Vaccines During Pregnancy: What You Need to Know
When you're pregnant, every decision feels magnified—especially when it involves medical interventions. You might wonder if vaccines are safe during pregnancy, which ones you actually need, and whether they could affect your developing baby. These are exactly the right questions to ask.
The science is clear: certain vaccines during pregnancy are not only safe but highly recommended because they protect both you and your baby. Your immune system changes during pregnancy, making you more vulnerable to serious illness, while vaccines can pass protective antibodies to your baby before they're even born.
Why Vaccines Matter During Pregnancy ACOG
Pregnancy changes your immune system, heart, and lungs in ways that can make some infections more dangerous for you than they would be otherwise.
Your increased vulnerability:
- Immune system adapts to prevent rejection of the baby
- Heart and lungs work harder during pregnancy
- Some infections carry higher risks of severe illness, hospitalization, and complications
- Certain infections can harm your developing baby
How vaccines protect your baby:
- Antibodies you produce from vaccines cross the placenta
- Your baby is born with some immunity (called passive immunity)
- This protection covers the vulnerable newborn period before they can be vaccinated
- Particularly important for diseases like whooping cough and flu
Recommended Vaccines During Pregnancy CDC
The following vaccines are specifically recommended for every pregnancy:
### Tdap (Tetanus, Diphtheria, Pertussis)
When: Between 27-36 weeks of each pregnancy (ideally early in this window)
Why it's critical:
- Whooping cough (pertussis) can be deadly for newborns
- Babies can't get their own pertussis vaccine until 2 months old
- Vaccinating during pregnancy passes antibodies to baby
- This passive immunity protects during the most vulnerable weeks
What the research shows:
- Maternal Tdap vaccination prevents about 78% of whooping cough cases in infants under 2 months
- This is the single most effective way to protect newborns from pertussis
- Getting Tdap in every pregnancy is necessary—immunity doesn't last from previous pregnancies
### Flu Shot (Influenza Vaccine)
When: During flu season (typically October-March), at any point in pregnancy
Why it matters:
- Flu is more dangerous during pregnancy—higher risk of hospitalization
- Flu during pregnancy can cause preterm birth and other complications
- Flu shot protects you AND passes antibodies to baby
- Babies can't get their own flu shot until 6 months old
Important notes:
- Get the flu shot (injection), not the nasal spray vaccine
- Flu shot is safe in any trimester
- Get vaccinated even if you've already had flu this season—you can get different strains
- Protects your newborn during their first flu season
### COVID-19 Vaccine
When: At any point during pregnancy; boosters as recommended
Why it's recommended:
- COVID-19 infection during pregnancy increases risk of severe illness
- Pregnant people are more likely to need ICU care and ventilation
- COVID during pregnancy associated with preterm birth and other complications
- Vaccination passes antibodies to protect your newborn
What research shows:
- COVID vaccines are safe during pregnancy
- Studies show no increased risk of miscarriage, birth defects, or preterm birth
- Vaccination reduces risk of severe illness by about 90%
- Antibodies are found in umbilical cord blood after vaccination
### RSV Vaccine
When: Between 32-36 weeks during RSV season (September through January in most areas)
Why it's new and important:
- RSV is the leading cause of hospitalization in infants
- There's now a maternal RSV vaccine approved specifically for pregnancy
- Protects baby during first 6 months when RSV is most dangerous
- Alternative to monoclonal antibody injections given to newborns
Note: Your provider will discuss whether RSV vaccine or nirsevimab (antibody injection for baby after birth) is recommended for your situation.
Vaccines That Are Safe If Needed CDC
These vaccines aren't routinely recommended for everyone during pregnancy, but are safe if you need them:
Hepatitis A: If at risk of exposure or traveling to certain areas
Hepatitis B: If not previously vaccinated and at risk
Meningococcal vaccines: If at risk or during an outbreak
Pneumococcal vaccine: If you have certain medical conditions
Tetanus/diphtheria (Td): For wound management if needed
Always discuss your specific situation with your healthcare provider.
Vaccines to Avoid During Pregnancy CDC
Some vaccines use live, weakened viruses and are NOT recommended during pregnancy:
Do not get during pregnancy:
- MMR (Measles, Mumps, Rubella)
- Varicella (Chickenpox)
- Live flu vaccine (nasal spray)
- Yellow fever (unless travel to high-risk area is unavoidable)
- Live typhoid vaccine
What if you got one of these before knowing you were pregnant?
- Don't panic—exposure doesn't mean harm occurred
- Most data shows no increased risk of problems
- Just don't get additional doses during pregnancy
- Tell your healthcare provider so they can monitor appropriately
Before pregnancy:
- If you need any of these vaccines, get them at least 1 month before trying to conceive
- Check your immunity to measles, mumps, rubella, and chickenpox before pregnancy
- Get caught up on any missing vaccines before pregnancy if possible
Common Concerns Addressed
"I've heard vaccines during pregnancy can cause miscarriage."
Large studies have found no increased risk of miscarriage after flu or Tdap vaccination during pregnancy. This concern has been thoroughly investigated and not supported by evidence. ACOG
"I don't want to put anything 'foreign' in my body while pregnant."
Your immune system encounters countless foreign substances daily. Vaccines are specifically designed to be safe and trigger protective immunity. The diseases they prevent are far more dangerous to you and your baby than the vaccines themselves.
"Can't I just be careful and avoid getting sick?"
Hand washing and avoiding sick people help, but aren't sufficient protection—especially for highly contagious diseases like flu and whooping cough. Many people spread these illnesses before they know they're sick.
"What about the ingredients in vaccines?"
Vaccine ingredients have been extensively studied in pregnancy. The amounts of any preservatives or additives are tiny and have not been shown to cause harm. The CDC and FDA monitor vaccine safety continuously.
"I don't usually get the flu—why do I need the shot now?"
Pregnancy changes your immune system. You may be more susceptible to flu and more likely to develop serious complications. Even if you've rarely been sick before, pregnancy increases your risk.
Protecting Your Baby After Birth
Your prenatal vaccines provide your newborn with important protection, but their immunity wears off over time. Additional strategies help keep them safe:
Cocooning: Everyone who will be around your newborn should be up to date on:
- Tdap (if not vaccinated in the last 10 years)
- Flu shot (during flu season)
- COVID-19 vaccination
- This includes partners, grandparents, siblings, caregivers
Your baby's own vaccines: Starting at 2 months, your baby will begin their own vaccination schedule. Keep all well-child appointments to ensure timely protection.
Talking to Your Healthcare Provider
Questions to ask:
- Which vaccines do you recommend for me this pregnancy?
- When should I get each one?
- Are there any vaccines I should avoid?
- Should my partner or family members get any vaccines?
- What if I have an egg allergy or previous reaction to a vaccine?
Be open about:
- Previous reactions to vaccines
- Allergies
- Medical conditions that might affect recommendations
- Travel plans during pregnancy
- Concerns or hesitations you have
The Bottom Line
Vaccination during pregnancy is one of the most effective ways to protect both yourself and your baby from serious, preventable diseases. The vaccines recommended during pregnancy have been thoroughly studied and have strong safety records.
The choice to vaccinate is ultimately yours, but the evidence clearly supports vaccination as the safer option compared to the risks of diseases like flu and whooping cough. Your baby will be born with antibodies that protect them during their most vulnerable weeks—a gift only you can give them.
Clara is here to answer any questions about vaccines during pregnancy and help you prepare for your baby's arrival.