| Recommended every pregnancy | Tdap + Inactivated Flu vaccine (CDC & ACOG guidance) |
| Optimal Tdap timing | Weeks 27–36 of pregnancy (CDC immunization schedule) |
| Live vaccines in pregnancy | Generally contraindicated (ACOG clinical practice guidelines) |
| Antibody transfer to newborn | Occurs via placenta before birth (Published immunology research) |
| COVID-19 vaccine | Recommended; consult provider for current guidance (CDC & ACOG recommendations) |
Why Vaccination Matters During Pregnancy
Pregnancy brings significant changes to the immune system. These changes help protect the developing baby but can also make certain infections more dangerous for the mother. Vaccines offer a two-part benefit during pregnancy: they help shield the mother from serious illness and transfer protective antibodies to the baby before birth — providing immunity during the newborn's earliest, most vulnerable weeks.
Major health organizations, including the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG), publish guidance on which vaccines are generally safe and recommended during pregnancy and which should be avoided. Individual circumstances vary, so every decision should be made in consultation with a qualified OB-GYN or midwife.
This article is for general health information only and is not a substitute for personalized medical advice. Always speak with your healthcare provider before making any decisions about vaccines during pregnancy.
| Recommended every pregnancy | Tdap + Inactivated Flu vaccine (CDC & ACOG guidance) |
| Optimal Tdap timing | Weeks 27–36 of pregnancy (CDC immunization schedule) |
| Live vaccines in pregnancy | Generally contraindicated (ACOG clinical practice guidelines) |
| Antibody transfer to newborn | Occurs via placenta before birth (Published immunology research) |
| COVID-19 vaccine | Recommended; consult provider for current guidance (CDC & ACOG recommendations) |
Vaccines Generally Recommended During Pregnancy
Two vaccines are broadly recommended for most pregnant people in the United States during every pregnancy, regardless of prior vaccination history:
- Tdap (Tetanus, Diphtheria, and Pertussis): Current guidelines recommend receiving Tdap during the third trimester, typically between weeks 27 and 36. This timing maximizes the transfer of pertussis (whooping cough) antibodies to the newborn, who cannot receive their own pertussis vaccine until two months of age. Whooping cough can be life-threatening in infants.
- Influenza (Flu) vaccine: An inactivated or recombinant flu vaccine is recommended during any trimester of pregnancy during flu season. Pregnant people are at higher risk for severe flu complications. The flu shot also passes antibodies to the baby.
A COVID-19 vaccine is also recommended by the CDC and ACOG for pregnant individuals, as pregnancy increases the risk of severe COVID-19 illness. Specific guidance may evolve; consult your provider for the most current recommendations.
For those planning to travel internationally, vaccination needs may differ. See our travel vaccines and destination-specific immunity planning guide for context on destination-based immunization.
Vaccines to Avoid During Pregnancy
Live attenuated vaccines — those containing a weakened but living form of a virus or bacterium — are generally not recommended during pregnancy due to a theoretical risk to the fetus. These include:
- MMR (Measles, Mumps, Rubella)
- Varicella (Chickenpox)
- Live attenuated influenza vaccine (the nasal spray version)
If immunity gaps are identified before conception, providers often recommend completing these vaccines at least one month before becoming pregnant. After delivery, they can be given safely — including while breastfeeding.
Live attenuated vaccine
A vaccine made with a weakened but living form of a pathogen. These stimulate strong immunity but are generally avoided during pregnancy due to potential risk to the fetus.
Tdap
A combination vaccine that protects against tetanus, diphtheria, and pertussis (whooping cough). It is recommended during the third trimester of every pregnancy.
Maternal antibody transfer
The process by which a pregnant person's antibodies cross the placenta and enter the fetal bloodstream, providing the newborn with temporary immune protection after birth.
Inactivated vaccine
A vaccine made with a killed or inactivated pathogen or protein fragment. These cannot cause infection and are generally considered safe to use during pregnancy.
Pertussis
Also known as whooping cough, pertussis is a highly contagious bacterial respiratory illness that can be life-threatening in newborns who are too young to be vaccinated.
Timing, Safety, and Individual Considerations
Vaccine recommendations are trimester-specific in some cases. The Tdap, for example, is most effective when given in the third trimester rather than earlier. Your provider will review your vaccination history, any prior adverse reactions, and underlying conditions before making recommendations.
Certain individuals — such as those with specific allergies, compromised immune function, or chronic health conditions — may have modified recommendations. Pregnant people in higher-risk occupations (healthcare, travel, etc.) may also receive additional guidance.
After delivery, the focus shifts to the newborn's own immunization schedule. Understanding that schedule can help new parents stay prepared. Our childhood vaccines guide for new parents offers a beginner-friendly overview of what to expect at each well-child visit.
This article is for informational purposes only and does not constitute medical advice. Speak with your OB-GYN, midwife, or another licensed healthcare professional for guidance specific to your health history and pregnancy.