Is it safe to get vaccinated during pregnancy?

Are vaccines safe during pregnancy?

It depends on the type of vaccine you're considering. It's important for pregnant women to get certain vaccines to keep them safe and healthy during pregnancy. Vaccines during pregnancy can protect the baby, too.

Mom's body develops antibodies against the disease, and these antibodies cross the placenta, protecting the newborn before they're old enough to be vaccinated. The vaccine also keeps Mom from potentially passing a serious disease to her newborn.

While there are some vaccines that are important to get, there are also some that doctors don't recommend during pregnancy. Those not recommended haven't been studied in pregnancy or use live, attenuated (weakened) viruses rather than inactivated viruses. (Inactivated viruses are made by inactivating or killing the germ when the vaccine is made.) While you can't catch the disease from a vaccine made from an inactivated virus, you can – theoretically – catch it from a vaccine made from a live virus.

There are also vaccines that may be used if needed – because the benefits of the vaccine during pregnancy outweigh the risks. This may be because you're traveling to a place that puts you at risk for the disease, or because you're already at high risk for a particular disease.

Recommended vaccines during pregnancy

Four vaccines are specifically recommended for pregnant women.

The flu (influenza) vaccine.

Because of changes in the immune system, pregnant and postpartum women are at higher risk for severe illness from influenza than women who aren't pregnant. A six-year studyOpens a new window of pregnant women concluded that the flu vaccine reduces a pregnant woman's risk of hospitalization from the flu by an average of 40 percent.

You can also pass protection from the flu vaccine to your baby. One reviewOpens a new window published in Human Vaccines & Immunotherapeutics found that mothers who got the influenza vaccine during pregnancy reduced the risk of their infants coming down with the flu by 48 percent. And they reduced their newborn's risk of hospitalization with the flu by 72 percent.

You can safely get a flu vaccine any time in pregnancy, but for best protection, schedule one by the end of October (before or during your pregnancy). Pregnant women should receive the inactivated influenza vaccine (IIV). The influenza nasal spray is made from a live attenuated virus (LAIV) and shouldn't be taken during pregnancy.

The Tdap (tetanus-diphtheria-acellular pertussis) vaccine

The Tdap vaccine during pregnancy protects you and your baby from tetanus, diphtheria, and pertussis (whooping cough). One dose is given during pregnancy (when you're 27 to 36 weeks pregnant) to guard against whooping cough. The vaccine is recommended during pregnancy even if you've had it before.

Whooping cough is still common in the United States. Newborns are most at risk for complications from whooping cough, and up to 20 babies die each year from the disease, according to the Centers for Disease Control and Prevention (CDC). Getting the whooping cough vaccine during pregnancy will help protect your baby during their first 2 months, until they get their first Tdap vaccine.

The COVID-19 vaccine

Pregnant women who contract COVID-19 are about three times more likely to require admission to the hospital and to the ICU than women of similar age who aren't pregnant. Getting the COVID-19 vaccination during pregnancy will protect you from COVID-19, and – because you'll also pass antibodies to your baby through the placenta – it will protect your newborn, too.

The CDC, the American College of Obstetricians and GynecologistsOpens a new window (ACOG), and the Society for Maternal-Fetal Medicine (SMFM) all recommend that women who are pregnant, breastfeeding, or hoping to become pregnant stay up to date on their COVID vaccines, including getting the latest shot when it's time.

There's no evidence that the COVID-19 vaccine affects fertility or present or future pregnancies in any way. A reviewOpens a new window of 71 studies involving more than 17 million pregnant women published in Vaccine concluded that there are no safety concerns for pregnant women receiving the COVID vaccine.

The RSV vaccine

In August 2023, the U.S. Food and Drug AdministrationOpens a new window (FDA) approved Abrysvo – the Respiratory Syncytial Virus vaccine – for use in pregnant women. The vaccine prevents lower respiratory tract disease (LRTD) caused by RSV – defense you can pass on to your newborn by getting vaccinated during pregnancy.

"RSV is probably the most common reason for a child to be hospitalized," says Paul Offit, M.D., director of the Vaccine Education Center at the Children's Hospital of PhiladelphiaOpens a new window as well as the Maurice R. Hilleman professor of Vaccinology and a professor of pediatrics at the Perelman School of Medicine at the University of PennsylvaniaOpens a new window. "Now, finally, we have a way to prevent this terrible disease."

The FDA recommends that pregnant women receive the vaccine between 32 and 36 weeks of pregnancy during RSV season (in most areas from September to January). The vaccine will protect a newborn baby through 6 months of age.

RSV is a highly contagious virus, and it's especially common in children. Infants are at highest risk for complications from RSV, such as pneumonia and bronchiolitis.

"This new vaccine, Pfizer's bivalent RSVpreF vaccine (trade name Abrysvo), has been shown to reduce the risk of RSV hospitalization for babies by 57 percent in the first six months after birth," says the CDC.

Abrysvo has been shown to reduce the risk of severe LRTD by 82 percent within 90 days after birth. Within 180 days after birth, it reduced the risk by 69 percent. It also reduced the risk of LRTD in pregnant women who received the vaccine by 35 percent, and the risk of severe LRTD by 91 percent, within 90 days after birth.

If you have a high-risk pregnancy, you may not be eligible for the shot, but check with your doctor or midwife.

Learn more about the RSV vaccine during pregnancy.

Vaccines to avoid during pregnancy

MMR vaccine

The MMR vaccine isn't recommended during pregnancy, and women should avoid becoming pregnant for 28 days after receiving the MMR vaccine. That's because it's made from a live, attenuated virus. This means that, theoretically, the MMR vaccine could lead to a rubella (German measles) infection in a pregnant woman.

While studies to date show the actual risk of the MMR during pregnancy to be nonexistent, coming down with rubella during pregnancy can cause miscarriage, preterm birth, stillbirth, and a variety of birth defects. Many women have received the MMR vaccine while pregnant and delivered healthy babies. If you got the MMR in the early weeks of your pregnancy before you knew you were expecting, there's no cause for alarm.

The measles and mumps parts of the MMR vaccine are also live, attenuated viruses. While some studies have shown that the infections can raise the risk of birth defects, this hasn't been proven. There's also some concern about a possible link between these infections and miscarriage. But again, the risk of contracting either measles or mumps from a vaccine is theoretical.

Chicken pox (varicella) vaccine

The chicken pox vaccine is also made from live, attenuated virus, so it's recommended that pregnant women not get it. The CDC advises women to wait a month after getting the chicken pox vaccine before trying to conceive.

However, contracting chicken pox during pregnancy can be dangerous for your baby. If you've never had the illness or been vaccinated, plan to get the first dose right after your delivery.

Human papillomavirus (HPV)

The HPV vaccine isn't made from a live virus. The reason the shot isn't recommended during pregnancy is that it hasn't been studied in pregnant women. If you received the vaccine before you knew you were pregnant, it's not cause for concern.

But if you found out that you're pregnant after starting the HPV series, the rest of the series should be delayed until after pregnancy.

Vaccines that may or may not be recommended during pregnancy

Some vaccines are recommended during pregnancy if the benefits of the vaccine outweigh the risk of immunization. Sometimes the risks of the vaccine are low (there's not a lot of safety data, but the vaccine is made from an inactivated virus, for example) compared with the benefits of protection for women who are at high risk of contracting the disease. The likelihood of exposure is also an important factor.

Vaccines that may or may not be recommended during pregnancy are:

• Hepatitis A
• Hepatitis B
• Hib (Haemophilus influenzae type b)
• Meningococcal
• Pneumococcal
• Polio
• Anthrax
• Rabies
• Smallpox (recommended after exposure only)
• Yellow fever

Always talk to your doctor about vaccines

Your healthcare provider will probably talk with you about vaccinations during your preconception visit and/or your first prenatal visit.

If you have any questions or concerns about what vaccines are appropriate for you during pregnancy, talk with your provider. While there are guidelines about what is or isn't considered safe, there are also many individual considerations.

Also talk with your provider about postpartum vaccinations if you're in need of a vaccine that you can't have while pregnant. For example, if you're found to be non-immune to rubella during your first trimester prenatal labs, you'll receive your MMR booster during your postpartum hospital stay. It's safe for women to receive most vaccines after delivery, even if they're breastfeeding.

This article was also reviewed by Paul Offit, M.D.. He is director of the Vaccine Education Center at the Children's Hospital of Philadelphia as well as the Maurice R. Hilleman professor of Vaccinology and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

Learn more:

• 12 steps to a healthy pregnancy
• The best kinds of exercise for pregnancy