Immunizations and pregnancy
Your immunity protects both you and your fetus. After you have been immunized (vaccinated) against or infected by a virus or bacteria, your body develops an immunity to that infectious agent. Full immunity can protect you from future infection, either for a lifetime or a limited period. Partial immunity strengthens your body's ability to fight that infection.
Before you become pregnant, be sure to review your immunization history with your doctor. Depending on the virus or bacteria, having had an immunization in childhood may not guarantee that you now have full immunity. To ensure a healthy pregnancy, make sure that you are immune to the following before conceiving:
Before pregnancy: Rubella, measles, mumps, chickenpox, whooping cough
Rubella, measles, mumps, and chickenpox can harm a growing fetus. They can cause birth defects, fetal death, or premature birth. Chickenpox can also be dangerous for you when you're pregnant.
Whooping cough (pertussis) would be dangerous if your baby were to get it after birth. It is most serious in babies younger than 4 months of age and can be deadly.
If you don't know whether you're immune to rubella, measles, or chickenpox, talk to your doctor about a blood test for antibodies to that virus. If you aren't immune, have the vaccination before becoming pregnant. To allow time for your body to develop antibodies to the virus, keep using birth control for at least 4 weeks after the vaccination.1
If you've never had a tetanus, diphtheria, and pertussis (Tdap) shot, you should get a dose before getting pregnant or right after your baby is born.2 Any teen or adult who expects to have close contact with your baby should also get this shot if they've never had it.
Before or during pregnancy: Flu (Influenza)
The flu can be dangerous for you when you're pregnant. If you will be pregnant during the October through mid-May flu season, get the seasonal flu vaccination before or during your pregnancy.3 This is especially important if you have a chronic illness or condition (including asthma).4 Also, get immunized against H1N1 flu. It's best to get the flu vaccine early, sometime in October or November, but you can get it any time during the season as long as the vaccine is available. The flu vaccine is effective for one season. When given during pregnancy, the flu vaccine injection is considered safe for your fetus and protects both you and your newborn. (The intranasal vaccine contains live virus, so it is not used during pregnancy.)
If you are already pregnant and are not immune
If you are not immune to rubella, measles, or chickenpox, your doctor will recommend that you not have the vaccine until after childbirth. Instead, you must take every precaution to prevent exposure to these viruses while you're pregnant. Vaccination is safe for you and your baby during breast-feeding.
If you are not immune to hepatitis B, hepatitis A, rabies, polio, diphtheria, meningitis, tetanus, or pneumococcal bacteria, you can be vaccinated during pregnancy. But your doctor is unlikely to recommend one or more of these vaccinations unless you are at risk of being exposed during your pregnancy. If you are due for a tetanus shot but have never had a Tdap shot, it's best to get a Tdap shot soon after you have your baby, before you go home from the hospital. In most cases, Tdap is not given during pregnancy.
Smallpox has been eliminated from all places in the world except for research labs. Smallpox vaccine is not recommended during pregnancy because of the small chance that it can affect you or the fetus. But risks related to the vaccine are not as great as the risk of having smallpox infection. So, in the unlikely event that you have or may have been exposed to smallpox, you would be vaccinated to reduce the severity of this life-threatening illness. For more information, see the topic Smallpox.
Your children should receive their immunizations on schedule. Having your child vaccinated against diseases does not increase your risk for becoming infected with them. You do not need to speed up or delay your child's immunizations.
For more information, see the topic Immunizations, Vaccine Information Statements, or topics related to the specific illnesses mentioned above.
- American College of Obstetricians and Gynecologists (2005). Infections during pregnancy. In Your Pregnancy and Birth, 4th ed., pp. 295–312. Washington, DC: American College of Obstetricians and Gynecologists.
- Centers for Disease Control and Prevention (2008). Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 57(RR-4): 1–51. [Erratum in MMWR, 57(26): 723. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5726a3.htm.]
- American College of Obstetricians and Gynecologists (2004, reaffirmed 2006). Influenza vaccination and treatment during pregnancy. ACOG Committee Opinion No. 305. Obstetrics and Gynecology, 104(5): 1125–1126.
- Centers for Disease Control and Prevention (2010). Recommended adult immunization schedule—United States, 2010. MMWR, 59(01): 1–4. Also available online: http://www.cdc.gov/mmwr/PDF/wk/mm5901-Immunization.pdf.
Last Updated: February 26, 2010
Author: Debby Golonka, MPH