[Vaccination in the early post-partum: Guidelines].

OBJECTIVES

To propose guidelines for clinical practice regarding pertussis, influenza, varicella and rubella vaccination in the early post-partum.

MATERIALS AND METHODS

Bibliographic searches were performed with PubMed and Cochrane databases, and within national guidelines and their references.

RESULTS

Women that have not got vaccinated in the past 10 years should receive a dose of diphtheria-tetanus-acellular pertussis-poliomyelitis vaccine in the early post-partum, and the family and friends should be included in the cocooning strategy (professional consensus). During seasonal influenza epidemic, influenza vaccine should be offered to women, who were not vaccinated during pregnancy, and delivered a vulnerable neonate (professional consensus). For all other women, the vaccination can be discussed on a case-by-case basis (professional consensus). In order to prevent congenital or neonatal varicella in a subsequent pregnancy, scientific data are weak to suggest a systematic screening and vaccination against varicella in women with no history or uncertain status about varicella, excepted in women coming from sub-Saharan Africa, East and Central Europe, more likely to have a negative serology for varicella (professional consensus). In order to prevent severe varicella in adulthood, the vaccination should be discussed with potentially seronegative women as recommended by the French High Council for Public Health (professional consensus). Rubella vaccine is recommended in the early post-partum with women with negative serology during pregnancy with a dose of measles-mumps-rubella vaccine (professional consensus). A new pregnancy should be avoided in the month following rubella and varicella vaccination, but contraception is not obligatory (professional consensus). Breastfeeding, recent rhesus immunoglobulin injection and blood transfusion do not prevent to perform vaccination in the early post-partum (professional consensus).