פרופ' זיידמן, מבקשת הבהרה בעניין

חיסון כלבת בעת טיפולי פוריות. החיסון לבני אדם ניתן מספר פעמים (ולא פעם אחת). האם הוא עלול לפגוע בהריון ? למנוע הריון ? להפריע להשתרשות עובר ? לפגוע במשהו בהליך IVF ? להלן שאלתי המקורית: http://www.doctors.co.il/forums/read.php?f=246&i=290369&t=290369 מיותר לציין שכרגע אני בטיפול (גונל + דפקטטיל), כך שבהחלט ייתכן שחלק ממתן החיסון 'יגלוש' לימי השאיבה או ההחזרה, שאז ההריון אינו ודאי. אנא, תשובתך המפורטת. אני בהחלט חוששת מהעניין.

החיסון נחשב בטוח בהריון, ובמידה והרופא סבור שיש הוריה ברורה אין להסס לתת אותו. Post-exposure prophylaxis with purified vero cell rabies vaccine during pregnancy--safety and immunogenicity. J Commun Dis. 1999 Dec;31(4):229-36. Sudarshan MK, Madhusudana SN, Mahendra BJ. Kempe Gowds Institute of Medical Sciences, Bangalore. This study was conducted with the main objective of determining the safety and immunogenicity of purified vero cell rabies vaccine (PVRV) during pregnancy. Twenty nine pregnant women exposed to rabies were vaccinated with PVRV as per the Essen regimen advocated by World Health Organization. None of the women experienced any adverse side effects to the vaccine. The intrauterine growth and development monitored by ultrasound examination was found to be normal and the outcome of pregnancy was satisfactory. There were no congenital anomalies in any of the infants born and they were healthy and had normal growth and development during the one year follow-up period. The rabies neutralizing antibody titers from day 14 to day 365 following vaccination in these women was adequate and well above the minimum protective level of 0.5 iu/ml of serum. Protective levels of antibodies were also present in serum of some of the babies tested, for up to 3 months of age. The mothers and infants followed for one year period were doing well at the end of the study period. Consequently, PVRV was found safe and immunogenically efficacious during pregnancy. Postexposure rabies vaccination during pregnancy: experience with 21 patients. Chutivongse S, Wilde H. Vaccine. 1989 Dec;7(6):546-8. Queen Saovabha Memorial Institute, Thai Red Cross Society, Chulalongkorn University, Bangkok. Twenty-one pregnant rabies exposed patients received postexposure vaccination using purified Vero cell rabies vaccine. Twelve of these with severe exposures were also given equine rabies immune globulin. Adverse reactions were mild, transient and required no treatment. Fifteen per cent of the patients reported side-effects such as myalgia, malaise, erythema and swelling at injection sites, urticarial rashes, and mild regional lymphadenopathy. The vaccine series was completed in all cases and none of the mothers or infants developed rabies after one year of follow-up. No congenital malformations were detected. All infants were well after one year. One patient experienced a spontaneous abortion.