Questions and Answers About Smallpox Vaccination while Pregnant or Breastfeeding

Should pregnant women receive the smallpox vaccine if there are no cases of smallpox?

If there is no disease present: No. Women who are pregnant or planning to become pregnant within 4 weeks after vaccination should NOT get the smallpox vaccine. In addition, anyone who has a close contact who is pregnant should not get the vaccine (close contacts include anyone living in your household and anyone you have close, physical contact with such as a sex partner or someone with whom you share a bed). The smallpox vaccine is a live viral vaccine that is made from a virus called vaccinia. Live virus vaccines are generally not recommended during pregnancy. Pregnant women should not get the smallpox vaccine unless they have been in contact with someone with smallpox disease. The vaccine can cause a very rare but serious complication in the fetus called fetal vaccinia (less than 50 cases of fetal vaccinia have ever occurred). However, most babies born after smallpox vaccine exposure will be fine. If a woman is vaccinated she should prevent pregnancy for a month. She should wait until the vaccination site has completely healed and the scab has fallen off before trying to become pregnant after vaccination. Until that time, effective measures should be taken to prevent pregnancy, such as birth control pills, injections, implants, IUDs, or abstinence. Other methods of birth control, such as condoms, diaphragms, spermicide, and natural family planning are less effective.

If there were ever a case of smallpox, would pregnant women be vaccinated?

If there is a smallpox outbreak, recommendations on who should get vaccinated will change. Anyone who is exposed to smallpox should get vaccinated, because they will be at greater risk from the disease than they are from the vaccine. Public health authorities will recommend who should be vaccinated at that time and what measures people can take to protect themselves from smallpox.

If a woman wants to get pregnant, how long does she need to wait after receiving the smallpox vaccine?

A woman should wait until the vaccine site has completely healed and the scab has fallen off before trying to become pregnant after vaccination. Generally, this means women who have received the smallpox vaccine should wait at least four weeks (28 days) before becoming pregnant. Until that time, effective measures should be taken to prevent pregnancy, such as birth control pills, injections, implants, IUDs, or abstinence. Other methods of birth control, such as condoms, diaphragms, spermicide, and natural family planning are less effective.

If a woman wants to get pregnant, how long does she need to wait if a close contact has received the smallpox vaccine?

A close contact includes anyone living in your household and anyone with whom you have close, physical contact (such as a sex partner). A woman should wait until the vaccine site in her close contact has completely healed and the scab has fallen off before trying to become pregnant after vaccination. Generally, this means a woman should wait at least four weeks (28 days) after close contact with a vaccinated person before becoming pregnant. Until that time, effective measures should be taken to prevent pregnancy, such as birth control pills, injections, implants, IUDs, or abstinence. Other methods of birth control, such as condoms, diaphragms, spermicide, and natural family planning are less effective.