Vaccines You Should (And Shouldn't) Get During Pregnancy

Whether you’re planning a pregnancy or currently expecting, you’ll want to brush up on which vaccines are recommended for moms-to-be, and which you should get well before you get pregnant to maximize your protection. “It’s important for pregnant women to be up to date on the recommended vaccines,” says Dr. Sara Twogood, MD, an ob-gyn at Cedars-Sinai Medical Center in Los Angeles. “The safety of these vaccines is well supported in the literature and the benefits are well established.” She assures patients that the vaccines given to pregnant women don’t contain live viruses, so you can’t get the infection from them. Here, a look at the vaccines moms-to-be may need—including why and when.

Key Takeaways

• Routinely recommended pregnancy vaccines: Doctors recommend receiving the Tdap, flu and COVID-19 vaccines in every pregnancy, and the RSV vaccine in your first eligible pregnancy during RSV season.
• While the U.S. Centers for Disease Control and Prevention (CDC) no longer provides specific guidance for the COVID-19 vaccine while pregnant, the American College of Obstetricians and Gynecologists (ACOG) strongly recommends this vaccine to all trying-to-conceive, pregnant and lactating women.
• ACOG recommends the flu vaccine to pregnant women at any time of year, while the CDC recommends it during flu season.
• If you have certain conditions or risk factors, you may need the hepatitis A vaccine and/or one of the meningococcal vaccines during pregnancy. Speak with your healthcare provider about your specific circumstances. The hepatitis B vaccine is recommended in pregnancy only if you haven’t already been vaccinated.
• The following vaccines are contraindicated during pregnancy (although you should get them before or after): MMR (measles, mumps and rubella), chickenpox and HPV.

Vaccines to Get During Pregnancy

There are a few vaccines that health experts encourage all pregnant women to get, to help protect both you and baby from dangerous diseases. If you have any questions about whether you should get them, speak with your doctor.

Tdap vaccine

Why you should get it: The American College of Obstetricians and Gynecologists (ACOG) recommends that every pregnant woman get the Tdap vaccine, which protects against tetanus, diphtheria and pertussis (aka whooping cough). Whooping cough can be life-threatening for newborns. About a third of babies under one year old who get whooping cough need to be hospitalized, and up to 20 babies die from whooping cough each year in the United States, according to Yale Medicine. The good news? “When Mom gets the Tdap vaccine, she builds up antibodies to pertussis, which cross the placenta and can help provide baby with a small amount of protection (antibodies) until baby’s old enough to receive the vaccines themselves,” Dr. Twogood says.

When to get it: Tdap can be administered at any point in pregnancy, but the CDC says the best time to get it is between 27 and 36 weeks of pregnancy, ideally closer to the 27-week mark to maximize protection for baby.

Flu vaccine

Why you should get it: Because of all the changes in your immune system, heart and lungs when you’re expecting, you’re more likely to get seriously ill from the flu during pregnancy. It can also increase the chances of premature labor. That’s why the CDC encourages pregnant women to get vaccinated against influenza during flu season. “The flu vaccine doesn’t guarantee no flu, but it can minimize the severity of the symptoms and sometimes prevent it altogether,” Dr. Twogood says. Plus, it’ll not only help protect you during flu season, but it’ll also protect baby for several months after birth. FYI: The nasal spray of live attenuated influenza isn’t recommended during pregnancy.

It’s also worthwhile to know that CDC currently recommends only single-dose, thimerosal-free flu-shot formulations, while ACOG’s position is that thimerosal-containing vaccines are safe in pregnancy. In practice, most single-dose flu shots are already thimerosal-free, but if you’re concerned you can ask your pharmacist.

When to get it: The flu vaccine can be administered at any point in pregnancy. ACOG recommends it at any time of the year, while the U.S. Centers for Disease Control and Prevention (CDC) only recommends it seasonally.

COVID-19 vaccine

Why you should get it: Studies have shown pregnant women who contract COVID-19 are at an increased risk for preterm birth and severe illness. While the CDC no longer includes a routine, blanket recommendation on COVID-19 vaccines for pregnant women, it still acknowledges that they can become severely ill and that vaccination can protect them. The American College of Obstetricians and Gynecologists (ACOG), on the other hand, has recently released updated clinical guidance that strongly recommends all pregnant, planning to become pregnant, or lactating women receive an updated COVID-19 vaccine, as evidence has consistently shown it to be safe and effective.

When to get it: The COVID-19 vaccine series does not contain a live virus and can be administered at any point during pregnancy. According to ACOG, it can also be given simultaneously with other vaccines, such as the flu shot and Tdap.

Respiratory syncytial virus (RSV) vaccine

Why you should get it: The RSV vaccine can help protect baby against severe respiratory illness before they’re even born.

When to get it: Both the CDC and ACOG recommend receiving one dose of this shot if you’re 32 to 36 weeks pregnant during RSV season (October through March). If you already got the RSV vaccine during a previous pregnancy, you don’t need one again—but in this case, baby will need nirsevimab, the RSV monoclonal antibody, after birth.

Hepatitis B vaccine

Why you should get it: Hepatitis B is an inflammation of the liver, often caused by a virus. It can range from a mild illness lasting a few weeks to a serious, life-long illness that can cause liver damage, liver cancer and death. Moms-to-be who haven’t yet received the hepatitis B vaccine are encouraged to get it, according to both the CDC and ACOG. If you contract the Hep B virus, you can pass it to baby during delivery, who then has a 90 percent chance of developing chronic hepatitis B.

When to get it: Talk to your doctor about getting tested and vaccinated for hepatitis B. The series of vaccines is usually given in three doses over the course of six months. According to the CDC, limited data suggests the vaccine (which contains a noninfectious form of the virus) doesn’t pose any risk to baby.

Vaccines You May Need During Pregnancy

There may be other vaccines that your doctor recommends based on your medical history and risk factors. Sit down with your primary care doctor, ob-gyn or specialist taking care of any pre-existing conditions to figure out if you’d benefit from these additional vaccines.

Hepatitis A vaccine

Why you might need it: If you have a history of chronic liver disease or at risk for contracting hepatitis A, your doctor may recommend the hepatitis A vaccine. The safety of hepatitis A vaccination during pregnancy hasn’t been determined, the CDC says—but because the vaccine is made from an inactivated form of the virus, any risk to baby is thought to be low. Talk to your doctor to weigh the risk of vaccination against your risk for exposure to the virus.

When to get it: If you and your doctor decide you should get the Hep A vaccine, it’s usually given in two doses 6 to 12 months apart.

Meningococcal vaccines

Why you might need it: If you work in a lab, have certain medical conditions (like the lack of a functioning spleen) or are traveling to a country where you may be exposed to meningococcal disease, a severe and possibly fatal bacterial infection, your doctor may recommend a meningococcal vaccine, says the CDC. The CDC says the MenACWY vaccine “may be used if otherwise indicated” during pregnancy. But when it comes to the MenB vaccine, few studies have been conducted on its safety, so vaccination should be put off unless you’re at increased risk and you and your doctor decide the benefits of the vaccine outweigh the risks.

When to get it: Speak with your doctor to determine if and when you should get a meningococcal vaccine.

Vaccines to Get Before or After (But Not During) Pregnancy

Even before becoming pregnant, make sure you’re up to date on all your vaccines. This will help protect you and your child from serious diseases—especially because, once you get pregnant, it may not be safe to get certain vaccines, including those that protect against measles, mumps, rubella and chickenpox. “If a pregnant woman is exposed to these infections during pregnancy and isn’t immunized, the virus can have detrimental effects on the developing fetus,” Dr. Twogood says. “For these reasons, I check for rubella and varicella immunity at a preconception visit and administer the vaccine if the patient doesn’t show immunity.” Keep in mind that it’s generally best to wait at least a month before getting pregnant after receiving these vaccinations.

MMR vaccine

Why you might need it: The MMR vaccine protects against measles, mumps and rubella. Rubella is a contagious disease that can be very dangerous if you get it while pregnant, potentially causing miscarriage or serious birth defects. However, since the MMR vaccine contains a live virus, it’s not safe to get during pregnancy.

When to get it: Most people were vaccinated as kids, but if you aren’t up-to-date on your vaccines (you can also get a blood test to see if you’re immune), you should get an MMR vaccine before you get pregnant. If you get the MMR vaccine, wait at least 28 days before trying to get pregnant.

Chickenpox vaccine

Why you might need it: Chickenpox, or varicella, is a highly contagious viral infection that causes an itchy, blister-like rash on your skin. Many people get chickenpox or the chickenpox vaccine as children, but adults who haven’t had either should get the vaccine, the CDC says. However, because the effects of the live virus in the vaccine on an unborn baby are unknown, pregnant women should not receive the vaccine.

When it get it: The vaccine is given in two doses at least 28 days apart and is best to get after you give birth, the CDC says. If you get it before pregnancy, avoid becoming pregnant for at least one month after each injection.

HPV vaccine

Why you might need it: HPV is the most common sexually transmitted infection in the US. There are several different types of HPV, some of which can cause health problems like genital warts and cancers. The CDC recommends that 11- to 12-year-olds get two doses of the vaccine to ward against cancers caused by HPV, but if you weren’t vaccinated when you were younger, you can speak with your provider who may recommend a catch-up vaccine. It’s not, however, recommended during pregnancy.

When to get it: You can get the three-dose series of the HPV vaccine before or after pregnancy.

To Sum It Up

To keep yourself and baby safe during pregnancy, there are four main vaccines most medical professionals recommend: Tdap, flu, COVID-19 and RSV. Make sure to speak to your provider about your individual situation, including what additional vaccines during pregnancy you might need.

How We Developed This Article

With mixed guidance out there, many moms-to-be find themselves confused which vaccines are actually required while pregnant. They may also have questions about the safety of various vaccines during pregnancy. We consulted both the American College of Obstetricians and Gynecologists and the U.S. Centers for Disease Control and Prevention to compare and contrast their recommendations. We also spoke with an ob-gyn to provide further context on vaccine safety.

After editing, this article was vetted through fact-check and reviewed by our ob-gyn medical adviser. Learn more about how we ensure the accuracy of our content through our editorial and medical review process.

About the author: Ashlee Neuman is the content director at The Bump and a mom of a two. She has more than a dozen years of experience in content creation—plus first-hand knowledge of the highs, lows and unexpected zigzags of birthing and raising tiny humans.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.