By Tuhin Choudhary, MD, MPH, MS
Taking care of your personal health is always important. But when you are expecting a baby, it jumps even higher on your priority list!
Along with good nutrition and exercise,
healthy sleep habits and the right dietary
supplements, vaccines are an important part of your prenatal health plan. Vaccines help you and your baby stay safe when germs that cause sickness are spreading around.
Health experts recommend getting some vaccines before you get pregnant and others
during pregnancy. Read on to learn what vaccines you need and when.
Pre-pregnancy vs. pregnancy vaccines: What's the difference?
The vaccines you get
before pregnancy have
live attenuated (weakened) viruses. They are generally not recommended during pregnancy because there is a small chance a weakened virus could cross the placenta. This is also why, ideally, getting pregnant should be postponed for 4 weeks after receiving a live-virus vaccine.
The vaccines you get
during pregnancy don't have weakened live viruses. That means there is no risk a weakened virus could cross the placenta.
So, it's best to talk with your doctor before you get pregnant. If you're already expecting, don't worry! Your doctor can review your vaccine record and recommend a schedule for catch-up doses after you deliver.
Watch this video to learn more here about vaccines, when to get them and how they equip your immune system—and your baby's—to resist dangerous diseases:
What vaccines do you get before pregnancy?
Your doctor may recommend several vaccines before getting pregnancy. The number and timing of those vaccines depends on your individual situation.
Depending on your age, lifestyle, current health condition, vaccination record and any travel plans you may have during pregnancy, your doctor will tell you if you need all the vaccines below and when you should get them.
Not getting the vaccines your doctor recommends before pregnancy can make you vulnerable to the dangerous infections they prevent.
Infectious diseases can increase the risk of miscarriage,
preterm delivery or
birth defects. This is why
getting vaccinated ahead of time is the safest option for you and your baby.
Traveling outside the United States
If you are planning to travel outside the U.S. while pregnant, it's important to find out which infectious diseases are common where you are going.
For example, there are places where
Zika and malaria are very common. Getting infected with those diseases can be dangerous for your and your baby's health.
Generally, pregnant people can travel safely, but it's best to talk to your doctor as soon as possible.
Ask them if you need vaccines in preparation for your trip and when you should get them.
What vaccines do you get during pregnancy?
Health experts recommend getting these 4 vaccines during pregnancy:
This vaccine protects you and your child against three serious diseases: tetanus, diphtheria and
pertussis (whooping cough).
You can get it anytime during pregnancy, but experts recommend doing so between weeks 27 and 36. Studies show this will give your baby the greatest level of protection after birth.
Even if you got the Tdap vaccine before—on a routine wellness visit or in a previous pregnancy—you should get a booster when you're pregnant. It will help you pass along protection against tetanus, diphtheria and pertussis to your baby.
Family members and caregivers who will be in close contact with your baby after birth should also receive a Tdap booster. When they receive the booster, they have less chances of getting sick and infecting your baby.
Flu vaccine
Millions of people have safely received the
flu vaccine over the years
while pregnant. Your doctor will give you the injected (inactive) form of the vaccine, not the nasal (live) form, which is not recommended during pregnancy.
If you are pregnant or plan to be in the fall and winter months, it's best to receive the flu vaccine before the end of October. This way you will prevent getting infected during peak flu season.
COVID-19 vaccine
When you are pregnant, your immune system does not respond quickly to infections. COVID-19 can make pregnant people very sick and may lead to hospitalization.
Getting the vaccine during pregnancy will lower the risk of that happening to you.
The vaccine will also protect your baby. It will help you pass along protective antibodies that may reduce your newborn's risk of getting COVID-19 after delivery.
Your baby will be protected against infection until they can get their own COVID-19 vaccine at 6 months old.
RSV vaccine
The respiratory syncytial virus (RSV) is the
most common cause of hospitalization in babies under 1 year of age. The infection can spread to the lungs and cause serious breathing problems.
If your baby will be born during RSV season (September through January),
you can get the vaccine (Abrysvo) at any time between 32 weeks and 36 weeks of pregnancy.
When you get the vaccine during pregnancy, the baby receives antibodies from you. This way, your little one will not need the vaccine right after birth. They will be protected for 6 months.
If your baby is born less than 14 days after you received the
RSV vaccine, they will need to get the immunization specifically made for them to ensure protection against RSV (nirsevimab or beyfortus).
The RSV vaccine for pregnant people is given just once. If you received the RSV vaccine during any pregnancy, you should not get another dose if you are pregnant again. Babies born from later pregnancies should receive the vaccine for babies.
Safety of vaccines during pregnancy
Vaccine recommendations for pregnant people are based on
extensive research. Recommendations are developed with the greatest concern for both mother and child. The vaccines you receive will protect both you and your child from serious diseases—protection that will last through your baby's first few months of life.
Is it safe to get vaccinated while breastfeeding?
If you missed some vaccines before or during pregnancy, you can still get them after giving birth, even if you're
breastfeeding.
Vaccines can help you pass along
protective antibodies to your baby while breastfeeding. Recent research has found that women who got the COVID-19 vaccine, for example, had protective antibodies in their breastmilk.
Vaccines with weakened viruses are safe while breastfeeding. Studies show most live vaccines are not present in breast milk, even if the mother has received them while breastfeeding. That means you can pass along protective antibodies to your baby safely.
The only exception is the yellow fever vaccine. It's not recommended while breastfeeding because there is a chance the mother could infect the baby through close contact. But doctors may recommend it if you need to travel to areas where the risk of infection is high. Ask your doctor for advice if you're planning an international trip while breastfeeding your baby.
Remember
Making sure you are up to date with the MMR, Varicella and HPV vaccines before getting pregnant will give you peace of mind while you work on your prenatal care plan.
Once you know you are expecting, getting the Tdap, COVID-19, flu and RSV vaccines will protect you and your baby. Vaccines during pregnancy will help you stay healthy and allow you to care for your baby the way you planned.
Talk with your doctor if you have any questions about being up to date on recommended vaccines if you're pregnant or planning to have a baby.
More information
About Dr. Choudhary
 Tuhin Choudhary, MD, MPH, MS, is a second year combined Internal Medicine-Pediatrics resident at Tulane University School of Medicine. Her professional interests include infectious disease and tropical medicine, health equity, global health, mentorship for first generation and non-traditional students and medical education.
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