Vaccines During Pregnancy: Are They Safe, Do They Work, and When Should You Get Them?
Nov 20, 2020

This Shot of Prevention blog post was originally published in October 2017 and was updated by Vaccinate Your Family on November 20, 2020.

There’s no shortage of advice during pregnancy. The list of what you should do (or shouldn’t) while pregnant just seems to get longer and longer. And that can get overwhelming, especially when preparing for the arrival of your first child. 

While you can be sure well-meaning friends and family will provide a constant stream of advice, expecting couples should get medical advice from trusted expert sources, such as the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse Midwives (ACNM), and the American Academy of Family Physicians (AAFP).

Here are five things medical experts say about vaccines recommended during pregnancy.

Vaccines during pregnancy protect against two serious illnesses: whooping cough and flu.

Pertussis (also known as whooping cough) is a highly contagious respiratory disease that spreads easily from person-to-person through coughing and sneezing. Because symptoms can be less severe in vaccinated people, a preteen, teen or adult may easily confuse pertussis with a bad cold or allergies and unknowingly pass whooping cough on to a baby or young child.

Unlike a cold, whooping cough doesn’t clear up in just a week or so. The nasal congestion eventually turns into thick mucus that accumulates inside the airways causing periods of intense coughing.  In young children, the cough can be so severe that it causes a child to gag, turn blue, vomit or pass out. A gasp for air after a coughing fit can sometimes produce a loud “whoop” sound — thus the name “whooping cough” — though it’s not uncommon to have whooping cough without producing the “whoop” sound. This intense coughing phase can last as long as 10 weeks.

Whooping cough can be very serious, and even deadly, for infants and young children. In the first 6 months of life, babies are at high risk for complications from whooping cough, even if they are healthy.  About 7 in 10 deaths from whooping cough are among babies younger than 2 months old. These babies are too young to be protected by their own whooping cough vaccinations (DTaP). The younger the baby is when they get whooping cough, the more likely they will need to be treated in a hospital. Some will suffer lifelong complications, and 1 out of every 100 children will die. 

Getting a Tdap (tetanus, diphtheria and pertussis) vaccine during pregnancy is the best way a woman can protect her baby from whooping cough at a time when the disease is most dangerous to her child.  

Seasonal influenza (flu) is also a respiratory illness, and it is caused by flu viruses. While many might dismiss the flu as no big deal, it’s actually a leading cause of vaccine-preventable deaths in the United States. On average, about 100 children die from flu each year in the U.S. and thousands more are hospitalized. Last flu season was particularly bad for children with 195 pediatric deaths due to flu. Even otherwise healthy people of all ages, including pregnant women, die or are hospitalized with flu each year in the U.S.

While we can try to treat the symptoms of the flu, and at times prescribe antivirals to help lessen the severity or duration of flu, there is no cure for the flu, and the disease must run its course.  The result is that pregnant women and children younger than 6 months of age often suffer severe complications, hospitalization and even death. 

Getting vaccinated during pregnancy protects both mom and baby.  

Your body changes a lot during pregnancy, and that includes how your heart, lungs and even immune system function. Pregnant women are more likely than non-pregnant women to get seriously sick from some diseases like the flu, which is why doctors and midwives recommend getting a flu shot during pregnancy. Getting vaccinated can reduce a pregnant woman’s chances of being hospitalized due to the flu.

But it’s not just pregnant women who benefit. When you get vaccinated during pregnancy, you help protect your baby from getting sick, too. Like pregnant women, newborns have a higher risk of being hospitalized or dying due to infections like the flu, and babies born to moms vaccinated during pregnancy are less likely to get seriously sick than those with unvaccinated moms. 

Getting vaccinated with flu and Tdap vaccines during each pregnancy – as opposed to before or after – allows a woman to pass on protective antibodies to her baby that will provide them with short-term protection against flu and whooping cough, until the baby is old enough to get their own vaccines.  

You should get the Tdap vaccine in your third trimester and the flu vaccine in any trimester.

The best time for a pregnant woman to get a Tdap vaccine is between 27 and 36 weeks of each pregnancy, preferably closer to 27 weeks. Protective antibodies are at their highest about 2 weeks after getting the vaccine, but it takes time to pass them to your baby. That’s why the preferred time to get a Tdap vaccine is early in your third trimester. Also, the amount of whooping cough antibodies in your body decreases over time. That’ why it’s recommended that you get a Tdap vaccine during each pregnancy, even if your pregnancies are only a year or two apart. 

A flu shot is recommended for pregnant women during any trimester of each pregnancy.   You want to get vaccinated, before the flu season begins, so that you are protected before the viruses start spreading in your community. Since it takes about two weeks after vaccination for a person’s body to develop antibodies, it is best to get your flu shot by the end of October, if possible. 

Why not just ask sick people to stay away from your newborn? It’s definitely a good idea, but it’s not foolproof. That’s why CDC and other medical experts say that the best way to protect your newborn from whooping cough and flu is to make sure you get vaccinated during pregnancy so your baby gets those antibodies and is born with protection. To help form a circle of disease protection around your baby, you can also ask your family members and caregivers to be up to date on their vaccinations before visiting your newborn.

Research shows Tdap and flu vaccines are safe when given to pregnant women

Despite what some anti-vaccine activists might claim, vaccines have been studied extensively for safety in pregnant women, and the results are clear: Tdap and flu vaccines are safe during pregnancy. 

Vaccinated women are not more likely to have pregnancy complications like chorioamnionitis, pre-eclampsia, or gestational hypertension, and getting a flu shot doesn’t make you more likely to miscarry. Vaccinations during pregnancy also won’t increase your baby’s chances of being born early or small. In fact, a recently published study shows that women who get sick with flu during pregnancy may have an increased chance of pregnancy loss and having a baby with a lower birthweight. So, getting a flu shot during pregnancy actually helps prevent certain health complications for pregnant women and their babies.

Maternal vaccines work

Tdap and flu vaccinations during pregnancy have not only been studied for safety, they have also been studied for effectiveness. Medical and public health experts from CDC, ACOG, ACNM, and AWHONN all agree that the benefits of flu and Tdap vaccines for pregnant women and their babies outweigh any potential risks.

Scientific studies show that vaccinating women during pregnancy protects up to 90% of infants against whooping cough, and that infants whose mothers got Tdap during pregnancy had a significantly lower risk of hospitalization and intensive care admission. Visit the CDC website to see the list of studies showing the effectiveness of Tdap vaccination during pregnancy.

A 2018 study shows that vaccinating during pregnancy reduces a woman’s risk for flu-related hospitalizations by an average of 40%, showing that pregnancy is in fact safer because of flu vaccination. Similarly, a study published in the journal Pediatrics showed that getting a flu vaccine during pregnancy reduced the risk of flu in infants in their first 6 months of life by as much as 70%, and reduced their likelihood of hospitalization by as much as 81%. Visit the CDC website to see a list of studies showing the benefits of flu vaccination during pregnancy.

It’s clear that vaccines during pregnancy are a proven way for women to effectively protect their babies from flu and whooping cough, but only about 50% of pregnant women in the U.S. are currently getting the recommended vaccines they need. While this number has been increasing, this means that about half of all babies are still being born without protection from these two dangerous diseases.

If you know someone who is expecting, please share this information and ask them to consider talking to their prenatal care provider about the need for flu and Tdap vaccines during pregnancy. This simple step can possibly save a child’s life.

Additional resources: 

• Vaccinate Your Family – Vaccines During Pregnancy
• CDC: Pregnancy and Vaccination  
• Immunization for Pregnant Women: A Call to Action (ACOG, ACNM, AAFP, AWHONN)
• World Health Organization; Safety of Immunizing During Pregnancy;  A review of the evidence (Global Advisory Committee on Vaccine Safety)

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