If you’re trying to conceive or are already pregnant, you probably know that you need to stay on top of your prenatal checkups and fit in plenty of healthy foods, exercise and sleep. But have you talked to your doctor about the vaccines you need to get before and during pregnancy?
You definitely should, and here's why: Pregnancy weakens the immune system to support your growing baby, whom your body considers a foreigner, which means that you're at greater risk of catching something and getting sicker.
Plus, some vaccine-preventable diseases, like whooping cough, can be very dangerous for newborn babies. And if you’re considered high-risk or are traveling outside the U.S., you may need even more vaccines. Other shots, however, are considered unsuitable and sometimes unsafe for pregnancy.
How can you keep all this info straight? Start by talking to your doctor. Then check out this guide to the vaccines you and your family should get before and during your pregnancy — plus those you should wait to get until after you've delivered.[1]
Vaccines to get before pregnancy
Chickenpox (Varicella)
Did you escape chickenpox as a child? Having avoided the calamine-soaked misery of this childhood illness may have seemed like a lucky break at the time, but now it means that you might be missing important immunity.
Having chickenpox as an adult can be quite serious. And if you’re pregnant, it’s not only uncomfortable, it could also spell trouble for your growing baby-to-be. Before you become pregnant, get checked by your doctor to see if you need the varicella vaccine — women who are already pregnant should not receive the vaccine.
If bloodwork reveals that you’re not immune to chickenpox, the vaccine helps keep the pox at bay. If you have not had two doses of the varicella vaccine before, you’ll need two doses, four to eight weeks apart. Then, if you can, hold off on conceiving until a month after your second dose.
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Measles, Mumps and Rubella (MMR)
In addition to all three of these being very uncomfortable illnesses, rubella — aka German measles — can cause miscarriage and birth defects, while a mumps infection increases miscarriage risk and measles ups the odds of preterm birth or a low-birth-weight baby. What’s more, you can't get the MMR vaccine during pregnancy.
Keep in mind that if your vaccination records show that you got an MMR shot when you were younger, you are considered protected for life and don’t ever need a booster dose. However if you weren’t immunized according to the childhood schedule, you should get vaccinated and then wait one month before trying to conceive.
Not sure whether you received the MMR vaccination and can’t find your vaccination records? Get the shots now, before you conceive — even if you were vaccinated, it’s perfectly safe to get an additional dose.
Hepatitis B
If you’re at high risk for this viral infection that attacks the liver — say, you’re a health care worker and you come into contact with infected people’s blood and bodily fluids, which is how hepatitis B is transmitted, or if you’ve had more than one sex partner in the past six months — then you’d be wise to make sure you’re up-to-date on the HepB vaccine.
Hepatitis B can be passed on to an unborn baby, and it can lead to liver failure and liver cancer. The vaccine comes in a series of three shots, but you don’t need to finish all three doses before conceiving. It’s safe to continue with the series during pregnancy.
HPV
The human papillomavirus (HPV) is responsible for most cervical cancers and genital warts. Right now, two doses of the HPV vaccine are recommended for kids ages 11 to 12, though it can be given to children as young as age 9. A third dose may be needed if kids aren't vaccinated until they're older.
It's also recommended for young adults up to age 27 for women and up to age 22 for men who haven't previously been vaccinated as children. Adults ages 27 to 45 can talk to their doctors to see if they, too, should receive the vaccine if they haven't already.
The HPV vaccine is not recommended during pregnancy and should be delayed until after baby is born if you haven't been vaccinated and are 26 or younger.
But don't worry too much if you had one dose in the series before you knew you were pregnant. Recent studies have shown no conclusive evidence that it can harm an unborn baby, even in early pregnancy. Just refrain from getting any more doses until after you give birth once you know for sure that you're expecting. And make sure to tell your doctor if he or she doesn't already know.
Vaccines during pregnancy
Influenza (the flu shot)
The flu shot helps prevent some strains of the flu, which can be very unpleasant for adults and much more serious (even deadly) for pregnant women, babies, small children, the elderly and anyone with a chronic medical condition or compromised immune system.
The Centers for Disease Control and Prevention (CDC) recommends that all expecting women get the flu vaccine if they’re pregnant during the cold and flu season, preferably toward the beginning of the season, or ideally by late October. The flu season can last from October through April or even May. Just avoid the nasal spray, which contains live flu viruses. The flu shot will protect pregnant women and their babies once they're born up to 6 months old, when they can get their own flu vaccine.
Got vaccinated last year? You should still get a new shot this — and every — year. Immunity wanes with time, and the flu shot is reformulated every year to incorporate whichever strains doctors think will be most prevalent.
Also be sure to get vaccinated if you're planning to get pregnant or are caring for a small child, and make sure your little one gets vaccinated as well. If you don't get the flu shot while you're pregnant, it's recommended that you get it just after you have your baby while you're still in the hospital.
Tetanus, Diphtheria and Pertussis (Tdap)
Tetanus is an infection caused by bacteria that can enter the body through a break in the skin. A toxin made by these bacteria cause nervous-system symptoms such as muscle spasms and seizures. Diphtheria and pertussis (whooping cough) bacteria are spread through coughing and sneezing and cause severe respiratory problems. The adult vaccine is called Tdap for protection from all three: tetanus, diphtheria and whooping cough.
All women should get the Tdap shot between 27 and 36 weeks of each pregnancy, preferably in the first few weeks of that window. That said, if you're at risk for whooping cough due to an outbreak in your community or if you get a deep cut in your skin and are due for your tetanus booster, the vaccine is also safe to get earlier in pregnancy.
When you get the Tdap vaccine during pregnancy, you pass on some immunity to help protect your newborn from whooping cough before he’s old enough to get the DTaP vaccine for children, the first dose of which he’ll get when he’s 2 months old. And that’s important, since whooping cough is highly contagious and can be deadly for young babies, whose immune systems are still developing.
COVID-19
Leading experts including the Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend that pregnant and lactating people get the COVID-19 vaccine.[2]
As of 2023, it's a one-shot bivalent vaccine targeting the strains predicted to be dominant during the current season, and everyone ages 6 months and older should get it annually.
An analysis of data from the CDC's COVID-19 reporting tool V-safe found that vaccination early in pregnancy (before 20 weeks) is perfectly safe and does not increase the risk of miscarriage or other complications.
Pregnant women have an increased risk of severe illness and hospitalization from COVID-19. The vaccine offers protection against serious illness and can also protect pregnant women's babies.
The COVID-19 vaccine is available to everyone in the U.S. free of charge, regardless of immigration status or whether or not you have health insurance. To figure out where to get the COVID vaccine, visit Vaccines.gov, speak to your practitioner or check the website of your local pharmacy.
RSV
In August 2023, a vaccine against RSV was approved for pregnant women. The vaccine will offer protection to their babies from birth through 6 months of age.
In September 2023, the CDC recommended that all pregnant women get the RSV vaccine,[3] known as Abrysvo, late in pregnancy (between weeks 32 and 36) to help prevent lower respiratory tract disease (LRTD) in babies from birth to 6 months caused by RSV.
Other vaccines you may need during pregnancy
You may also want to talk to your doctor about getting these vaccines during pregnancy if you meet particular risk factors, such as having a chronic illness or working or traveling in places where you may be exposed to the disease:
- Pneumococcal vaccines: These vaccines protect people who are at risk from the infections caused by this bacteria — i.e. cigarette smokers; those with chronic heart, lung, liver or kidney disease; asthma sufferers; and those with compromised immune systems — including pneumonia, meningitis and ear infection.
- Hepatitis A vaccine: The hepatitis A virus, which is usually transmitted through food that has been contaminated with an infected person's feces, causes an inflammation of the liver. If you have chronic liver disease, take medication with clotting factor agents or work in a lab where you’d be exposed to the hepatitis A virus, you may need this vaccination. Your doctor may also decide to give you the shot if you’re traveling to a place where there’s an increased risk of contracting the disease, including Mexico, Eastern Europe and Central or South America.
- Hepatitis B vaccine: The hepatitis B virus also causes liver disease and is transmitted through sexual contact, body fluids or shared hypodermic needles, and it can be present in the body for many years without showing any symptoms. If you’re at high risk of hepatitis B — for example, ou're a health care worker, dialysis patient, have had sex with more than one partner in the last six months, have diabetes and are younger than 50, or are traveling to a place where hep B is prevalent, including many countries in Africa, the Middle East, Asia and Western Europe — you should get vaccinated during pregnancy.
- Meningococcal vaccines: Meningococcus bacterial infection can result in severe meningitis (infection of the membranes covering the brain) and can progress extremely rapidly, sometimes causing death in 24 to 48 hours. The good news is the disease is not common in the U.S., but you may need to get a meningococcal vaccine if you are at increased risk of contracting the disease.
Vaccines to avoid during pregnancy
There are several vaccines you definitely shouldn’t get during pregnancy. While in some cases there has been no definitive evidence of problems linked to these vaccines, more research needs to be done to prove they’re safe for you and your baby — which is why doctors recommend avoiding the following vaccines while you’re pregnant.
Chickenpox (Varicella)
If you’re not immunized against the chickenpox virus, you should get this vaccine before you conceive. Because the vaccine contains a live virus, it’s not safe for women who are already pregnant. Talk to your doctor before you become pregnant if you never had chickenpox as a child or were never vaccinated as a child.
If you’re exposed to the varicella virus while you’re pregnant — say, your nephew’s preschool class has an outbreak — and haven’t received the vaccine, talk to your doctor about getting the varicella-zoster immune globulin, which can offer you temporary immunity and prevent complications should you come down with a case of the pox.
MMR
Like varicella, the MMR vaccine (which stands for measles, mumps and rubella) contains live viruses, so it is not safe for women who are already pregnant. If possible, try to wait four weeks between receiving the vaccine and becoming pregnant.
Shingles (Zoster)
This shot protects people from shingles — which, like chickenpox, is caused by the varicella zoster virus. It’s most common in those older than 50 and in people with certain medical issues.
There isn’t much research on the effects of the vaccine on pregnant women, so doctors advise you get the shot — if it’s recommended for you before age 50 — after you deliver.
Some vaccines for travel
The CDC says you should not receive the following vaccines since not enough studies have been done on pregnant women to determine whether they're safe for baby:
- BCG (for tuberculosis)
- Japanese encephalitis
- Typhoid
Do keep in mind, however, that these vaccines are safe if you’re breastfeeding — and, if you get these shots postpartum, you’ll pass some temporary immunity on to your baby through your breast milk.
Vaccines your partner and family should get
Anyone who takes care of or spends a lot of time with your baby — including grandparents, siblings, caregivers, babysitters and day care providers — should be up-to-date on their shots too.
They should all get a flu shot, since the virus is so prevalent and the formulation changes every year. And also make sure they are up-to-date on their Tdap or DTaP vaccines, since pertussis is highly contagious, and statistics show that most babies get whooping cough from a family member.
The CDC also recommends that all those 6 months and older get the annual COVID-19 vaccine that targets the most dominant strains that season.
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