Protecting your pregnancy when travelling
Drickus Maartens • November 14, 2019
Should you vaccinate during pregnancy?
What steps can pregnant women who are intending to travel take to protect their pregnancy? Are there vaccines available that can help to safeguard their health and that of their unborn baby? These are questions that Dr Pete Vincent of Netcare Travel Clinics
and Medicross
Tokai is commonly asked by expectant women who are travelling to countries requiring certain mandatory vaccinations, or to areas where specific health risks are prevalent.
“We recommend that pregnant women who intend travelling consult a travel doctor well in advance of their planned trip to obtain advice on which vaccines are safe to use and what measures they should take to best protect their health and that of their unborn baby,” advises Dr Vincent.
Dr Vincent says that inactive vaccines — such as the influenza vaccine and the quadrivalent vaccine are considered safe during pregnancy and are also important for newborn babies, who are entirely dependent on maternal antibodies to provide passive immunity protection against common viral infections.
“Netcare Travel Clinics therefore advises pregnant travellers to have the current southern hemisphere influenza vaccination at least two weeks prior to travelling, should they not already have done so. This is because pregnancy can make them more susceptible to complications should they contract flu, and it will also provide some protection for the newborn baby.”
He says it is especially important for all women to be vaccinated between 27 and 36 weeks during each of their pregnancies with the inactive quadrivalent vaccine, which provides protection against whooping cough, tetanus, diphtheria and polio, and also provides the newborn with maximum passive immunity from their mother.
“There has been a rise in the number of reported cases of whooping cough, which is potentially dangerous for newborn babies, both in South Africa and globally, so it is critical to be protected against this highly infectious virus. I would suggest that not just mothers-to-be, but anyone who is likely to come into contact with newborns, including fathers, child minders, siblings and grandparents, should be vaccinated against whooping cough,” notes Dr Vincent.
“This is particularly important when one considers that babies are born with little or no immunity against infections like whooping cough, which is responsible for an alarming number of newborn deaths every year, ensuring that mothers-to be receive this vaccine can provide important protection during a baby’s first months’ of life. According to the Centres for Diseases Control and Prevention [CDC] in the United States, a whooping cough vaccine can provide as much as 78% greater protection to the child during their first two months of life than if the mother had not been vaccinated during pregnancy.”
Dr Vincent says it should be noted that active vaccines such as for measles, rubella and chickenpox, rabies and others — which contain a live but weakened form of a particular virus — may carry a theoretical risk for the foetus and should not be administered during pregnancy unless there are special circumstances, for example if the expectant mother may have been exposed to rabies.
“The CDC and the South African Society of Travel Medicine advise women who are planning pregnancy and have not already had these vaccinations to consider having them administered before falling pregnant to protect themselves from infections such as measles, chickenpox and rubella, which can cause severe complications to the foetus during pregnancy.”
Dr Vincent emphasises that pregnant women who inadvertently receive an active vaccine should not become alarmed about it and consider terminating the pregnancy, as there are no documented cases of these inoculations causing harm to the foetus. However, he does advise that they should consult their doctor.
Expectant women who plan to visit an area where malaria is present should note that pregnancy greatly enhances the risk of developing potential complications should they contract malaria. There is no safe anti-malaria prophylaxis available for pregnant women and areas where malaria is prevalent should be strictly avoided.
Listererosis is a food borne bacterial infection that can have serious implications for maternal health, and be fatal for both unborn and newborn babies, warns Dr Vincent. This bacterial disease can be contracted by consuming contaminated processed deli meats or unpasteurised milk products, and he therefore advises pregnant women to be cautious about what they eat while travelling, when one is more inclined to consume foods on the go.
Dr Vincent explains that a healthy individual does not usually become seriously ill from a listeria infection, and even pregnant women are likely to only experience mild signs and symptoms. “It can, however, result in pregnancy loss and could cause meningitis in a newborn infant. For this reason, pregnant women who suspect that they may have contracted the infection should urgently consult their doctor, as prompt treatment with antibiotics can assist in preventing the infection from causing harm to the foetus,” he advises.
“Travel clinics, which are in constant contact with healthcare authorities around the globe in order to provide up-to-date information on health hazards and healthcare trends, are best placed to advise expectant mothers on how to protect their health during their travels,” concludes Dr Vincent.
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With Rare Disease Day on the 28th of February 2025, the Rare Diseases Access Initiative (RDAI) is driving an evolution of the country’s healthcare, through innovative strategies to better care for over 4.2million people living with an estimated 7000 rare diseases. “As our healthcare system faces significant changes in the years ahead, it is vital that we also advocate for people living with rare diseases in South Africa, especially those with limited healthcare access,” said Kelly du Plessis, CEO of Rare Diseases South Africa (RDSA), a member of RDAI. “As part of our ongoing research and awareness efforts, RDAI has conducted an initial analysis of the incidence and prevalence of rare diseases within the country.” This research will assist in improving access to healthcare, policy development, and patient advocacy, while giving critical insight into the challenges faced by patients. “According to research, some rare diseases affect fewer than 1 in a million people, while others, such as Down syndrome, cystic fibrosis, and haemophilia, have a more recognisable prevalence,” says Dr. Helen Malherbe, RDAI lead researcher on rare disease prevalence data. “Many conditions are undetected, underdiagnosed or misdiagnosed, with too many having no information available about them at all.” The RDAI was formed in 2019 to promote a more favourable environment for those impacted by rare diseases in South Africa. Participants include Ampath, the Board of Healthcare Funders (BHF), Discovery Health, Genetic Counsellors South Africa (SASHG), the Government Employees Medical Scheme (GEMS), Health Funders Association (HFA), Medihelp, Medscheme, North-West University (NWU), Rare Diseases South Africa (RDSA), the South African Medical Association (SAMA) and The South African Medical Technology Industry Association (SAMED). The Council for Medical Schemes (CMS) participates as an observer. In the same year, Rare Disease International signed a memorandum of understanding with the World Health Organisation leading to an international rare disease policy framework. In 2021, the United Nations General Assembly moved to adopt a resolution recognising 300 million people living with rare diseases worldwide. “A general lack of awareness and delayed diagnosis remain major hurdles for those affected by rare diseases. Policymakers and healthcare stakeholders need to prioritise access to treatment, diagnosis, and support for rare disease patients,” says Bada Pharasi, CEO of IPASA, “Through this initiative, working collaboratively with stakeholders at every level of the healthcare supply chain, we can bring real and meaningful change to those affected, including family members and care givers, through smart and efficient strategies.” The globally agreed definition of a rare disease is any medical condition with a specific pattern of clinical signs, symptoms, and findings that affects fewer than or equal to 1 in 2000 persons in a population. “Most are genetic, and some are inherited and passed down in families,” Malherbe says. “Some affect only the patient’s genetic recipe, while others may be acquired during life due to infection, trauma, or environmental effects. For many, the cause is still unknown. “These conditions mainly affect children, as they are largely incurable and many are life-threatening. Some require specialised and co-ordinated care, some have limited and expensive treatment options, while others have no information or effective treatments at all,” she adds. The RDAI is calling for a patient-centred care model built on equitable access, transparency and efficiency. Naturally, this model calls for the open participation of patients, the healthcare industry, health professionals, and the Government. “The most critical elements are robust diagnosis standards, improved access to treatment, data collection and management, co-ordination of care, measurement of outcomes and ongoing collaborative research,” du Plessis says. “We need to establish rare disease advisory committees, map gaps and opportunities, establish system requirements, create a roadmap and plan a phased implementation with clear timelines.” The RDAI states that these policy development steps would be a start in quantifying the disease burden and defining standards of care. This would be followed by building and strengthening the capacity to facilitate appropriate diagnosis, treatment, continuity and data monitoring. Thoneshan Naidoo, Chief Executive Officer of the Health Funders Association noted that, “We appreciate the unique opportunity provided by RDAI which enables stakeholders across the industry to work together and identify strategies that improve equitable access to the appropriate diagnosis, treatment and healthcare services for rare disease patients, in an affordable and sustainable manner, taking account of the other pressing needs across the healthcare system.” “True innovation in healthcare is only possible through partnerships and joint advocacy efforts that raise awareness and improve access to treatment. Our long-term goal is the development of a rare diseases policy framework and guidelines for coordinated care,” says Pharasi. “Our members are united in the commitment to unlocking improved patient outcomes and improving access to services and robust health needs assessment facilities.” he concludes. About RDAI The Rare Diseases Access Initiative (RDAI) is dedicated to advocating for improved healthcare access, policy development, and patient support for those affected by rare diseases in South Africa. The initiative brings together key healthcare stakeholders, including pharmaceutical associations, funders, genetic specialists, and patient advocacy groups, to drive impactful change. About RDSA Founded in 2013, Rare Diseases South Africa (RDSA) is a non-profit organisation advocating to ensure that people living with rare diseases and congenital disorders experience greater recognition, support, improved health service and better overall quality of life. Started out of personal need following the diagnosis of organisation founder, Kelly du Plessis' son, it became evident that there was a lack of awareness and support for rare diseases in general in South Africa. About IPASA The Innovative Pharmaceutical Association South Africa (IPASA) is a voluntary trade association representing 24 leading pharmaceutical companies committed to research, development, and innovation. Our mission is to drive healthcare advancement by advocating for policies that improve patient access to safe, high-quality, and affordable medicines.
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