Why are vaccines important during pregnancy?

Vaccinations or immunizations are shots you get to protect you from certain diseases. The best time to talk about vaccinations is during a visit with your doctor before you get pregnant. If you get vaccinated before pregnancy then you and your baby are protected during pregnancy. There are certain vaccinations that are safe during pregnancy while others are not safe and they are contraindicated.

Some infections can harm your baby if you are exposed to them while you are pregnant, and in some cases, the vaccine that prevents the infection may also be harmful. In many cases, experts don’t know whether it is riskier to get a particular vaccine or not.

While you should avoid unnecessary risks during pregnancy, you also don’t want to open the door to any illnesses that may have dangerous consequences for both you and your baby. This is why it’s very important to talk to your health care provider about vaccinations.

Your doctor may tell you that the benefits of getting vaccinated outweigh potential risks if all of the following are true:

  • You are very likely to be exposed to a particular infection.
  • The infection would pose a serious risk to you or your baby.
  • The vaccine is unlikely to cause harm to you or your baby.
  • If you are at an increased risk for infection, your doctor may suggest that you receive a vaccination that generally isn’t recommended during pregnancy.

Here are some examples of people who are often at increased risk of infection:

  • Those who work in healthcare facilities
  • Those who are traveling to areas where the infection is common
  • Discuss each vaccine with your health care provider on a case-by-case basis and carefully weigh the risks and benefits of the protection that the vaccination will provide.

If you become pregnant within four weeks after your last vaccination, talk to your healthcare provider about whether or not the vaccination may affect the baby.

The US Department of Health and Human Services recommends the following vaccines preconception before pregnancy:

  • Influenza/Flu
  • HPV Human Papilloma Virus
  • MMR Mumps Measles Rubella
  • Tdap
  • Varicella/Chickenpox
  • Hepatitis B if you are at risk
  • Pneumococcus vaccine (if indicated eg smoker, diabetes, asthma)

Vaccinations and Pregnancy

From: ACOG

These vaccines are recommended during pregnancy

  • tDap Tetanus-Diphtheria/Pertussis
  • Influenza (Recommended to all pregnant women)

Vaccines which may be safely administered during pregnancy 

  • Hepatitis B
  • Rabies
  • Inactivated polio
  • Meningococcal
  • tDap Tetanus-Diphtheria/Pertussis
  • Influenza (Recommended to all pregnant women)

Vaccines that should not be given during pregnancy

  • Mumps-Measles-Rubella
  • Varicella (chickenpox)
  • Yellow fever (may be considered if travel to high-risk area is unavoidable)
  • HPV Human Papilloma Virus
  • BCG
  • Vaccinia

Vaccines for which safety data during pregnancy are not available

  • Hepatitis A (immune globulin probably preferable)
  • Typhoid (the injection with Typhim Vi may be safer since it's inactivated while the other typhoid vaccine is oral and has live attenuated bacteria)
  • Japanese encephalitis (avoid travel to high-risk areas)

The risk to a developing fetus from vaccination of the mother during pregnancy is primarily theoretical. No evidence exists of risk from vaccinating pregnant women with inactivated virus or bacterial vaccines or toxoids. Live vaccines pose a theoretical risk to the fetus.

Benefits of vaccinating pregnant women usually outweigh potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm. Generally, live-virus vaccines are contraindicated for pregnant women because of the theoretical risk of transmission of the vaccine virus to the fetus. If a live-virus vaccine is inadvertently given to a pregnant woman, or if a woman becomes pregnant within 4 weeks after vaccination, she should be counseled about the potential effects on the fetus. But vaccination is not ordinarily an indication to terminate the pregnancy. Whether live or inactivated vaccines are used, vaccination of pregnant women should be considered on the basis of risks versus benefits (i.e. the risk of the vaccination versus the benefits of protection in a particular circumstance).

(From the CDC)

The following table may be used as a general guide:

Recommended in Pregnancy

  • Hepatitis B 
  • Influenza (Inact.) 
  • Tetanus - Diphtheria - Pertussis (Tdap) 

Safe if Indicated

  • Hepatitis A
  • Meningococcal (MCV4) 
  • Pneumococcal 
  • Polio (IPV) 
  • Anthrax 
  • Japanese Encephalitis 
  • Meningococcal (MPSV4) 
  • Rabies 
  • Typhoid (Parenteral) 
  • Yellow Fever

Contraindicated/Not Recommended in Pregnancy

  • Influenza (LAIV)   
  • MMR 
  • Measles  
  • Mumps  
  • Rubella  
  • Varicella  
  • BCG 
  • Vaccinia 
  • Zoster 
  • HPV  - Human Papilloma Virus
  • Typhoid (oral)

Read More:
Travel Safety During Pregnancy
Pregnancy Safety Guide