Which of the following vaccine is contraindicated in pregnancy?

Appeared in: UPPSC 2023

Explanation

The Varicella vaccine is a live attenuated vaccine, meaning it contains a weakened form of the live varicella-zoster virus.
Live vaccines are generally contraindicated in pregnancy due to the theoretical risk that the weakened virus could cross the placenta and infect the fetus.
Fetal infection with the varicella virus can lead to congenital varicella syndrome, which is associated with severe birth defects.
Women are advised to avoid pregnancy for at least one month after receiving the varicella vaccine to ensure the virus is cleared from their system.

Option A: The Hepatitis B vaccine is a recombinant vaccine, which does not contain live virus and is considered safe to administer during pregnancy.
Option C: The Hepatitis A vaccine is an inactivated (killed) virus vaccine. It does not pose a risk of infection to the fetus and is considered safe during pregnancy when indicated.
Option D: The Rabies vaccine is an inactivated (killed) virus vaccine. It is safe for use in pregnancy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Vaccine contraindications during pregnancy as background academic context rather than a clinical decision trigger.
A crucial nursing responsibility is to screen all women of childbearing age for pregnancy before administering a live vaccine like Varicella or MMR.
Patient education is vital. Nurses must counsel women to use effective contraception and avoid becoming pregnant for at least one month after receiving a live vaccine.
Nurses should also educate pregnant women about the vaccines that are recommended during pregnancy, such as the Tdap and influenza shots, to protect both mother and baby.

How to Approach the Question

First, identify the core of the question, which is asking for a vaccine that is 'contraindicated' in 'pregnancy'.
Recall the fundamental principle of immunization during pregnancy: live attenuated vaccines are generally avoided.
Next, classify each of the options into its vaccine type (live vs. inactivated/recombinant).
Hepatitis-B is a recombinant vaccine.
Varicella is a live attenuated vaccine.
Hepatitis-A is an inactivated vaccine.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 288-290

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 96-98

E6 Obstetrics Williams p. 61-83

Practise the full UPPSC 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.