The Immunisation Department of the Health Protection Agency is undertaking surveillance of women given certain vaccines in pregnancy (VIP). This surveillance was established in 1981 specifically for rubella vaccine, originally under the National Congenital Rubella Surveillance Programme.
It is known that if women are infected with rubella disease during the first 20 weeks of pregnancy there is a risk to the baby. Before the rubella vaccine had been widely used there were therefore concerns that the rubella virus in the vaccine might also be harmful in pregnancy. The surveillance was therefore established to provide more information on whether there was a risk from vaccinating pregnant women with live rubella vaccine virus.
In recognition of the wider use of the varicella vaccine following the Chief Medical Officer Health Care Worker recommendations in 2003, the Immunisation Department within the Health Protection Agency's Centre for Infections, also established surveillance of cases of inadvertent varicella vaccination in pregnancy.
As with rubella-containing vaccine, this surveillance was set up to address concerns of a theoretical risk from this live vaccine virus because of the known risk of congenital varicella. After many years experience with both rubella-containing and varicella vaccines the information collected consistently shows the safety of these vaccines when given in pregnancy.
Human papillomavirus (HPV) vaccine has been offered to the UK schoolgirl population from September 2008. On a precautionary basis, HPV vaccine is not advised in pregnancy. This precaution is not due to any known risk associated with giving HPV vaccine during pregnancy, but due to limited data. Limited data are available because pregnant women were specifically excluded from clinical trials of HPV vaccine. The UK VIP surveillance is therefore being extended to include HPV vaccine.
The objectives of the UK VIP surveillance are to compile additional information on, and allow further analysis of, women who are immunised with these specified vaccines whilst pregnant. These data will be used to help better inform pregnant women who are inadvertently immunised, their families and health professionals who are responsible for their care.
There is no specific risk if a woman is immunised with any of these vaccines in pregnancy or shortly before becoming pregnant for either her or her baby. For details of safety information on each of the vaccines covered by our Vaccine in Pregnancy surveillance please vist the apropriate pages.
If you are pregnant and have been immunised with MMR, varicella or HPV vaccine there is no known cause for concern. It is recommended that you discuss this with your GP or midwife who can then report this to the Health Protection Agency. You can also report directly either by completing the form below or by telephone (01788 540298 or 020 8327 7471). Ordinarily subsequent follow-up will be with your GP.
If you would like to report a case of HPV, MMR or varicella vaccine given in pregnancy please print and complete the form below or complete it electronically. The completed form can be e-mailed or posted to the Health Protection Agency (see details on the form).
Alternatively you can report directly by telephone (01788 540298 or 020 8327 7471).
Please note that "in pregnancy" for the purposes of this surveillance also covers a period before the baby was conceived and this is different for each vaccine because of the individual characteristics of the vaccine and related experience:
All information provided will be treated in strict confidence. The HPA has approval under Section 60 of the Health and Social Care Act 2001 (now subsumed into the National Information Governance Board for Health and Social Care with Section 60, now Section 251 of the NHS Act 2006) to process confidential patient information for the purposes of monitoring the efficacy and safety of the vaccination programme with exemption for the requirement for consent. (see http://www.legislation.hmso.gov.uk/si/si2002/20021438.htm and the Patient Information Advisory Group page).
Whilst consent does not therefore need to be obtained, if you are a health professional reporting a case in one of your patients we would recommend that the details of this surveillance are discussed with your patient
If you have any other concerns or would like to discuss this further, please call Helen Campbell on 01788 540298.