A pregnant client’s prenatal immunization history is reviewed. Which immunization should the nurse instruct the client to receive after pregnancy?

• A. Measles, Mumps and Rubella
• B. Hepatitis B
• C. Varicella
• D. Influenza

Answer: (A)

Postpartum timing for vaccines often centers on protecting both the mother and future pregnancies. The Measles, Mumps and Rubella vaccine is a live attenuated vaccine, so it is not given during pregnancy due to potential risk to the fetus. After delivery, it is safe and recommended if the mother is not immune, particularly to rubella, because rubella infection in pregnancy can cause serious fetal harm. Administering this vaccine after birth helps ensure the mother’s immunity for her remaining childbearing years and reduces the risk of congenital rubella in future pregnancies.

Hepatitis B is an inactivated vaccine and can be given during pregnancy if indicated, so it isn’t specifically a postpartum requirement. Varicella is also a live vaccine and would be postponed until after pregnancy if the patient is non-immune, but the option that most directly addresses the pregnancy-related rubella concern is the MMR vaccine. Influenza vaccine is recommended during pregnancy as well, not restricted to the postpartum period.