Which of the following vaccines contraindicated in pregnancy?

Appeared in: WCL Staff Nurse - 2019

Explanation

The Rubella vaccine is a live attenuated virus, meaning it contains a weakened form of the live virus.
Live vaccines are generally contraindicated during pregnancy due to a theoretical risk that the weakened virus could cross the placenta and infect the fetus, potentially causing congenital anomalies (Congenital Rubella Syndrome).
The MMR (Measles, Mumps, Rubella) vaccine should be avoided during pregnancy. Women of childbearing age should be advised to avoid conception for at least one month after receiving the MMR vaccine.
If a woman is found to be non-immune to rubella during pregnancy, the vaccine should be administered in the postpartum period.

Option B: The Diphtheria vaccine is an inactivated toxoid, not a live vaccine. It is considered safe during pregnancy.
Option C: The Tetanus vaccine is an inactivated toxoid and is safe for administration during pregnancy.
Option D: The Hepatitis B vaccine is a recombinant (inactivated) vaccine, which does not contain live virus and is safe during 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.
Nurses must assess the immunization status of all prenatal patients, specifically checking for rubella immunity (Rubella IgG titer).
Patient education is a critical nursing role. Non-immune women must be counseled to receive the MMR vaccine after delivery and advised to use effective contraception to avoid pregnancy for at least one month post-vaccination.
Nurses are responsible for administering the recommended Tdap vaccine between 27-36 weeks of gestation to protect the newborn from pertussis.

How to Approach the Question

First, identify the core of the question, which is asking for a vaccine that is 'contraindicated' (should not be given) in pregnancy.
Recall the fundamental principle of immunization during pregnancy: Live attenuated vaccines are generally avoided.
Categorize each option as either a 'live' or 'inactivated/toxoid' vaccine.
A. Rubella: This is a live attenuated vaccine (part of MMR).
B. Diphtheria: This is an inactivated toxoid (part of Tdap).
C. Tetanus: This is an inactivated toxoid (part of Tdap).

Concept Tested & Keywords

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E6 Obstetrics Williams p. 61-83

E6 Medicine Harrison 22e Part 1 p. 1046-1048

Practise the full WCL Staff Nurse - 2019

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