USE OF TETANUS/DIPHTHERIA/POLIO (Td-IPV) VACCINES IN PREGNANCY
Date of issue: October 2016, Version: 1
In the UK the Td-IPV vaccine Revaxis® is indicated for use in individuals over 10 years of age who require vaccination against tetanus, diphtheria and/or polio. Monovalent vaccines for these conditions are not available in the UK.
There are currently no published studies specifically regarding use of Td-IPV vaccines, such as Revaxis® in pregnancy. Tetanus/diphtheria/pertussis/polio (Tdap-IPV) vaccines have however been widely used in the UK maternal pertussis vaccination programme. Data from over 6,600 Tdap-IPV-exposed pregnancies do not suggest increased risk to the fetus of stillbirth, low birth weight/intrauterine growth restriction, or reduced gestational length. There are insufficient first trimester exposure data to permit an evidence-based assessment of the risk of congenital malformations.
UK guidelines state that tetanus-containing vaccines can be given to pregnant women when protection is required without delay. If a woman with unknown or incomplete vaccination status requires immunisation against tetanus after week 16 of pregnancy, the Department of Health suggests that an initial dose of tetanus/diphtheria/pertussis/polio (Tdap-IPV) vaccine be given in place of Td-IPV vaccine, and that Td/IPV vaccine is then given at appropriate intervals to complete the course of immunisation against tetanus.
Exposure to tetanus/diphtheria/polio vaccine at any stage in pregnancy would not be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.
This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to NHS health care professionals who are logged in.
If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.
If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.