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Obstetrical#postpartum#vaccinesPGY 1/2/3/4

Postpartum Vaccinations

Rh-, MMR (live-attenuated CI), Tdap, Varicella, Flu, COVID — postpartum vaccination decision rules.

Source: PGY-1 Resident Handbook 2026-2027

Check status under “Health Maintenance” or “Immunizations” tab in Epic.

  • Rh negative: order RhIG Post Natal/Trauma Evaluation with postpartum orders. F/U infant’s blood type and RhIg. Order Rhophylac (Rhogam) if infant is Rh+. Order extra Rhogam if RhIg is positive.
  • Rubella: if equivocal or non-immune, order PP MMR vaccine. NOTE: live-attenuated vaccine — contraindicated if patient is on immunosuppressive agent (e.g., many patients with IBD or SLE).
  • Tdap: recommended for all patients in 3rd trimester of each pregnancy. If NOT vaccinated during pregnancy, give PP only if not received in last 10 years.
  • Varicella: if non-immune, patient can receive inpatient or with PCP.
  • Flu: recommended during flu season. If not received with prenatal care, give postpartum.
  • COVID: vaccines + boosters available postpartum.

Referenced by handoffs