Table of Contents
Introduction
Vaccinations during pregnancy are one of the most effective ways to protect both mother and baby from serious illness.
With evolving public health guidelines and emerging infections, pregnant women, their partners, and healthcare providers need to stay informed about which vaccines are safe, recommended, and necessary.
This guide provides science-backed answers to the most common questions about safe vaccines during pregnancy, vaccine timing, and why you should avoid certain vaccines.
Whether you’re early in your pregnancy or planning for one, this guide will help you make informed, evidence-based decisions.
Why Vaccination Matters for Mom and Baby
How Maternal Antibodies Protect Newborns
When a pregnant woman receives a vaccination, her body produces protective proteins called antibodies. These antibodies can pass through the placenta to the baby, providing the baby with some protection after birth, especially during the first few months when the baby is still too young to receive vaccinations.
This early protection is essential for serious illnesses like the flu and whooping cough, which can be dangerous for newborns.
For instance, antibodies from the mother can help shield the baby during the first 2–3 months of life, when the baby’s immune system is still developing, which is especially helpful during seasons when respiratory infections are common.
Risks of Vaccine-Preventable Diseases in Pregnancy
Pregnant women have a higher risk of severe illness from some vaccine-preventable diseases due to immune system changes.
Influenza can lead to complications like pneumonia and preterm labor. Similarly, pertussis can be transmitted to newborns, who are at high risk of hospitalization and even death.
COVID-19, which has affected pregnant women more severely than the general population in some cases, also highlights the importance of immunity.
Studies show that pregnant women with COVID-19 are more likely to require intensive care and may face risks such as preterm delivery.
CDC-Recommended Vaccines During Pregnancy
The CDC issues updated guidelines on vaccinations during pregnancy to protect both maternal and fetal health. These guidelines are endorsed by professional organizations such as the American College of Obstetricians and Gynecologists (ACOG).
1. Flu Shot
The inactivated flu vaccine is considered safe at any stage of pregnancy. Pregnant women are at increased risk of severe flu complications, and getting the vaccine reduces the chance of hospitalization. The vaccine also helps protect the baby for several months after birth.
Ensure you get vaccinated before or during flu season (typically from October to March), as immunity takes approximately two weeks to develop.
2. TDAP
The Tetanus, Diphtheria, and Pertussis (TDAP) vaccine is recommended during each pregnancy, ideally between 27 and 36 weeks of gestation. This timing maximizes the transfer of protective antibodies to the baby.
Pertussis can be deadly for newborns. Because babies can’t be vaccinated until two months of age, maternal TDAP coverage offers early protection.
3. Hepatitis B Vaccine
Hepatitis B is a severe liver infection that can be transmitted from mother to baby during delivery. If you haven’t been previously vaccinated and are at risk (e.g., healthcare worker, multiple sex partners, injection drug use), the hepatitis B vaccine is safe and recommended during pregnancy.
4. Hepatitis A Vaccine
While not routinely recommended for all pregnant women, the inactivated hepatitis A vaccine is considered safe during pregnancy and may be advised for those traveling to endemic areas or at risk due to occupational exposure.
5. Meningococcal Vaccine
This vaccine protects against bacterial meningitis. While data are limited, the meningococcal (MenACWY) vaccine is considered safe if required due to risk factors or travel needs.
6. Pneumococcal Vaccine
PPSV23 is recommended for pregnant women with chronic illnesses like diabetes, heart disease, or asplenia. Pneumococcal disease can lead to pneumonia or bloodstream infections.
7. Respiratory Syncytial Virus Vaccine
Approved for use during late pregnancy (32–36 weeks gestation during RSV season), the maternal RSV vaccine protects newborns from severe lower respiratory tract infection in the first six months of life.
Vaccines to Avoid
Live Vaccines
Live attenuated vaccines, such as MMR (Measles, Mumps, Rubella) and varicella (Chickenpox), as well as the live nasal flu vaccine, are not recommended during pregnancy due to a theoretical risk of transmitting the live virus to the fetus.
If a woman is not immune to rubella or varicella before pregnancy, she should wait at least one month after vaccination before trying to conceive.
If a live vaccine is accidentally administered, the CDC does not recommend termination of the pregnancy. However, extra monitoring may be required.
Frequently Asked Questions
There is no credible evidence linking inactivated vaccines (such as the flu shot or TDAP) to miscarriage. Extensive studies involving thousands of pregnant women have shown no increase in pregnancy loss associated with these vaccines.
A study published in the Journal of the American Medical Association found no increased risk of miscarriage among women who received the influenza vaccine during pregnancy.
The ideal window for the TDAP shot is between 27 and 36 weeks gestation, preferably closer to 27 weeks, to ensure optimal transfer of protective antibodies to the baby.
Women should receive the TDAP vaccine with each pregnancy, regardless of prior immunization history.
Yes. Multiple studies from the CDC, NIH, and international public health bodies have concluded that mRNA COVID-19 vaccines are safe during all trimesters. There is no evidence of increased congenital disabilities, miscarriage, or infertility.
Vaccinated mothers also pass COVID-specific antibodies to their babies, providing additional protection.
Final thoughts for you
Getting vaccinated during pregnancy isn’t just about protecting yourself—it’s also one of the best ways to protect your baby, especially in those fragile first few months of life.
Vaccines like the flu shot, Tdap, and even the COVID-19 vaccine can help prevent serious illness for both mom and baby. However, it’s just as important to know which vaccines to avoid, such as the MMR and chickenpox vaccines, and to follow trusted guidelines, like those from the CDC.
As a pharmacist, I encourage every expectant mom to talk openly with their doctor or midwife about vaccines. These conversations matter. With the right timing and reliable information, you can feel confident that you’re making the safest choice for you and your baby.
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ACOG. Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. American College of Obstetricians and Gynecologists
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