Vaccines during pregnancy: Benefits, risks, schedule

You want a healthy pregnancy and a safe baby. The fastest way to get there? Know exactly which vaccines during pregnancy are recommended, when to get them, and why they matter. Think of this as your friendly, practical guidelike chatting with a friend who did the homework and brought the color-coded sticky notes.

Short answer upfront: The flu shot, Tdap (between 2736 weeks), COVID-19, and RSV (3236 weeks during the season) are recommended and considered safe in pregnancy. Live vaccines like MMR and varicella can wait until after delivery. Below, we'll walk through timing, benefits vs. risks, and the questions to bring to your next prenatal visitso you can decide with confidence.

Why it matters

Let's start with the "why." Pregnancy is a wild, wonderful timeand your immune system shifts gears to support your baby. That shift can make you more vulnerable to infections that hit harder than usual. Vaccines during pregnancy step in like a safety net for both of you.

Protection for you and baby

When you get vaccinated in pregnancy, your body creates antibodiestiny bodyguards that recognize and fight specific germs. Here's the cool part: You pass many of those antibodies to your baby through the placenta. It's like packing their first suitcase with protective gear.

Passive antibody transfer: how long it lasts

These maternal antibodies provide "passive immunity" for your newborn, especially in the first 24 months of life. Protection gradually fades as your baby's own immune system and vaccines take the lead, which is exactly the bridge we want.

Why newborns are vulnerable

Newborns haven't had their full vaccine series yet, and their immune systems are still learning the ropes. That's why giving them antibodies in advancethrough youcan be such a game-changer in those early weeks.

Big outcomes to prevent

Which illnesses are we most worried about during pregnancy? Flu, pertussis (whooping cough), RSV, and COVID-19 top the list because they can cause severe illness in pregnant people and serious complications in newborns.

Risks of severe disease

Pregnant people have higher risks of complications like pneumonia, dehydration, and hospitalization from flu and COVID-19. And pertussis in a newborn can progress fast. Preventing severe disease is the goal line.

Early-life protection for baby

Before infant shots start to kick in, maternal antibodies from Tdap and RSV vaccination can offer crucial early protectionespecially in those first fragile months when infections can escalate quickly.

Are they safe?

Let's clear the air: safety is the heart of this conversation. The general rule is simple and reassuring.

Inactivated vs. live vaccines

Inactivated vaccines are recommended

Vaccines that use inactivated (killed) componentslike the flu shot, Tdap, COVID-19, and RSV vaccinesare considered safe in pregnancy. These don't contain live germs and can't cause the disease.

Live vaccines wait until after birth

Live vaccines like MMR (measles, mumps, rubella) and varicella (chickenpox) are not recommended during pregnancy. If you need them, plan for postpartum, or get them before pregnancy if you're not yet immune.

What the experts say

Major health organizations align on this. According to the CDC's guidance on vaccines and pregnancy and consistent recommendations from ACOG, getting the flu shot, Tdap, COVID-19, and seasonally timed RSV during pregnancy is safe and effective. You'll see the same message echoed in Mayo Clinic expert resources ("Vaccines during pregnancy: Are they safe?"), which break down inactivated vs. live vaccines in plain language.

Side effects: what's normal

Mild, short-lived side effects are common and normal: arm soreness, redness, fatigue, mild fever, headaches, or body aches. Rest, hydration, and a cool compress help. Call your provider if you have a high fever, symptoms that worry you, or signs of an allergic reaction (like hives, wheezing, or swelling).

Vaccine schedule

Let's map out a practical pregnancy vaccine schedule. Consider this your trimester-by-trimester guide to keep things simple.

First trimester: plan smart

If it's flu season, you can get the flu shot anytime during pregnancyincluding the first trimester. You can also get the COVID-19 vaccine or booster when you're due, regardless of trimester. If you're at risk or not immune, talk with your provider about Hepatitis B; Hepatitis A may be considered for specific risk scenarios (like certain travel or exposure risks).

Second trimester: stay on track

Continue flu and COVID-19 vaccination as needed. This is a great time to plan for the Tdap window and talk through RSV timing if your due date overlaps with fall/winter RSV season.

Third trimester: timing is key

Tdap at 2736 weeks

The Tdap vaccine is recommended in every pregnancy, ideally earlier in that 2736 week window so your body has time to build and transfer antibodies.

RSV at 3236 weeks in season

If you're in the fall or winter months, the maternal RSV vaccine can be given at 3236 weeks. If timing doesn't fit, there's an infant option after birth (a long-acting monoclonal antibody) that your pediatrician can provide. Your provider can help compare both choices based on due date and local RSV patterns.

Postpartum and breastfeeding

After delivery, catch up on any deferred vaccines (like MMR or varicella if you weren't immune). Breastfeeding also passes certain antibodies through milkthink of it as bonus support for your baby's developing immune system.

What to get

Here's a closer look at each recommended vaccine and the "why" behind it.

Flu shot

Why flu hits harder

Flu can be more serious in pregnancy due to changes in the heart, lungs, and immune system. The flu shot reduces the risk of severe illness for you and helps protect your newborn in those first months. If possible, getting vaccinated by the end of October is idealbut it's helpful any time during flu season.

Injection only, not nasal spray

Stick with the inactivated flu shot; the nasal spray is a live vaccine and not recommended in pregnancy.

Tdap vaccine

Newborn protection from pertussis

Whooping cough can be devastating for young babies. The Tdap vaccine during pregnancy helps your body make antibodies you pass to your baby, giving them a buffer until their own vaccine series begins. Each pregnancy needs a fresh Tdap because antibody levels wane over time.

Best timing

Get Tdap between 2736 weeks, with earlier in that window often preferred for optimal antibody transfer.

COVID-19 vaccine

Stay up to date

COVID-19 vaccination during pregnancy reduces the risk of severe illness, hospitalization, and complications like preterm birth. It also provides some antibodies to your baby. You can receive it in any trimester, including boosters when you're due. If there's a local surge or you have high exposure risk, talk with your provider about ideal timing.

RSV vaccine option

3236 weeks in season

Maternal RSV vaccination protects your baby during the first RSV season they encounter. If the timing isn't right, your pediatrician can give your baby a long-acting monoclonal antibody after birth instead. Both strategies aim to prevent severe RSV disease in infancy.

How to decide

Your due date, local RSV season, and access to infant immunization all factor in. A quick conversation with your OB or midwife can help you choose the route that best fits your family.

Other vaccines if needed

Hepatitis B and Hepatitis A

If you're not immune to Hepatitis B or you're at risk, vaccination during pregnancy is recommended. Hepatitis A may be considered for certain exposures or travel plans.

Travel planning

Traveling while pregnant? Plan vaccines 46 weeks ahead. Some travel vaccines are inactivated and can be considered; others are live and deferred. Map your itinerary with your care team to protect both you and baby without unnecessary risks.

Avoid these

There aren't many "don'ts," but a couple matter.

Live vaccines: MMR, varicella

Why they're deferred

Because they're live, MMR and varicella are avoided during pregnancy. If possible, check immunity before you conceive; after an MMR shot, standard guidance is to wait a month before trying to get pregnant.

Shingles (Shingrix)

Delay until postpartum

Shingrix isn't typically given during pregnancy. It's a great vaccinejust better timed after baby arrives.

Benefits vs risks

Let's put the pros and cons on the table, clearly and calmly.

Benefits you can feel good about

Fewer serious infections

Vaccines during pregnancy help prevent severe disease in you and reduce the chance of hospitalization for you and your baby.

Antibody bridge for baby

Think of maternal vaccination as a bridge to your baby's own vaccine schedulehelping them cross those first months safely.

Risks and side effects

What the evidence shows

Mild side effects are common. Serious adverse events are rare and closely monitored through robust safety systems. Guidance from the CDC and ACOG reflects large datasets and ongoing review, which is why recommendations have stayed consistent as evidence has grown.

Talk with your provider

Good questions to ask

What's the ideal timing for me? Can I get more than one vaccine on the same day? How do my medical conditions affect this plan? Should I time RSV or Tdap around travel or family events? Ask anythingthat's what your team is there for.

Before you leave the visit, jot down your pregnancy vaccine schedule and next steps. It feels surprisingly calming to have a plan in black and white.

Real-life tips

Let's make this practical and human. Here are small things that make a big difference:

Bring your questions to your next appointment. Wear a short-sleeved top on vaccine day and plan a mellow evening with extra water and a cozy blanket. If you're nervous, that's normalask your partner or a friend to come along. I've sat in those waiting rooms too, wondering if I was "doing it right." Having a plan made it easier to breathe.

Also, consider the "cocooning" strategy: ask close caregivers and family who'll be around your newborn to get updated on flu, COVID-19, and Tdap if needed. Building a ring of protection around your baby can lower exposure risks in those early weeks.

Special cases

Every pregnancy is unique. Here's how to adapt with care.

High-risk pregnancy or chronic conditions

Tailor with your specialist

If you have conditions like diabetes, asthma, heart disease, or an immunocompromising illness, vaccines can be even more important. Your OB, maternal-fetal medicine specialist, and primary care provider can coordinate timing to balance protection and comfort.

Limited records or hesitancy

Finding your footing

Can't locate your vaccine records? Check with previous clinics, school records, your state's immunization registry, or past employers. If you're feeling hesitant, that's okayask for the data behind recommendations. According to the ACOG patient resources on vaccines in pregnancy, maternal vaccination has a strong safety record and clear benefits for mom and baby. Take your time, bring your questions, and make the choice that fits your values and risks.

Travel while pregnant

Destination decisions

Heading abroad? Review destination-specific vaccine needs early. Some vaccines are fine in pregnancy, others aren't. Your provider can help you weigh the benefit of travel vs. the timing of vaccines, and discuss alternatives like preventive medications or itinerary tweaks.

Trust the process

It helps to know there's a big, careful system behind these recommendations. Surveillance programs and advisory committees constantly review safety signals and effectiveness data. That's why guidance from the CDC and organizations like ACOG stays aligned and evolves with evidence. If anything important changes, your prenatal team will be the first to help you adjust.

What experts agree on

Again and again, major guidelines come back to the same core recommendations: inactivated flu shot during flu season, Tdap at 2736 weeks in every pregnancy, staying up to date on COVID-19, and seasonally timed RSV vaccination or infant protection after birth. These aren't arbitrary; they're designed to protect two people at once.

How safety is watched

Safety monitoring doesn't stop once a vaccine is releasedit intensifies. Ongoing systems track outcomes in real time, which is how we know side effects and rare events. This is also why providers can confidently discuss benefits vs. risks with you using current data.

Where to read more

If you like to dig into details, look for plain-language pages from respected organizations. For example, the CDC's pages on vaccines and pregnancy and Mayo Clinic's expert explanations are clear and up to dateperfect for printing and bringing to your appointment.

Your next step

Vaccines during pregnancy protect you now and give your baby a head start when they're most vulnerable. The big four are clear: flu shot if it's flu season, Tdap at 2736 weeks, COVID-19 anytime to stay up to date, and RSV at 3236 weeks in the fall/winteror plan infant RSV protection after birth. Live vaccines like MMR and varicella can wait until after delivery.

Still deciding? Totally normal. Bring this pregnancy vaccine schedule to your next prenatal visit and talk it through. Share your medical history, your travel plans, even your worries. Your care team can tailor the timing so you get the benefits while minimizing side effects and stress. And if you've been through this beforewhat helped you feel confident? Share your experience with someone who's just starting out. You've got options, evidence, and support on your side.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.