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Vaccinations in Pregnancy

Written by Amina Hatia RM
Medically reviewed by Marley Hall BA RM Diphe

Vaccinations offered in pregnancy

You will be offered a range of vaccines (immunisations) during your pregnancy by your midwife or GP to help protect you from certain infections or to help keep your baby safe from infection during the first few weeks of their life until your baby has had their own vaccinations.

In pregnancy your immune system is weaker than when you are not pregnant, which means that you are more likely to pick up certain infections that may be harmful to either you or your baby.

This is why certain vaccinations are offered to all pregnant women in the UK – such as the seasonal flu vaccine, the whooping cough vaccine and more recently the Covid-19 vaccination.

Covid-19 vaccination during pregnancy

COVID-19 vaccines are strongly recommended for all adults including anyone who is currently pregnant or planning a pregnancy. 

The Covid-19 vaccines are advised for all pregnant women because infection from COVID-19 can have adverse effects on the mother (such as admission to intensive care) and to the baby (such as premature birth).  

The Royal College of Obstetricians and Gynaecologists (RCOG) also advise that evidence from recent studies have also found that pregnant women who “ tested positive for COVID-19 are more likely to develop pre-eclampsia or require an emergency caesarean” – RCOG 2022.

What covid-19 vaccines are offered in pregnancy?

The Pfizer-BioNTech or Moderna mRNA vaccines are the preferred and recommended vaccinations for pregnant women by the Joint Committee on Vaccination and Immunisation (JCVI) in the UK. They are recommended because they have been given to more than 275,000 pregnant women in both the UK and the USA and have not raised any safety concerns.

When should you receive the Covid-19 vaccine during pregnancy?

The Covid-19 vaccines are considered to be very safe to be taken at any stage of pregnancy – including the first trimester. It is important that you receive both doses and the booster dose of the covid-19 vaccine to have the best protection against the coronavirus. Whilst one dose of COVID-19 vaccine can provide good protection against the original infection, two doses are necessary to achieve a good level of immunity. The booster (3rd) dose is recommended to provide protection against the most recent variant.

Is the Covid-19 vaccine safe during pregnancy?

The Covid-19 vaccines offered to pregnant women in the UK have been shown to be safe. The vaccines used in the UK are not live vaccines, which means that they cannot cause COVID-19 infection in you or your baby. Pregnant women are offered other non-live vaccines such the whooping cough or the seasonal flu vaccine.

Continuing evidence highlights that there are no pregnancy-related safety concerns after having the Covid-19 vaccines in pregnancy.

Further information on Covid-19 vaccines in pregnancy can also be found here: Gov.uk Covid-19

What vaccinations will I normally receive during pregnancy? 

All pregnant women in the UK will be offered if appropriate, the seasonal flu vaccine and the whooping cough vaccine.

Whooping Cough (Pertussis)

What is the whooping cough vaccine?

The whooping cough vaccination is offered to all pregnant women in the UK because the rates of whooping cough (pertussis) have risen sharply in recent years. This affects pregnant women because new-born babies are at greatest risk until they start their vaccinations around 8 weeks.

Having the whooping cough vaccine in pregnancy means that your body will produce antibodies against whooping cough which are passed to your baby providing them with some protection until they start their vaccinations.

When do you normally receive a whooping cough vaccine during pregnancy?

Your midwife will advise that the ideal time to have the whooping cough vaccine is anytime from 16 weeks up to 32 weeks in your pregnancy. This is so that your baby has the best chance of being protected once they are born.

If you are unable to have the vaccine before 32 weeks, it’s still a good idea to have it – anytime up until you are labour. Whilst your baby is less likely to get protection from you if given after 32 weeks and the vaccination may not directly protect your baby, it will still help protect you from whooping cough infection and from passing the infection on to your baby.

Is the vaccine safe during pregnancy?

There is no evidence that suggests the whooping cough vaccine is not safe for either yourself or your unborn baby. It’s important to know that the whooping cough vaccine is not a ‘live’ vaccine, which means it will not give you whooping cough.

The NHS has further information on the whooping cough vaccine in pregnancy in this link: NHS – Whooping Cough Vaccination. 

Flu vaccine

What is the flu vaccine?

Your midwife or doctor will advise you to have the seasonal flu vaccine in pregnancy if needed as your body’s natural defence system is weakened in pregnancy, making you more prone to infections such as the seasonal flu. You are more likely in pregnancy to have complications from the flu and if you become unwell – more at risk of being admitted to hospital. 

This is why the seasonal flu vaccine is offered to pregnant women.

When do you normally receive a flu vaccine during pregnancy?

The flu vaccine can be given at any stage in pregnancy. You will be offered the flu vaccine sometime in the autumn before seasonal flu starts circulating. Whilst it is best to have the vaccine as early as possible – you can have it anytime in the flu season.

Is the vaccine safe during pregnancy?

Yes – extensive research shows that the flu vaccine is safe given at any time in pregnancy. It may be reassuring to know that the flu vaccine is not a live vaccine and therefore will not give you or your baby seasonal flu.

Travel vaccinations

It is best to avoid visiting countries or areas where travel vaccinations are required if you are pregnant unless you have already been vaccinated prior to your pregnancy. 

If you travel to a country which requires a travel vaccine, then you should first discuss with your doctor about the risks and benefits of vaccinations you might need.  They can advise on the risk of travelling unvaccinated compared to the risk of having the vaccination in pregnancy.

If you travel to a country where you are at risk of Malaria, you should in the first instance avoid travelling there if possible whilst pregnant as you are particularly susceptible to malaria in pregnancy. Severe malaria in pregnancy can be fatal for both a mother and her baby.

If travelling to a country at risk of Malaria is unavoidable for you, preventative treatment in the form of antimalarial tablets is available to reduce your risk of getting malaria.

Some antimalarial medication such as doxycycline can cause discoloration of your unborn baby’s milk teeth if taken in the first trimester.

If you would like further information on what antimalarial medications are used in pregnancy, visit the BUMPS website. 

What vaccinations are best to avoid during pregnancy

Vaccines that use a live version of a virus should be avoided in pregnancy as there is a risk your baby may become infected with the virus.

It is important to note that there may be times that your doctor may advise that it is necessary for you to have a live vaccine whilst pregnant as the risk of infection is thought in this circumstance to be greater than the risk of the vaccination. 

Whilst live vaccines should be avoided where possible – there is no evidence live vaccines cause birth defects.

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