where it can lead to congenital rubella syndrome (CRS), resulting in severe birth defects. While measles is also a concern, the focus on rubella in pregnancy discussions is due to its direct link to fetal health outcomes.

5. Diphtheria, Pertussis, and Tetanus Vaccination: The recommendation for the Tdap (tetanus, diphtheria, and pertussis) vaccine before pregnancy is based on the need to protect both the mother and the newborn. Pertussis (whooping cough) can be particularly dangerous for infants, and maternal vaccination during pregnancy helps to pass protective antibodies to the baby. The CDC recommends that pregnant women receive the Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks of gestation.
In Taiwan, vaccination rates for Tdap among pregnant women have been increasing, but specific statistics may vary. It is advisable to consult local health authorities or your healthcare provider for the most current data.

In conclusion, if you are planning to become pregnant, it is crucial to ensure that you are fully vaccinated against both measles and rubella, as well as to consider the Tdap vaccine. Consulting with a healthcare provider for personalized advice based on your health history and vaccination status is essential. This proactive approach can significantly reduce the risks associated with these infections during pregnancy and ensure better health outcomes for both you and your future child.

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