Vaccinations During Pregnancy: Protecting You and Your Baby

Author: Samreen Usman, Pharm-D, MPhil (Pharmaceutical Chemistry)

Medical Reviewer: Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• Vaccines recommended in pregnancy are safe and helpful for both you and your baby.
• They strengthen your immune system and lower your chances of getting serious infections.
• Your baby also receives protective antibodies from you, giving them early protection after birth.
• The flu (influenza) and whooping cough (Tdap) vaccines are especially advised to keep both mother and baby safe.
• Some vaccines, like measles, mumps, rubella (MMR), chickenpox (varicella), and yellow fever, are not safe in pregnancy and should be avoided.

Introduction

One of the most asked questions by moms-to-be is ‘How safe is vaccination during pregnancy?’. The  answer is that many vaccines are completely safe and play a crucial role in protecting both mother and baby; however, a few may not be safe. Healthcare professionals advocate for vaccination during pregnancy so that serious infections can be avoided, and you and your baby remain healthy. These vaccines are safe and proven to be effective for pregnant women and their babies.

Despite the benefits, some women living in low-resource settings, like some regions of Africa, are hesitant to vaccinate. This is due to a myriad of societal misinformation and other unproven myths.  Their babies, as well as the mothers, are exposed to serious infections during pregnancy, and this highlights the need for health education.

The goal of this article is to provide helpful information for expectant mothers and to advocate for vaccination during and after pregnancy. With this knowledge, you can better prepare for pregnancy and give your baby the best possible start

Why Vaccinations Matter During Pregnancy

Your immune system undergoes certain changes during pregnancy, which can make you more vulnerable to specific infections. In pregnant women, infections such as influenza (flu) and pertussis (whooping cough) can become severe and may cause complications for both the mother and the baby. Vaccination helps prevent these infections and protects the health of both mother and child [1].

The routine immunisation schedule aims to minimise the burden of infections in a protective manner. You should be actively involved and receive the vaccines advised by your healthcare provider to protect both yourself and your baby [2].

 How Vaccines Strengthen Immunity for the Mother and Baby

When vaccines are given during pregnancy, the immune system is activated, and antibodies are produced. These antibodies are protective proteins that help your immune system fight foreign cells.You become immune as these antibodies are retained in your circulation.

Transfer of Antibodies to the Baby

The last trimester is key to this transition, and during pregnancy, the placenta serves as a temporary organ.Your baby’s circulation receives protective antibodies from you.This process is called passive immunity, because your baby gains protection without producing its own antibodies.

Protection for the Newborn

Your baby is born with some antibodies that were actively produced by the mother and transferred to the baby before birth.This protection is very important because newborns have immature immune systems and are too young to receive certain vaccines (e.g., whooping cough, flu).

After birth, antibodies are also transferred through breast milk, providing continued protection [3].The mother’s antibodies protect the baby during the crucial early months of life until the baby’s own vaccines begin to produce active immunity.

In effect, these vaccines provide dual protection:

• Mother: These vaccines reduce the risk of getting seriously ill from infections during pregnancy, when she is more susceptible.
  
  
• Baby: The antibodies passed to the baby provide the first line of defence against infections after birth.

Are Vaccines Safe in Pregnancy?

Vaccine administration in expecting mothers is not entirely forbidden. Some vaccines support better maternal care, while others should be avoided. The decision on which vaccine to administer depends on:

• The stage of pregnancy
• The type of vaccine
• The balance between maternal and fetal safety
• The level of protection needed against high-risk infections

It is important that you receive vaccines that protect against infections compromising you and your baby’s safety. The primary intention is to address the target disease, and both mother and baby can greatly benefit from appropriate vaccination.

Recommended Vaccines During Pregnancy

To protect against serious diseases,  your healthcare provider would recommend certain vaccines during pregnancy. 

The most commonly recommended vaccines include: [4]

1. Tdap Vaccine (Tetanus, Diphtheria, and Pertussis): 

• The Tdap vaccine is given to pregnant women, usually between the 27th and 36th weeks of gestation.
• It is administered to protect against pertussis (whooping cough).
• Through maternal immunisation, the baby also receives protection and is shielded from pertussis during the first few months of life.
• In many countries, tetanus toxoid alone is still widely used in pregnancy, while Tdap is not yet part of standard antenatal immunisation schedules. 
• The recommended tetanus immunisation schedule by the World Health Organization is  a total of five doses given one month apart in the first pregnancy, the 3rd dose is given at least 6 months later, then 1 dose in each subsequent pregnancy (or intervals of at least 1 year), to a total of five doses

2. Influenza Vaccine (Flu Shot):  

• The flu vaccine is an effective tool for protecting expectant mothers and their babies, particularly during the fall and winter months, typically from October to May.
  
  
• Pregnant women are more susceptible to the flu due to changes in their immune system, heart, and lungs.
  
  
• The flu vaccine helps protect the mother and also transfers antibodies to the baby, providing protection after birth.

3. Respiratory Syncytial Virus (RSV) Vaccine:

• The RSV vaccine protects babies from severe lung infections caused by Respiratory Syncytial Virus.
  
  
• When given during pregnancy, it passes protective antibodies to the baby, reducing the risk of severe RSV infection during the first six months after birth.
  
  
• The vaccine is typically offered around the 28-week antenatal appointment, but can also be given later if needed, providing crucial protection for newborns.
  
  

4. COVID-19 Vaccine:

• It is recommended by the US Centres for Disease Control. 
• It can be given at any stage of pregnancy.
• It decreases pregnancy complications and disease severity.
• The vaccine also transfers antibodies to the baby.
• Booster doses may also be suggested depending on the region.
  
  

Other Vaccines for Pregnant Women 

The other  recommended vaccines for pregnant women include [5]: 

• Hepatitis B: If a pregnant woman is infected with hepatitis B, the baby may become infected during delivery. Consult your healthcare provider about testing and vaccination plans.
  
  
• Hepatitis A: If a pregnant woman has chronic liver disease, the healthcare provider may recommend the hepatitis A vaccine.
  
  
• Travel Vaccines: If a pregnant woman needs to travel internationally, she should consult before the trip for specialised guidance and necessary vaccines.
• 
  
• Pneumococcal or Meningococcal Vaccines: Women with chronic illness or high exposure risk should receive these vaccines after guidance from their healthcare provider.
  
  
• Rabies Vaccine: If a woman is bitten or exposed during pregnancy, she should receive this vaccine without delay.

Vaccines to Avoid During Pregnancy

Some vaccines are not recommended during pregnancy because their active components contain live or weakened pathogens that could potentially cross the placenta and harm your baby. 

Such vaccines are usually not given until after the baby is born. Here are the main vaccines to avoid during pregnancy [6]:

1. MMR (Measles, Mumps, Rubella)

• Live vaccine.
• Must be given at least 1 month before pregnancy as part of the preconception care plan, if applicable.
• Not recommended during pregnancy due to the potential risks to the developing baby.

2. Varicella (Chickenpox)

• Live vaccine.
• Not recommended in pregnancy.
• If a woman is found to have no immunity during pregnancy, vaccination is recommended after the baby is born.

3. Live Attenuated Influenza Vaccine (Nasal Spray)

• The nasal spray version is a live vaccine and must be avoided.
• If a woman wants to get the vaccine, she is encouraged to receive the inactivated (injection) influenza vaccine.

4. HPV Vaccine (Human Papillomavirus)

• During pregnancy, these vaccines are not advised because of insufficient data regarding the risk of infection and its consequences.
• If a woman becomes pregnant after starting the HPV series, the remaining doses should be given after the baby is born.

5. Other Live Vaccines (less commonly encountered)

• Yellow Fever Vaccine (for travellers): Avoid during pregnancy unless travel is unavoidable and the risk of infection is high. In such cases, it may be considered under specialist guidance.
• BCG (tuberculosis vaccine): Not recommended during pregnancy.
• Oral Typhoid Vaccine (live): Contraindicated in pregnancy; however, the injectable inactivated version can be used if necessary.

Always remember:

• Inactivated, toxoid, or recombinant vaccines (e.g., flu shot, Tdap) are generally safe during pregnancy.
• Live vaccines are avoided during pregnancy due to the potential risk of harm to the developing infant.
• If a live vaccine is accidentally given during pregnancy, it is not an indication for termination, but careful monitoring is advised.

Vaccines Recommended Before Pregnancy (Preconception Care) [3]

1. MMR (Measles, Mumps, Rubella)

• It is important to ensure immunity before pregnancy.
• Live vaccines should be administered at least 1 month before conception.
• This helps protect against rubella infection in early pregnancy, which could otherwise lead to congenital rubella syndrome.
  
  

2. Varicella (Chickenpox)
   
   

• Advised if the woman has not been previously infected or vaccinated.
• Live vaccines should be administered at least one month before pregnancy.
• Helps prevent congenital varicella syndrome and related complications in the mother.
  
  

3. Hepatitis B

• Recommended for women at risk (e.g., healthcare workers, chronic liver disease, multiple partners).
• Safe before and during pregnancy, though it is preferable to get vaccinated beforehand.
  
  

4. HPV (Human Papillomavirus)

• Recommended for women before the age of 26. Although it can be given up to 45 years.
• Not advised during pregnancy, so completing the course beforehand is recommended.

5. Influenza (Flu Shot)

• If flu season is approaching, it is better to get vaccinated before or during pregnancy.
  
  

6. COVID-19

• Recommended for women before pregnancy to ensure safety before conception.

Always remember:

• Live vaccines (MMR, Varicella, Yellow Fever, Oral Typhoid, BCG) should be given at least 1 month before conception.
  
  
• Avoid becoming pregnant immediately after receiving a live vaccine, as advised by your healthcare provider
  
  

Conclusion

Vaccines given to a pregnant woman help protect both her and the unborn child from serious infections. They strengthen the mother’s immune defences, reducing her chances of getting sick, while also providing the newborn with early protection through the womb.

 Vaccines such as influenza and Tdap are recommended during pregnancy and offer protection during a particularly vulnerable time for both mother and baby. Vaccination should always be done in consultation with healthcare professionals to ensure a safe pregnancy and to give the newborn the best possible start in life.

References

1. Bianca Cinicola, Maria Giulia Conti, Gianluca Terrin, Mayla Sgrulletti, Reem Elfeky, Rita Carsetti, Ane Fernandez Salinas, Eva Piano Mortari, Giulia Brindisi, Mario De Curtis, Anna Maria Zicari, Viviana Moschese, Marzia Duse, The Protective Role of Maternal Immunization in Early Life. Front Pediatr. Apr 2021. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8113393/

2. Youssouf Sereme, Eya Toumi, Estelle Saifi, Helène Faury, David Skurnik, Maternal immune factors involved in the prevention or facilitation of neonatal bacterial infections. Cellular Immunology, Volumes 395–396, Feb 2024. Available from: https://doi.org/10.1016/j.cellimm.2023.104796.

3. Stephanie N Langel,  Maria Blasi, Sallie R Permar. Maternal immune protection against infectious diseases. Cell Host Microbe. 2022 May 11;30(5):660-674. Available from: https://pubmed.ncbi.nlm.nih.gov/35550669/

4. Anwar H Nassar, Elie Hobeika, Dina Chamsy, Faysal El-Kak, Ihab M Usta, Vaccination in pregnancy. Int J Gynaecol Obstet. 2023 Jul;162(1):18-23. Available from: https://pubmed.ncbi.nlm.nih.gov/37283471/

5. Mala Arora, Rama Lakshmi. Vaccines-safety in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2021 Feb 19;76:23–40. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7992376/

6. Alexandra Cairns, Jennifer Hogan, Lucy Mackillop. Vaccinations in pregnancy. Obstet Gynaecol Reprod Med. 2022 Aug;32(8):163-171. Available from: https://pubmed.ncbi.nlm.nih.gov/35702629/

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published September 24, 2025