Vaccines You Need During Pregnancy

Quick Pregnancy Vaccine Schedule

Why Vaccines During Pregnancy Protect Two People

Pregnancy changes the immune, heart, and lung systems. Those changes are normal, but they can make respiratory infections such as influenza and COVID-19 more likely to become severe. Vaccination lowers the chance of serious illness and may reduce the likelihood that an infection leads to hospitalization or pregnancy complications.

There is also a second layer of protection. After vaccination, your immune system produces antibodies. Some of those antibodies cross the placenta and reach the fetus. That passive protection can help during the first weeks or months after birth, when a newborn is especially vulnerable and too young to receive certain vaccines.

Think of it as lending the baby a starter set of immune-system tools. The loan is temporary, so the baby will still need routine childhood immunizations on schedule.

1. Tdap: The Vaccine Recommended During Every Pregnancy

Tdap protects against tetanus, diphtheria, and pertussis. Pertussis, better known as whooping cough, is the main reason Tdap is emphasized in prenatal care. The infection can be life-threatening in young infants, who do not begin their own pertussis vaccine series until about two months of age.

When should you get Tdap?

Get one Tdap dose during every pregnancy, preferably during the earlier part of weeks 27 through 36. This recommendation applies even if you received Tdap before pregnancy, during a previous pregnancy, or as a teenager. Repeating the dose is not because your medical chart has forgotten you; it is intended to maximize the antibodies passed to each baby.

Tdap may be given earlier when it is needed for wound care or during a pertussis outbreak. If it is administered earlier in the same pregnancy, it generally is not repeated during the usual 27–36-week window.

What side effects are common?

Arm soreness, redness, fatigue, headache, or a mild fever can occur. These effects are usually brief. Severe allergic reactions are rare, but anyone with a history of anaphylaxis to a vaccine component should review it with a clinician before vaccination.

2. The Flu Shot: Safe in Any Trimester

Influenza is not merely an inconvenient week under a blanket. Pregnant people have a higher risk of severe flu and hospitalization. Fever and serious maternal illness can also create concerns for the pregnancy.

The recommended option is an inactivated or recombinant flu shot. It can be given during the first, second, or third trimester. Because flu strains change, vaccination is needed each season, even if you received a flu shot during a previous pregnancy or late in the prior season.

Which flu vaccine should be avoided?

Do not receive the nasal-spray flu vaccine during pregnancy because it contains live attenuated influenza virus. Ask for the injection instead. The shot cannot give you influenza, although your arm may complain dramatically for a day.

For most adults, vaccination in September or October works well. Timing may be adjusted when a person is in the third trimester during summer or might not have another opportunity to be vaccinated before flu activity rises.

3. Maternal RSV Vaccine: Protection for a Baby’s First RSV Season

Respiratory syncytial virus, or RSV, often resembles a cold in healthy adults. In infants, however, it can cause bronchiolitis, pneumonia, breathing difficulty, and hospitalization. Maternal vaccination gives families a way to provide protection starting at birth.

When is the RSV vaccine given?

In most of the continental United States, a single dose of Pfizer’s Abrysvo is given from 32 weeks and 0 days through 36 weeks and 6 days of pregnancy, generally from September through January. Timing may differ in places with unusual RSV seasonality, including some tropical areas and Alaska.

Abrysvo is currently the only RSV vaccine used during pregnancy. Arexvy and mResvia are not approved for maternal vaccination. The product name matters here, so this is one appointment where being politely nosy about the vial is entirely reasonable.

Do you need maternal RSV vaccination in every pregnancy?

Current U.S. guidance does not recommend another maternal RSV dose if you received it during a previous pregnancy. In that situation, the newborn may receive a preventive monoclonal antibody, such as nirsevimab, during the appropriate RSV season.

Most infants need either maternal RSV vaccination during the current pregnancy or infant antibody protectionnot both. A pediatric clinician may recommend additional protection in certain unusual or high-risk circumstances.

4. COVID-19 Vaccination: Discuss the Current Dose With Your Clinician

Pregnancy remains a risk factor for severe COVID-19. The American College of Obstetricians and Gynecologists’ 2026 maternal immunization schedule continues to recommend COVID-19 vaccination during pregnancy. Federal CDC schedules adopted an individual or shared clinical decision-making approach in 2025, so the conversation now requires more attention to personal risk, previous vaccination, recent infection, and the currently available formulation.

Ask your prenatal clinician whether you are due for an updated dose. Factors that may strengthen the case include chronic heart or lung disease, diabetes, obesity, immune suppression, frequent public contact, limited ability to avoid exposure, and a long interval since vaccination or infection.

COVID-19 vaccination can be administered during pregnancy, and professional obstetric guidance supports staying up to date. Mild short-term effects may include arm pain, fatigue, headache, chills, or fever. Ask your care team how it prefers you to manage fever during pregnancy.

Other Vaccines You May Need During Pregnancy

Hepatitis B

Pregnancy is not a reason to postpone hepatitis B vaccination. If you have not completed the series, your clinician may recommend starting or finishing it during pregnancy. Prenatal hepatitis B screening is also important because an infected parent can transmit the virus to a baby during delivery, and the newborn may need immediate preventive treatment.

Hepatitis A

Hepatitis A vaccination may be recommended when exposure risk or the risk of a severe outcome is elevated. Examples include chronic liver disease, certain occupational exposures, homelessness, drug use, close contact with an international adoptee, or travel to an area where hepatitis A is common.

Travel and exposure-based vaccines

Rabies vaccination may be used after a credible exposure because untreated rabies is almost always fatal. Meningococcal, polio, pneumococcal, mpox, or certain travel vaccines may also be considered when the disease risk outweighs the theoretical or known vaccine risk.

Pregnant travelers should arrange a consultation at least four to six weeks before departure whenever possible. Do not assume that every vaccine normally recommended for a destination is suitable during pregnancy. Some trips may need to be postponed when the infection risk is high and an appropriate vaccine cannot safely be used.

Vaccines Usually Avoided or Delayed During Pregnancy

Live vaccines are generally avoided because they contain weakened organisms that can replicate. Vaccines commonly delayed until after delivery include:

• MMR, which protects against measles, mumps, and rubella
• Varicella, which protects against chickenpox
• The live nasal-spray influenza vaccine
• Live oral typhoid vaccine

HPV vaccination is also postponed until after pregnancy, although it is not a live vaccine. If a dose was given before you knew you were pregnant, do not panic. Inadvertent MMR, varicella, or HPV vaccination is not automatically evidence of fetal harm and is not, by itself, considered a reason to end a pregnancy. Contact your obstetric clinician so the exposure can be documented and the remaining schedule adjusted.

Ideally, immunity to rubella and chickenpox is reviewed before conception. People who need MMR or varicella vaccination can receive it before pregnancy and follow the recommended waiting period before trying to conceive.

Can You Receive More Than One Vaccine at the Same Visit?

Yes. Tdap, the flu shot, COVID-19 vaccination, and maternal RSV vaccination can generally be administered during the same visit when you are eligible for each one. Receiving multiple vaccines together does not overload the immune system.

Combining appointments can also prevent the classic prenatal-care problem of saying, “I’ll do it next time,” and then discovering the next appointment is already devoted to three tests and an unexpectedly long discussion about heartburn.

You may prefer injections in different arms if you are prone to soreness. Tell the vaccinator about previous reactions, severe allergies, current illness, fainting with needles, or anxiety. Sitting or lying down during and shortly after vaccination can help people who tend to feel lightheaded.

When Should Vaccination Be Delayed?

A mild cold without significant fever usually does not prevent vaccination. A clinician may recommend waiting if you have a moderate or severe acute illness, a high fever, or symptoms that require medical evaluation.

A vaccine should not be given to someone who experienced a severe allergic reaction to a previous dose or a known ingredient unless an allergy or vaccine specialist determines that it can be administered safely. Certain neurological conditions, immune disorders, medications, or previous vaccine reactions may also require individualized guidance.

After vaccination, seek urgent medical care for trouble breathing, swelling of the face or throat, widespread hives, severe dizziness, weakness, or other symptoms of a serious allergic reaction. Contact your prenatal team about a persistent high fever, severe symptoms, chest pain, or anything that worries you.

A Simple Plan for Organizing Pregnancy Vaccines

1. At the first prenatal visit: Bring your vaccination record and discuss flu, COVID-19, hepatitis B, and any travel plans.
2. Before 27 weeks: Confirm when Tdap will be offered and whether your due date overlaps the maternal RSV window.
3. At 27–36 weeks: Receive Tdap, preferably early in the window.
4. At 32–36 weeks: Receive Abrysvo if you are eligible, it is the appropriate season, and you did not receive maternal RSV vaccine in a previous pregnancy.
5. Before delivery: Decide who will provide the baby’s RSV protection if maternal vaccination was not given.
6. After delivery: Catch up on MMR, varicella, HPV, or other vaccines that were deferred.

Frequently Asked Questions About Pregnancy Vaccines

Can vaccines cause the diseases they prevent?

The inactivated, recombinant, toxoid, protein-based, and mRNA vaccines commonly discussed during pregnancy cannot cause the infections they are designed to prevent. Live vaccines are generally delayed because they use weakened organisms, not because routine non-live maternal vaccines can give you the disease.

Do maternal vaccines replace the baby’s vaccines?

No. Antibodies transferred during pregnancy provide temporary protection. Your child will still need vaccines according to the recommended pediatric schedule.

Should family members be vaccinated too?

Partners, grandparents, siblings, and other close caregivers should be up to date on routinely recommended vaccines, especially Tdap, influenza, and COVID-19 when appropriate. Ideally, anyone who needs Tdap should receive it at least two weeks before close contact with the newborn.

What if vaccination records are missing?

Ask your medical practice, former schools, previous employers, pharmacies, or state immunization registry. Your clinician can still recommend an appropriate plan when records cannot be located. In some situations, blood testing may help determine immunity.

Experience-Based Lessons: What the Process Often Feels Like

The vaccine schedule looks tidy on paper. Real pregnancy, naturally, has other plans. A common experience is that a patient arrives for a routine appointment expecting a blood-pressure check and leaves with a Tdap bandage, a flu-shot reminder, and a calendar note about RSV. That can feel like a lot. The easiest approach is to ask the care team to write down three things: the vaccine name, the recommended week, and whether it must be repeated in a future pregnancy.

Consider a typical composite situationnot a real patient. A first-time parent reaches 28 weeks in October. She received Tdap four years earlier after cutting her hand and assumes she is covered. Her obstetrician explains that Tdap is repeated during each pregnancy to boost antibody transfer to this baby. She gets Tdap that day and schedules the flu shot at the pharmacy. At 32 weeks, the office reviews RSV eligibility. Because it is RSV season and she has never received maternal RSV vaccine, she chooses Abrysvo. What initially looked like a confusing pile of recommendations becomes three appointments with clear purposes.

Another common experience is hesitation after a rough reaction to a previous vaccine. Someone may remember spending a day with chills, fatigue, or a sore arm and worry that pregnancy will make the reaction worse. It helps to distinguish expected immune responses from warning signs. Mild soreness and fatigue are common. Trouble breathing, facial swelling, widespread hives, chest pain, persistent high fever, or symptoms that feel severe require prompt medical advice. Discussing a previous reaction before the injection gives the clinician time to check ingredients, choose an appropriate setting, and create a plan for monitoring.

Scheduling can be the biggest obstacle. Pharmacies may stock flu and COVID-19 vaccines but not maternal RSV vaccine. Some prenatal offices administer Tdap but ask patients to obtain other vaccines elsewhere. Before driving across town with pregnancy bladder and zero patience, call and ask four questions: Is the exact vaccine in stock? Does the location vaccinate pregnant patients? Will insurance cover it there? Do you need a prescription or referral? Five minutes on the phone can prevent a surprisingly emotional encounter with a closed pharmacy gate.

Family conversations are another part of the experience. Grandparents or caregivers may ask why the pregnant patient needs another Tdap dose or whether visitors should be vaccinated. A useful answer is simple: maternal vaccination helps give the baby antibodies before birth, while vaccination of close contacts reduces the chance that someone brings an infection into the home. These strategies complement rather than replace the baby’s own immunization schedule.

Finally, keep a record. Take a photo of the vaccination card, save the pharmacy receipt, and send documentation to the prenatal office if the shot was given elsewhere. After delivery, share relevant maternal RSV information with the baby’s pediatrician. The goal is not to become the household chief epidemiologist. It is simply to make sure every clinician knows what protection has already been given and what still needs to happen.

Conclusion

The most important vaccines during pregnancy are Tdap, the inactivated or recombinant flu shot, maternal RSV vaccine for eligible patients, and a current COVID-19 vaccine after an individualized discussion. Hepatitis B and other vaccines may also be appropriate based on vaccination history, medical conditions, travel, or exposure.

The key is timing. Tdap is repeated during every pregnancy, RSV has a narrow gestational and seasonal window, flu vaccination is needed each season, and COVID-19 recommendations should be reviewed using the latest formulation and guidance. Bring your records, ask which product is being used, and make a written plan early. Pregnancy already contains enough surprises; your vaccine schedule does not need to be one of them.