What are your recommendations regarding administration of pneumovax to a pregnant who is found to have low pneumococcal titers and is being evaluated for possible specific antibody deficiency due to chronic infections. The CDC states that "There is no evidence that PPSV is harmful to either a pregnant woman or to her fetus. However, as a precaution, women who need the vaccine should be vaccinated before becoming pregnant, if possible." Would you vaccinate during pregnancy (patient is approx. 6 weeks gestation) or wait until after delivery of baby?


I asked Dr Charlotte Cunningham-Rundles for a response. She stated that if the patient has been ill and requiring a lot of antibiotic use, it might be helpful to proceed with Pneumovax to increase her antibody titers during the pregnancy. The immunization would also allow transfer of maternal antibodies to the fetus later in the pregnancy. She indicated that if the obstetrician preferred that Pneumovax no be administered to the patient, then she would abide by the obstetrician's preference.

I hope this answer is helpful to you.

Jacqueline A. Pongracic, MD, FAAAAI


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