Which vaccines during pregnancy are recommended and which ones should I avoid?
Answer From Mary Marnach, M.D.
Generally, vaccines that contain killed (inactivated) viruses can be given during pregnancy. Vaccines that contain live viruses aren't recommended during pregnancy.
Vaccines that are routinely recommended during pregnancy include:
- Flu (influenza) shot. The flu shot is recommended for people who are pregnant during flu season. The flu shot is made from an inactivated virus, so it's safe for both you and your baby. Avoid the influenza nasal spray vaccine, which is made from a live virus.
- Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine. One dose of Tdap vaccine is recommended during each pregnancy, regardless of when you had your last Tdap or tetanus-diphtheria (Td) vaccination. Receiving the Tdap vaccine during pregnancy helps protect your newborn from whooping cough (pertussis). Ideally, the vaccine should be given between 27 and 36 weeks of pregnancy.
Additionally, if you're pregnant or planning to become pregnant, the COVID-19 vaccine is recommended. Studies have shown COVID-19 vaccines don't pose any serious risks for people who are pregnant or their babies. If you become pregnant after receiving the first dose of a COVID-19 vaccine that requires two doses, it's recommended that you get your second shot. It's also recommended that pregnant people receive a COVID-19 booster shot when it's time. If possible, people who live with you also should be vaccinated against COVID-19 to help prevent the spread of disease.
Getting the COVID-19 vaccine, the flu shot and the Tdap vaccine during pregnancy can protect you from infection and can also help protect your newborn after birth before your baby can be vaccinated. This is important because babies under age 1 might be at increased risk of severe illness with COVID-19 when compared with older children. Also, the flu and whooping cough can be particularly dangerous for infants.
Your health care provider might also recommend other vaccines during pregnancy if you're at increased risk of certain infections — such as the hepatitis B vaccine.
Your health care provider will recommend avoiding vaccines that contain live viruses during pregnancy because they might pose a risk to a developing baby. Examples of vaccines that contain live viruses and aren't recommended during pregnancy include:
- Chickenpox (varicella) vaccine
- Measles, mumps and rubella (MMR) vaccine
Although the new shingles vaccine (Shingrix) doesn't contain the live virus, it's recommended that pregnant people delay vaccination.
If you're planning a pregnancy, talk to your health care provider about any vaccines you might need beforehand.
March 10, 2022
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See more Expert Answers
- AskMayoExpert. Vaccination before, during, and after pregnancy. Mayo Clinic; 2021.
- Vaccines & pregnancy: Top 7 things you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/pregnancy/pregnant-women/need-to-know.html. Accessed Feb. 11, 2022.
- Recommended adult immunization schedule for ages 19 or older, United States, 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/hcp/index.html. Accessed Feb. 11, 2022.
- American College of Obstetricians and Gynecologists. Committee Opinion No. 718. Update on immunization and pregnancy: Tetanus, diphtheria, and pertussis vaccination. Obstetrics & Gynecology. 2017; doi:10.1097/AOG.0000000000002301. Reaffirmed 2020.
- Guidelines for vaccinating pregnant women. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/guidelines.html. Accessed Feb. 11, 2022.
- COVID-19 vaccines while pregnant or breastfeeding. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html. Accessed Feb. 11, 2022.
- COVID-19 vaccination considerations for obstetric-gynecologic care. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care. Accessed Feb. 11, 2022.
- COVID-19 vaccines for people who would like to have a baby. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/planning-for-pregnancy.html. Accessed Feb. 11, 2022.
- Lipkind HS, et al. Receipt of COVID-19 vaccine during pregnancy and preterm or small-for-gestational-age at birth — Eight integrated health care organizations, United States, December 15, 2020-July 22, 2021. MMWR Morbidity and Mortality Weekly Report. 2022; doi:10.15585/mmwr.mm7101e1.
- Information for pediatric healthcare providers. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html. Accessed Feb. 11, 2022.
- Shingrix recommendations. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/recommendations.html. Accessed Feb. 18, 2022.