Midwives play a vital role in providing reliable advice and information to women/wāhine and their whānau during pregnancy and postnatal care. Midwives provide support in parents’ decision making surrounding immunisation during pregnancy and for their baby/pēpe, both after birth and in early childhood.
This webpage provides information to support midwives promoting antenatal vaccination, post-partum vaccination and neonatal vaccination. The information below provides links to resources, other relevant sources, and websites to assist midwives information sharing and decision making support.
The Immunisation Advisory Centre (IMAC) has worked with the New Zealand College of Midwives to provide reliable information for midwives and other health professionals involved in caring for pregnant people, and their whānau during pregnancy and the neonatal period, including immunisation advice.
IMAC has developed an immunisation toolkit for midwives, which provides a quick summary of key information, with links to relevant resources, websites and online education resources to assist midwives in immunisation - you can view the toolkit here.
IMAC has an online immunisation course tailored specifically for midwives. The Midwife Vaccinator Course (online) is available here.
Providing information, prescribing and administering specific vaccinations are within the midwifery scope of practice.
To pregnant people
However, most midwives are not resourced to provide a full vaccination service, which requires adherence to standards for cold chain management, monitoring and appropriate support and equipment to treat anaphylaxis.
Midwives may choose to provide vaccination as part of their maternity care/service. Support, information, and updates are available from Regional and Local Advisors.
The Immunisation Advisory Centre (IMAC) has an online immunisation course tailored specifically for midwives. It provides midwives with immunisation knowledge relevant to their practice including the National Immunisation Schedule changes, vaccine composition, safety of vaccines in pregnancy, administration of vaccines and talking with parents about vaccines.
The course is approved as continuing midwifery education by the Midwifery Council.
The Midwife Vaccinator Course (online) is available here.
All adult vaccines are usually administered into the deltoid and neo-nates in the vastus lateralis.
For guidance on appropriate site and needle selection, see Chapter 2 of the Immunisation Handbook (Processes for safe immunisation).
Vaccines are delicate biological substances and to maintain potency, must be stored in a temperature-controlled situation. The cold chain is the process that ensures vaccines are continuously stored at the required temperature between +2°C to +8°C. If exposed to temperatures above or below, vaccines may be damaged and may not provide the expected level of protection.
Maintenance of cold chain is required at all times, including while vaccines are stored in chilly bins for transport and during off-site vaccination clinics. Click here for more information.
Contact your local immunisation coordinator for support and guidance.
For more information and list of minimum staff and emergency equipment requirements, see the Immunisation Handbook Appendix 4
Resource: IMAC Management of Anaphylaxis
Pregnant people need to be provided with recommendations for pregnancy. Vaccination during pregnancy stimulates the immune system to make antibodies, which will protect both the pregnant person and cross the placenta to protect their newborn.
Vaccines recommended during pregnancy are:
All three vaccines are currently recommended in NZ during pregnancy and can be given at the same time or separately into different sites in the deltoid.
From a biological perspective all non-live vaccines are expected to be safe for use during pregnancy and for live vaccines potential risks are theoretical only and have not been demonstrated in practice. For non-live vaccines the vaccine remains localised before being digested and does not pass to the fetus.
In the real world, vaccine safety is assessed in a number of ways allowing detection of a possible signal, verification of a signal and testing to see if there is an increased risk following a vaccine.
Whether or not a vaccine causes a particular type of adverse event is established using #5 comparing vaccine exposed and non-exposed in some way. All these approaches contribute different levels of information that together establish the safety profile of a vaccine, including in sub populations such as pregnant women.
For further information on vaccine safety data, visit Global Vaccine Data Network.