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What to know about immunizations & pregnancy

A pregnant woman needs to take precautions to ensure her health and her baby’s. That includes getting certain vaccinations — and avoiding others until after the birth.

What effect do immunizations have on a pregnant woman?

Immunizations work by getting the body to form antibodies that fight specific bacteria or viruses. When an expectant mother builds those antibodies, she passes them on to her unborn child through the placenta or, if she is breastfeeding, through breast milk.

The guidelines

The American College of Obstetricians and Gynecologists (ACOG) recently released a clear and simple guide for doctors to follow when making recommendations to expectant mothers. Here are those recommendations and the reasons behind them.

For all expectant mothers


ACOG recommends that expectant mothers get an inactivated influenza vaccine with each flu season. An inactivated vaccine consists of virus particles that have been grown and killed in order to prevent infection. The nasal spray immunization for flu is not recommended for pregnant women.

When: It can be given at any point during pregnancy.

Why: An expectant mother’s immune system changes during pregnancy, and she can become more vulnerable to the effects of the flu. Mothers who contract the flu are at higher risk for premature delivery, which can affect the baby’s health. The vaccine also protects the baby after birth, when they are most vulnerable to the effects of the flu.

Tdap (Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis)

ACOG recommends that expectant mothers get the Tdap vaccine.

When: 27-36 weeks into pregnancy.

Why: This vaccine protects mother and infant against whooping cough, which affects the ability to breathe and is very dangerous to infants, especially those under 4 months old. For that reason, a new mother who did not get a Tdap vaccine during pregnancy should get it immediately after delivery.

For high-risk expectant mothers

ACOG has determined that these immunizations can be safely given during pregnancy in specific populations to ensure the health of mother and baby.


Women at high risk for pneumonia complications include smokers and those with heart, lung or sickle cell disease.


There are a number of different types of meningitis, all of which cause swelling of the membranes around the brain and spinal cord. Women who may have been exposed to meningitis (through a local outbreak, during travel, or in microbiology work) should speak to their doctor about the circumstances to determine if they need to get vaccinated.


Hepatitis is an inflammation of the liver that can affect the organ’s function. It’s typically caused by a virus, though heavy alcohol use, toxins, medications, and certain medical conditions can cause hepatitis.

Hepatitis A

The hepatitis A vaccine is recommended for women with who are at increased risk for severe reactions to Hepatitis A infection, including those who:

  • Have chronic liver disease
  • Experience clotting factor disorders
  • Use drugs
  • Were exposed to infection during their pregnancy

Hepatitis B

This vaccine is recommended for women who may have been exposed to Hepatitis B infection through:

  • Sexual contact
  • Travel to certain countries
  • Drug use
  • HIV
  • Liver disease
  • Exposure to infection during pregnancy

After delivery

In addition to the vaccines listed above, ACOG has determined the following immunizations can be given safely postpartum and when breastfeeding but are not recommended during pregnancy.

Human Papillomavirus (HPV)

This vaccine protects against a sexually transmitted virus that can increase the risk of cervical cancer.

Measles-mumps-rubella (MMR)

Not recommended during pregnancy due to increased risk of miscarriage and birth defects.

Chicken pox

Not recommended during pregnancy due to an increased risk of serious birth defects, including incomplete brain development.

Talk with your doctor

Prenatal care plays a significant role in a healthy pregnancy. The best way to know which immunizations to get before, during and after pregnancy is to talk with your OB/GYN.

BCBST members can get pregnancy support and resources through the Healthy Maternity program. Healthy Maternity offers benefits for an expecting mother through every stage of her pregnancy, including personalized, one-on-one support from a maternity nurse and additional tools to support her every step of the way.

For more articles on pregnancy and motherhood, click here.

Nancy Henderson

Nancy Henderson, a writer and editor originally from New York, moved to Nashville more than 25 years ago and considers herself more Tennessean than Yankee these days. She has written about health care and wellness for a variety of publications.

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Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.

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WellTuned does not offer medical advice. Any personal health questions should be addressed to your doctor.

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