By Edith Bracho-Sanchez, MD, FAAP
Taking care of your health is always important. But when you're expecting a baby, it jumps even higher on your priority list! Along with good nutrition and exercise, plenty of sleep and the right dietary supplements, certain vaccines should be part of your prenatal health plan.
While some vaccines need to be administered before you get pregnant, there are also a number you need to get while you're expecting. Learn more here about vaccines, when to get them, and the how they equip your immune system—and your baby's—to resist dangerous diseases.
Are vaccines safe to get while you're pregnant?
Vaccine recommendations for pregnant people are based on extensive research. They're developed with the greatest concern for both mother and child. The vaccines you receive will protect both of you from serious diseases—protection that will last through your baby's first few months of life.
There are some vaccines that should not be given during pregnancy, though. Vaccines that contain a live attenuated (weakened) virus, for example, are generally not recommended during pregnancy. This is because of a theoretical risk that the weakened virus in the vaccine 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.
Before pregnancy: vaccines you should get
The vaccines you need will depend on your age, lifestyle, health status, prior vaccines and any travel plans you may have while pregnant. Depending on these factors, your doctor may recommend these vaccinations several weeks or months ahead of your pregnancy:
Getting these serious infections during pregnancy can increase risks for miscarriage, premature delivery or birth defects. Getting vaccinated ahead of time is the healthiest step for you and your baby.
If you'll be travelling outside the United States
If you are planning to travel outside the U.S. while pregnant, there are other health issues such as Zika and malaria you need to know about. Generally, pregnant people can travel safely, but it's best to discuss risks and prevention steps with your doctor as soon as possible.
Vaccines you need during each pregnancy
Health experts recommend that all pregnant people receive certain immunizations after becoming pregnant. Doses should be given each time you're pregnant to prevent serious health issues for you and your baby.
Flu vaccine
Millions of people have safely received the flu vaccine over the years. 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 your dose before the end of October to prevent infections during peak flu season.
This vaccine protects you and your child against three serious diseases: tetanus, diphtheria, and pertussis (also known as whooping cough). It can be given anytime during pregnancy, but experts recommend you receive it somewhere between 27 and 36 weeks. This timing has been shown to lead to the greatest level of protection for your baby following birth.
Even if you have gotten the Tdap vaccine before, you should get a booster when you're pregnant. This lets you to pass along protection against pertussis to your newborn. Family members and caregivers who will be in close contact with babies younger than one year old should also receive the Tdap booster. This lowers the risk of passing the infection to the infant.
Is it safe to get vaccines if you're breastfeeding?
If you missed certain vaccines during pregnancy, you can still get them after giving birth, even if you're breastfeeding. Research shows that most live vaccines are not present in breast milk, even if the weakened virus reproduced in the mother's system. But vaccines do let you pass along protective antibodies to your baby. Recent research found that women who got the COVID-19 vaccine, for example, had protective antibodies in their breastmilk.
The only exception is yellow fever vaccines. These are not recommended during breastfeeding unless you need to travel to areas where risks are high. This is because of the theoretical risk of the mother transmitting the virus though close contact. Ask your doctor for advice if you're planning international travel while breastfeeding your baby.
Getting the COVID-19 vaccine while you're pregnant
Research suggests that pregnancy puts people at higher risks for breakthrough COVID infections than any other medical condition–even cancer. In part, this is because during pregnancy, your immune system isn't as quick to respond to potential infections, including COVID.
The good news is that, based on scientific evidence and the experience of millions of pregnant people, COVID vaccines are considered safe before and during pregnancy. Here are reasons to consider getting up-to-date on COVID vaccines if you are expecting:
COVID infections can cause serious symptoms such as fever, cough, shortness of breath, shakes and chills, muscle pain, headache and sore throat. Getting a COVID infection can cause extra fatigue and discomfort at a time when you need to feel your healthiest.
Long COVID, which causes lingering symptoms such as fatigue, cough, breathing problems, body aches, memory issues, sleep disruption and more, can last for months after you recover from the virus. Feeling this way during your child's first months of life can make things especially hard for both of you, as well as other family members.
Peace of mind
Before my husband and I got pregnant, I made sure my vaccinations were all up to date. Once I knew I was expecting, I got the flu vaccine, the Tdap vaccine, and the COVID-19 vaccine. Our son, William, is a healthy and happy little guy, and staying healthy myself has allowed me to care for him the way I'd planned.
Remember
Talk with your doctor if you have any questions about getting up-to-date on recommended vaccines if you're pregnant or planning to have a baby.
More information
About Dr. Bracho-Sanchez  Edith Bracho-Sánchez, MD, FAAP is a primary care pediatrician and the director of the pediatric telemedicine program at the Ambulatory Care Network of Columbia University Irving Medical Center. She was born and raised in Caracas, Venezuela and obtained her medical degree from New York University, followed by pediatric training at The Children's Hospital of Philadelphia and a fellowship in Global Health and Media at Stanford University. Dr. Bracho-Sánchez is on the Executive Committee of the American Academy of Pediatrics' Council on Communications and Media. Dr. Bracho-Sánchez lives in New York City with her husband and her baby William. Follow her on Twitter @DoctoraEdith.
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