Travel Vaccines and Pregnancy: What You Need to Know
March 22, 2023
Travel during pregnancy is generally considered safe. However, since every pregnancy is unique, it is essential to consult your healthcare provider and take appropriate precautions before finalizing any travel plans. For most uncomplicated pregnancies, the second trimester (between 18 and 24 weeks) is typically the safest time to travel.
Travel may expose pregnant individuals to an increased risk of infections and complications that could adversely affect the fetus. In addition, medical standards and healthcare access can vary significantly between countries, potentially limiting the quality of care available compared to Canada.
The decision to travel during pregnancy should be made collaboratively between the pregnant person and their primary obstetrical provider. Several factors should be considered, including:
If travel is deemed safe and appropriate, it is important to bring the following:
Vaccinations During Pregnancy
Vaccination during pregnancy offers significant benefits, primarily by protecting the pregnant individual from vaccine-preventable diseases that could pose risks to both mother and fetus. Many vaccines are considered safe during pregnancy. Inactivated (non-live) vaccines are generally regarded as safe, as there is no evidence suggesting teratogenicity.
Live vaccines—such as MMR (measles, mumps, rubella), yellow fever, and varicella—are typically contraindicated during pregnancy due to a theoretical risk to the fetus. However, in certain high-risk situations (e.g., during a rubella outbreak), the benefits of immunization may outweigh the potential risks.
Travel-related vaccines that may be considered during pregnancy include:
Air Travel
Most North American airlines permit pregnant passengers to fly up to 36 weeks gestation, while many international carriers set the limit at 35 weeks. Always verify airline-specific policies before booking.
Long-haul flights can contribute to immobility, increasing the risk of venous thromboembolism (VTE) due to venous stasis. Although pregnant individuals are not inherently at higher risk for deep vein thrombosis (DVT) or pulmonary embolism (PE), preventive measures are recommended. These include wearing compression stockings, performing lower limb exercises, and walking or stretching at least every two hours during the flight.
Insect Precautions and Bite Prevention
Pregnant individuals should take enhanced precautions to avoid insect bites, particularly in regions where mosquito-borne diseases are prevalent. Diseases such as dengue, West Nile virus, and Zika have no available vaccines and can pose serious risks to both mother and fetus. Areas such as Southeast Asia, South America, and the Caribbean carry significant risk for these infections.
Malaria, another mosquito-borne illness, can cause severe complications including miscarriage, stillbirth, maternal and neonatal death, and low birth weight. Travel to malaria-endemic regions should be avoided during pregnancy unless absolutely necessary. While prophylactic medications are available, some—especially those required for chloroquine-resistant Plasmodium falciparum—are contraindicated during pregnancy.
Effective personal protection measures include:
When used as directed, DEET has not been shown to pose risks to fetal development.
There is limited data on the safety of high-altitude travel during pregnancy. Short-term stays at altitudes up to 2,500 meters (8,200 feet) are generally considered safe for healthy pregnancies. However, complications such as bleeding and preterm labor have been reported.
Poor outcomes may be associated with preexisting maternal or fetal conditions, rapid ascent, dehydration, or strenuous activity. The U.S. Centers for Disease Control and Prevention (CDC) recommends that pregnant individuals avoid travel to elevations above 3,658 meters (12,000 feet), and that those in late or high-risk pregnancies avoid elevations above 2,500 meters (8,200 feet).
Acetazolamide, a medication commonly used to prevent altitude illness, has shown teratogenic effects in animal studies at high doses, though no adverse pregnancy outcomes have been confirmed in humans. Its use during pregnancy should only be considered under medical supervision, with informed consent after a thorough discussion of potential risks and benefits.
While travel during pregnancy can be safe and enjoyable, it requires careful planning and consideration of potential health risks to both mother and baby. Consulting with your healthcare provider and travel clinic before traveling is essential to ensure that all necessary precautions are taken, including appropriate vaccinations, travel insurance, and preventive measures against travel-related illnesses. By staying informed and prepared, pregnant individuals can make well-informed decisions that support a healthy pregnancy while enjoying the benefits of travel.
Resources and Further Reading:
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