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Vaccines during pregnancy: what you need to know

Topics covered in this article:

Recommended vaccines in pregnancy

Vaccines to avoid in pregnancy (patient dependent)

Are you pregnant or planning a pregnancy?

If so, do you know how to handle your vaccines? Are you aware of which vaccines are recommended for you during your pregnancy — and which you should avoid?

Vaccine safety during pregnancy is important for both you and your baby. Here’s how you can set up a proper vaccination plan:

Because infant immune systems are not fully developed, babies can be particularly vulnerable to some infections. Those who might be around your baby should also be up to date on their routine vaccines, including Tdap and flu.17

Getting the Tdap vaccine while pregnant

It's recommended that you get vaccinated for tetanus, diphtheria and pertussis (whooping cough) during your pregnancy. Whooping cough can be a serious infection for anyone, but according to the CDC, it can be life-threatening for some newborns.1

"Your Tdap vaccination provides antibodies to your baby that they’ll have when they’re born, and it helps protect them during the months when they are most vulnerable”

Babies can’t get vaccinated against whooping cough until they’re at least two months old.5 Your Tdap vaccination provides antibodies to your baby that they’ll have when they’re born, and it helps protect them during the months when they are most vulnerable to having complications from whooping cough, including hospitalization or death. In general, an early third-trimester vaccination would offer the best protection for your baby.6

Get more information on the Tdap vaccine

Yes, if you’re pregnant, you can get both the Tdap and flu vaccines at the same time during your pregnancy.5 You can also get them at different visits — unlike with the Tdap vaccine, you don’t have to wait until later in your pregnancy to get vaccinated against the flu.5 You can talk with your health care provider to figure out how best to schedule these vaccines throughout your pregnancy.

Yes! Whether you are planning to conceive, currently pregnant or recently been pregnant, the CDC recommends that you stay up to date on your COVID-19 vaccines, including the updated bivalent mRNA COVID-19 vaccine.15 This is for a couple of reasons:

  • If you are currently pregnant or have recently given birth, research shows that you are more likely to have a more serious case of COVID-19 infection compared to people who are not pregnant, so it is a good idea to stay up to date.3

  • If you get COVID-19 during your pregnancy, there is a higher risk that you or your baby could develop complications, such as “delivering a preterm or stillborn infant.”3

Of course, you should speak to your health care provider if you have any concerns, but, barring certain health exceptions, current evidence shows that women can get the COVID-19 vaccination at any time during pregnancy.3 According to the CDC, “The benefits of receiving a COVID-19 vaccine outweigh any potential risks of vaccination during pregnancy.”3

Although the overall risks of vaccination are low, there are some you should be aware of as you make your vaccination decisions.3 Speak with your health care provider about getting vaccinated for COVID-19 — and what time might be right for you.3

If you haven’t yet been vaccinated or received any updated bivalent COVID-19 doses, you should be able to continue or start a COVID-19 vaccination schedule at any time in your pregnancy.3 If you are already on a vaccination schedule, you should be able to follow it as you normally would.3

For the most up-to-date recommendations on COVID-19 vaccine schedules, you can visit the CDC’s COVID-19 Stay Up to Date page, or you can speak with your pharmacist or other health care provider.

Although side effects can occur after being vaccinated, the good news is that pregnant patients aren’t indicating any different side effects compared to others after getting either Moderna or Pfizer-BioNTech vaccines.3 Common side effects include: 16

  • Pain and swelling on your arm where you got the shot
  • Fever
  • Headache or tiredness

Your health care provider can offer ways to minimize their impact.

For patients who are pregnant or are planning to be, the benefits of receiving a COVID-19 vaccine outweigh any potentially risks of getting vaccinated.3 It’s important to note that the COVID-19 vaccines do not cause COVID-19 — either for you or your baby.3

Yes, and smaller studies are finding great results:

Data is still being collected regarding breastfeeding, but the CDC reports that the current data "indicate no severe reactions after the first or second monovalent COVID-19 doses, neither in the breastfeeding person nor in the breastfed child. There has been no evidence to suggest that COVID-19 vaccines are harmful either to people who have received a vaccine and are breastfeeding, or to their babies.”3

Moreover, there is data showing that the antibodies to COVID-19 are expressed in breastmilk, but more data are needed to determine what level of protection these antibodies might provide to the baby.”3

Getting a flu shot while pregnant

It’s safe to get vaccinated against the flu during your pregnancy — provided you get the inactivated flu vaccine shot, NOT the live, attenuated (i.e., “weakened”) nasal spray. If you get vaccinated during your pregnancy, this will provide your baby with some protection against influenza after you give birth. September and October are generally good times to be vaccinated each year,8 but it’s important to talk to your doctor to develop a schedule that’s right for you.

Get more information on the flu shot

Yes! If you’re currently pregnant, the CDC recommends that you get the inactivated flu vaccine — ideally by the end of October.2

According to the CDC, “Getting the flu vaccine during pregnancy is one of the best ways to protect yourself and your baby for several months after birth from flu-related complications.”7 Pregnancy raises the risk of your facing severe complications from the flu. Flu shots help bring that risk down quite a bit, according to the CDC:

Because you pass some of your influenza antibodies to your baby, the vaccine’s protection also lasts for several months after your baby’s birth.2

However, if you’re pregnant, the one caveat is that you should NOT get the type of flu vaccine that contains the live, attenuated version of influenza.7

Every pregnancy is different, so it’s a good idea to speak with your health care provider about when you should get vaccinated against the flu.

Yes! The CDC states that “flu vaccines have been given to millions of pregnant women over the years, and scientific evidence shows that it is safe.”2

As stated earlier, if you’re pregnant, you should NOT get the live, attenuated influenza vaccine (the nasal spray version of the flu vaccine), which contains the live but weakened version of influenza.

You may experience some side effects from getting the flu vaccine, but they aren't any different than those non-pregnant people get. Some of the more common side effects are:8

  • Soreness in the area you received your shot
  • Headaches
  • Fever
  • Muscle aches
  • Nausea
  • Fatigue

These reactions are usually mild and go away on their own within one to two days.8 Although severe or potentially deadly allergic reactions to vaccines are rare, if you have a serious allergy to one or more of the vaccine's ingredients or had a severe reaction to a previous vaccine, you should consult with your doctor before deciding to get vaccinated so that you can plan what’s right for you.8

Yes! Getting a flu shot while breastfeeding is safe. In fact, when you breastfeed, the antibodies that your body eventually develops will be shared with your child through your breast milk.8

Getting an RSV vaccine during pregnancy

The respiratory syncytial virus, or RSV, is a common respiratory virus. According to the CDC, the virus often causes mild symptoms, similar to that of a cold, and most people recover within one or two weeks of being infected.18 However, the CDC warns that infections can become more serious, especially for infants, some of whom may develop severe symptoms and need to be hospitalized.18

The CDC recommends two ways to protect babies from developing a severe case of RSV.19 The first is to get vaccinated with Pfizer’s bivalent RSVpreF vaccine (Abrysvo) during weeks 32 through 36 of your pregnancy.19 Please be aware that Pfizer’s Abrysvo vaccine is currently the only RSV vaccine approved to be given during pregnancy to protect infants from lower respiratory tract infections brought on by RSV.20

You may also choose for your infant to receive an age-appropriate RSV immunization directly, but the CDC notes that babies born to those who received an RSV vaccine at least two weeks before their baby’s delivery should be protected and will likely not need a separate RSV immunization later.19 21

Vaccines to avoid during pregnancy

There are some vaccines that are contraindicated during pregnancy — that is, you should avoid receiving them while you’re pregnant because the potential risks may be greater than their benefits. This includes certain travel vaccines, any vaccines that contain live, attenuated viruses or bacteria, and any that your doctor might determine to be too risky for you and your baby. Always ask your doctor if you’re unsure about which vaccines you should schedule while you’re pregnant.

For the full list of vaccinations and recommendations in pregnancy, visit: the CDC guidelines for vaccinating pregnant women.

Any other vaccines that contain live, attenuated (i.e., weakened) versions of viruses or bacteria should generally be avoided if you’re pregnant. These live versions have been weakened so that healthy immune systems will keep any serious infection from developing.14 However, because the viruses (or bacteria) are alive, there is still a theoretical risk of them infecting the developing fetus and doing harm.10 Always talk to your doctor before deciding on any vaccination during your pregnancy, so you both can compare the benefits and risk factors.

If you plan to travel while pregnant, you should talk to a health care provider if specific vaccines are recommended for the locations you are going to. You and your doctor should assess the risks of getting a vaccine versus not getting it.

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SOURCES

DISCLAIMERS

*This content is for educational purposes only and is not medical advice. Consult with your health care provider prior to beginning or changing any health care practices.

  • *FOR THE COVID-19 VACCINE AND MORE: Availability varies by state based on regulations. This is not an all‐inclusive list of who should be vaccinated. Age restrictions apply. Talk to your CVS Pharmacy® immunizing pharmacist to see if any of these vaccines are right for you.

  • *FOR BIRTH CONTROL CONSULTATION: In Nebraska, our practitioners provide this service to females age 19 or older.

  • *FOR SCHEDULE VACCINES: Availability varies by state based on regulations. This is not an all-inclusive list of who should be vaccinated. Age restrictions apply. Consult with your health care provider or talk to your CVS® pharmacist to see if any of these vaccines are right for you.

  • *FOR MENSTRUAL SERVICES: Services may vary by location.