Vaccinations during pregnancy: 4 essential shots to get — and why

It can be difficult to know which vaccinations to get during pregnancy — and which ones to avoid. Luckily, the American College of Obstetricians and Gynecologists (ACOG) provides specific recommendations on which vaccines are safe and beneficial while pregnant.

In this article, we’ll cover: 

• The benefits of vaccinations during pregnancy
• Vaccination timing while pregnant
• Vaccines to avoid during pregnancy
• 4 essential vaccinations during pregnancy
• Other vaccines recommended as needed

Read the Report: Maternal Health in the Workplace 

Benefits of vaccinations during pregnancy

Vaccination during pregnancy is one of the most effective ways to protect both the pregnant person and their baby from serious illnesses. Some vaccines are particularly important because they help pass immunity to the baby before birth, offering early protection. Early protection is critical, because babies can’t receive many immunizations until several months after birth. 

Vaccination timing while pregnant

The timing of vaccines during pregnancy is important to protect both the pregnant person and the baby. Some vaccinations can be received simultaneously — for instance, COVID-19, flu, and RSV vaccines can be given at the same time as each other or with other routine shots like Tdap. Be sure to schedule vaccinations according to recommendations from your providers. 

Avoid these vaccinations during pregnancy

Some vaccines are not considered safe during pregnancy because they contain live viruses. These include:

•  MMR (measles, mumps, rubella) vaccine
•  Varicella (chickenpox) vaccine
•  Live (nasal spray) flu vaccine (Only the flu shot is recommended during pregnancy)

If a pregnant person needs any of these vaccines, they should be given after delivery since they aren’t safe during pregnancy.

4 essential vaccinations to get during pregnancy

Below are the latest vaccine recommendations from the American College of Obstetricians and Gynecologists. The vaccines that ACOG recommends during pregnancy have been shown to be safe and effective.

1. Flu (influenza) vaccine

• Recommendation: The flu shot is recommended for all pregnant people during flu season (typically from October to May).
• Reason: Pregnant people are more likely to get seriously sick with the flu, which can be life-threatening. The vaccine helps protect both the pregnant person and the baby.
• Best timing: The flu vaccine can be given at any stage of pregnancy.

2. Tdap (tetanus, diphtheria, and pertussis) vaccine

• Recommendation: The Tdap vaccine is recommended during every pregnancy (even if the person has already received this vaccine in the past)
• Reason: This vaccine helps protect the baby from whooping cough (pertussis) until they are old enough to get the vaccine themselves. Whooping cough can be very dangerous for newborns.
• Best timing: The best time to get the Tdap shot is between 27 and 36 weeks of pregnancy.

3. RSV (respiratory syncytial virus) vaccine

• Recommendation: Getting the RSV vaccine during pregnancy helps protect newborns from RSV right after birth and during the first 6 months of their life.
• Reason: RSV is the leading cause of hospital visits for babies in the United States and can be a very serious disease in newborns and young children. There is no newborn vaccine for RSV and the only alternative is an injection of antibodies after birth for protection of the newborn against RSV. Recently, shortages of protective RSV antibody therapies have left some infants without important protection against this serious virus. Getting a vaccine while pregnant decreases or eliminates the need for this treatment.
• Best timing: Between September and January, pregnant individuals who are 32 to 36 weeks pregnant can get the RSV vaccine. The Pfizer Abrysvo vaccine is the only RSV vaccine approved for use during pregnancy and provides antibodies to protect newborns for the first six months of life.

4. COVID-19 vaccine

• Recommendation: ACOG strongly recommends that pregnant people get the COVID-19 vaccine, and also follow CDC guidance for updated shots.
• Reason: People who are pregnant are more likely to get very sick from COVID-19 compared to those who are not pregnant.There is also an increased risk of complications that can affect a patient’s pregnancy and baby including, preterm birth or stillbirth.
• Best timing: Pregnant people can receive this vaccine at any point during their pregnancy.

Vaccines recommended as needed

Depending on the pregnant person’s risk levels for certain infectious diseases, one or more of the following vaccinations might also be recommended. 

Hepatitis B vaccine

• Recommendation: This vaccine is recommended for pregnant people who are at risk of hepatitis B infection (for example, healthcare workers, those with multiple sexual partners, who use intravenous drugs, or who live with someone with hepatitis B).
• Reason: Hepatitis B can cause long-term liver damage, and the vaccine helps to protect both the person who is pregnant and the baby.

Hepatitis A vaccine

• Recommendation: Pregnant people at risk of hepatitis A (such as those with liver disease or traveling to certain countries) should get this vaccine.
• Reason: Hepatitis A can cause complications in pregnancy, including preterm labor.

Pneumococcal vaccine

• Recommendation: This vaccine is recommended for pregnant people who have certain health problems, like chronic heart, lung, or liver disease, or a weakened immune system.
• Reason: People with these conditions are more likely to get serious infections requiring hospitalization caused by the pneumococcus bacteria.

Meningococcal vaccine

• Recommendation: This vaccine is not routinely recommended, but pregnant people who are at high risk (such as those in areas with meningococcal outbreaks) may need it.
• Reason: Meningococcal disease can be very severe and lead to complications.

Vaccinations during pregnancy: Know the facts

Staying up-to-date with vaccinations during pregnancy is a crucial step in protecting both the pregnant person and their baby from preventable illnesses. 

Following ACOG’s recommendations ensures the best possible protection, providing immunity to the baby before and after birth and reducing the risk of complications. (The CDC also has some helpful resources on this topic.) Vaccination options should be discussed with a healthcare provider to ensure a safe and healthy pregnancy.