Pregnancy Vaccination Chart

I’ve never been pregnant myself, but I’ve helped quite a few friends prepare for parenthood. One of the most important things you can do during pregnancy is protect your baby from infectious diseases that could cause serious health issues. To make sure you’re up to speed on your shots, I’ve put together this guide on vaccines that are safe during pregnancy.

Pregnant mothers should get flu and whooping cough vaccinations during pregnancy.

The flu vaccine is recommended for pregnant women in any trimester. It’s especially important to get the vaccine early in pregnancy, as a growing fetus can experience serious health problems if a mother becomes ill with the flu. Whooping cough vaccines are recommended for pregnant women only during their third trimester (the last three months of pregnancy), because it’s easier to spread whooping cough to newborns than it is to other adults.

Whooping cough vaccines should be given in the first 20 weeks of pregnancy, preferably in the first trimester, because studies show that an infant’s immune system isn’t fully developed until after 20 weeks of gestation.

Tetanus, diphtheria and pertussis (Tdap) are part of the vaccine schedule for pregnant moms.

The Tdap vaccine is a booster shot that protects against tetanus, diphtheria and pertussis. It’s recommended for all pregnant women in their third trimester.

The Centers for Disease Control (CDC) states that “the Tdap vaccine is safe to receive during any trimester of pregnancy and can help protect both mom and baby from diseases caused by bacteria such as whooping cough (pertussis).” The CDC also notes that “Tdap vaccination reduces the risk of infection in pregnant women by 70% to 80%.”

The measles, mumps and rubella (MMR) vaccine is available for pregnant moms and is safe during pregnancy.

Pregnant women who are considering getting the MMR vaccine should know that it is safe for them to get during pregnancy. The MMR vaccine is recommended for pregnant women because it can protect babies from measles, mumps and rubella before they are born.

If you’re planning on getting vaccinated against these diseases, talk to your healthcare provider about what’s right for you and your baby.

Use this chart to know which shots are safe during pregnancy.

  • Tdap is the most important vaccine for pregnant women. The Tdap vaccine protects against tetanus, diphtheria and pertussis (whooping cough).
  • MMR vaccine is safe during pregnancy. The MMR vaccine protects against measles, mumps and rubella (German measles).
  • Some vaccines are not safe during pregnancy. For example, flu shots should be avoided until after delivery unless you have a serious medical condition that would make being vaccinated unsafe for you or your baby.

Conclusion

The best way to protect yourself and your baby from the flu is to get a yearly flu shot. You should get it during any trimester of pregnancy. It’s safe for you and your baby, and it can help prevent serious complications like pneumonia. Getting vaccinated will also protect your newborn after birth until he or she is old enough to be vaccinated at 6 months of age.

VACCINATIONS AND PREGNANCY

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KEY POINTS

  • Make sure your vaccinations are up to date before you get pregnant.
  • When you do get pregnant, talk to your health care provider about vaccinations that are safe to get during pregnancy.
  • Vaccinations can help protect you from certain infections that can harm you and your baby during pregnancy.
  • Vaccinations you get during pregnancy help keep your baby safe from infection during the first few months of life until he gets his own vaccinations.
  • Pregnant and breastfeeding people who want to get vaccinated against COVID-19 may choose to do so.

What is a vaccination?

A vaccination is a shot that contains a vaccine. A vaccine is a medicine that helps protect you from certain diseases. During pregnancy, vaccinations help protect both you and your baby. Make sure your vaccinations are current before you get pregnant. And talk to your health care provider about vaccinations that are safe to get during pregnancy.

Our vaccination chart shows which routine vaccinations are recommended before and during pregnancy. It’s based on the chart from the Centers for Disease Control and Prevention (also called CDC) shows which vaccinations are recommended before, during and after pregnancy.

Before you get any vaccination, tell your provider if you have any severe allergies or if you’ve ever had a severe allergic reaction to a vaccine. An allergy is a reaction to something you touch, eat or breathe in that makes you sneeze, itch, get a rash or have trouble breathing. For example, some vaccines are made with eggs. If you’re allergic to eggs, those vaccines may cause an allergic reaction for you. If you have allergies, your provider can tell you which vaccines are safe for you. And you may need to get the vaccine at your provider’s office or at a hospital or health clinic so you can get treatment quickly if you have an allergic reaction.

What vaccinations are recommended before pregnancy?

If you’re thinking about getting pregnant, get a preconception checkup. This is a medical checkup you get before pregnancy to help make sure you’re healthy when you get pregnant. At your checkup, ask your provider if you need any vaccinations and how long to wait after getting them to try to get pregnant.

If you have a copy of your vaccination record, share it with your provider. If you don’t have a copy, your provider can do blood tests in most cases to find out what vaccinations you need.

Your provider may recommend these vaccinations before you get pregnant:

  • Flu (also called influenza). Get a flu shot once a year during flu season (October through May). The flu is a serious disease that can cause fever, chills, cough, sore throat, body aches, vomiting and diarrhea. Getting the flu when you’re pregnant increases your risk of preterm labor and preterm birth (labor and birth before 37 weeks of pregnancy). Babies born prematurely may have more health problems and may need to stay in the hospital longer than babies born later. The flu shot is safe to get before and during pregnancy.

    There are many different flu viruses, and they’re always changing. Each year a new flu vaccine is made to protect against three or four flu viruses that scientists think are going to be most common during the upcoming flu season.
  • HPV (stands for human papillomavirus). HPV is the most common sexually transmitted infection (also called STI, sexually transmitted disease or STD) in this country. An STI is an infection you can get from having unprotected sex or intimate physical contact with someone who is infected. HPV can cause genital warts or cervical cancer. You can’t get the HPV vaccine during pregnancy, so if you need it, get it before you get pregnant.
  • MMR (stands for measles, mumps and rubella). You probably got the MMR vaccine as a child, but you may need a booster shot (another dose) as you get older. Before you get pregnant, ask your health care provider for a blood test to see if you’re immune to measles, mumps and rubella. If you do get a booster shot, get another blood test after the shot to check your immunity again before you get pregnant. Wait 4 weeks after you get an MMR vaccination before you get pregnant.

    Measles spreads easily and can cause rash, cough and fever. It can be harmful during pregnancy and can cause miscarriage. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Mumps can cause fever, headache and swollen glands in the face and neck. Rubella can cause mild flu-like symptoms and a rash. It can cause serious problems during pregnancy, like miscarriage, stillbirth, premature birth or congenital rubella syndrome (also called CRS). Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy. CRS may cause a baby to be born with one or more birth defects, including heart defects, vision problems and hearing problems.
  • Varicella (also called chickenpox). Chickenpox spreads easily and can cause itchy skin, rash and fever. If you get chickenpox during pregnancy, it can cause birth defects. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works. If you’re thinking about getting pregnant and haven’t had chickenpox or been vaccinated for it, tell your provider. This vaccination isn’t safe to get during pregnancy. If you need it, get it before you get pregnant. Wait 1 month after you get this vaccination to get pregnant.
  • Other vaccinations. Your provider may recommend vaccinations to protect you against other diseases, depending on your risk. These include: 
    • Pneumonia. This is an infection in one or both lungs.
    • Meningitis. This is an infection that causes swelling in the brain and spinal cord.
    • Hepatitis A and B. These are liver infections caused by the hepatitis A and B viruses.
    • Haemophilus Influenzae Type b (also called Hib). This is a serious disease caused by bacteria. It can cause meningitis, pneumonia, other serious infections and death. Bacteria are tiny organisms that live in and around your body. Some bacteria are good for your body, and others can make you sick.
    • Tdap (stands for tetanus, diphtheria, and pertussis). Pertussis also is called whooping cough. In some cases, providers recommend a Td vaccination, which protects against tetanus and diphtheria but not pertussis. Ask your provider what’s best for you.
    • COVID-19 vaccine. Coronavirus disease 2019, also called COVID-19, is a new disease caused by  severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pregnant people are at increased risk for severe illness from COVID-19. The Advisory Committee on Immunization Practices (ACIP) has recommended that the COVID-19 vaccines currently approved for emergency use can be used in people ages 16-18 and older for the prevention of COVID-19.

What vaccinations are recommended during pregnancy?

The CDC recommends two vaccinations during pregnancy:

  1. Flu shot if you weren’t vaccinated before pregnancy.
  2. Tdap vaccine as early as possible between 27 and 36 weeks of pregnancy. Getting the Tdap vaccine during pregnancy helps protect your baby from pertussis in the first few months of life before she gets vaccinated herself. The first few months after birth are when your baby’s most at risk of getting pertussis and when pertussis is most dangerous. Get a new Tdap vaccine during every pregnancy.

If your provider thinks you may be at risk, he may recommend vaccinations during pregnancy to help protect you from:

  • Hepatitis A and B
  • Meningitis
  • Pneumonia
  • Tetanus and diphtheria (Td vaccination), although the Tdap vaccination is recommended.

If you’re at high risk for serious infections because of travel outside the United States or other possible exposure, your provider may recommend these vaccinations during pregnancy:

  • Anthrax. This is a rare disease caused by bacteria. It can be found in soil, and people can get very sick when they come in contact with it. It’s not passed from person to person.
  • Japanese encephalitis. You can get the Japanese encephalitis virus from a bite from an infected mosquito. This disease can cause swelling of the brain. It kills 1 in 4 people who get infected.
  • Polio. This is a disease is caused by a virus that infects the central nervous system (brain and spinal cord). It can cause lasting disabilities.
  • Rabies. You get rabies from a bite from an infected animal. If you’re bitten by an animal with rabies, call your health care provider right away. Rabies is a serious disease that can cause death if it’s not treated immediately.  
  • Typhoid (also called typhoid fever). Typhoid fever is serious and common in most of the world. You can get it from food and water. It can cause high fever. In rare cases, it can cause internal bleeding (bleeding inside your body) and death.
  • Vaccinia (for smallpox). Smallpox is a disease caused by a virus. It can spread from person to person, causing a rash and sometimes death. You don’t need this vaccination unless you’ve been exposed to smallpox, which isn’t likely. Because of vaccinations, there have been no cases of smallpox in the United States since 1949 and in the world since 1977. If you think you’ve been exposed, tell your provider.
  • Yellow fever. This disease is caused by a virus and spread by infected mosquitoes. In some cases, it causes high fever, bleeding, organ failure and death.
  • COVID-19. According to the CDC, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), pregnant and breastfeeding people may choose to get the COVID-19 vaccine when it’s available to them.

Can you get a COVID-19 vaccine with other vaccines?

The CDC is learning more about how safe and effective the COVID-19 vaccine is when it’s given at the same time as other vaccines, such as the flu or Tdap vaccine. The CDC currently recommends:

  • That you wait at least 14 days after getting the COVID-19 vaccine to get any other vaccine.
  • That you wait at least 14 days before getting a COVID-19 vaccine after getting other vaccines.
  • That you complete your vaccinations on schedule even if you’ve gotten a COVID-19 vaccine.

What vaccinations are not recommended during pregnancy?

These vaccinations are not recommended during pregnancy:

  • BCG for tuberculosis. Tuberculosis is caused by bacteria that usually infects the lungs.
  • HPV
  • MMR
  • Varicella
  • Zoster to protect you against shingles, which causes a painful rash

If you had any of these vaccinations before you knew you were pregnant, tell your provider.

What vaccinations are recommended after pregnancy?

If you haven’t caught up on vaccinations before or during pregnancy, do it after your baby’s born. This can help protect you from diseases in future pregnancies.

If you didn’t get the Tdap vaccine before or during pregnancy, get it right after you give birth. It takes your body 2 weeks to build up protection after getting vaccinated. Once that happens, you’re less likely to pass pertussis to your baby. Your baby gets his first pertussis vaccination at 2 months old. Until then, the best way to protect him is to get vaccinated yourself and keep him away from people who may have pertussis. Care givers, close friends, relatives and anyone else who spends time with your baby should get a Tdap vaccine at least 2 weeks before meeting your baby.

Your provider may recommend other vaccinations after you give birth. Most babies don’t start getting most vaccinations until they’re 2 months old. By getting vaccinated, you can help keep from getting sick and passing an illness to your baby.

If you’re breastfeeding, most vaccinations are safe for you and your baby. Tell your provider you’re breastfeeding before you get any vaccination to make sure it’s safe.

Do vaccinations cause autism spectrum disorder?

No. Vaccinations do not cause autism spectrum disorder (also called ASD). ASD is a developmental disability that can cause major social, communication and behavior challenges.

Which Vaccine is Contraindicated in Pregnancy

An essential component of preventative health care, immunization reduces the incidence and severity of vaccine-preventable diseases. [1Pregnant women and neonates are particularly vulnerable to infectious disease due to altered and underdeveloped immune responses. Vaccination in pregnancy provides maternal protection through active immunization, while passive maternal antibody transfer across the placenta to the developing fetus has the potential to protect neonates and infants. [2 In 2008, the Advisory Committee on Immunization Practices (ACIP) established general principles on the immunization of pregnant and breastfeeding women and cited the following rationale for maternal immunizations: a) to protect the mother b) to protect the fetus c) to protect the neonate or d) to protect the young infant. [3 Growing evidence on the safety and efficacy of influenza and tetanus, diphtheria, and pertussis (Tdap) immunizations in pregnancy has highlighted maternal immunization as an important strategy to reduce morbidity and mortality in women and newborns. [45678]

All women, including women of reproductive age, should have their immunization history and eligibility assessed to ensure they have been immunized according to current Centers for Disease Control (CDC) adult immunization schedules, which are approved yearly by the ACIP. [1, 9]  Although recommended routine adult immunizations are ideally administered prior to pregnancy, pregnant women should receive appropriate vaccines as indicated by age or risk factor.

Immunization Schedule

This schedule of recommended immunizations may vary depending upon where you live, your child’s health, the type of vaccine, and the vaccines available.

Some of the vaccines may be given as part of a combination vaccine so that a child gets fewer shots. Talk with your doctor about which vaccines your kids need.

Birth

  • HepB: Hepatitis B vaccine. Ideally, the first dose is given within 12–24 hours of birth, but kids not previously immunized can get it at any age. Some low birth weight infants will get it at 1 month or when they’re discharged from the hospital.

1–2 months

  • HepB: Second dose should be given 1 to 2 months after the first dose.

2 months

  • DTaP: Diphtheria, tetanus, and acellular pertussis vaccine
  • Hib: Haemophilus influenzae type b vaccine
  • IPV: Inactivated poliovirus vaccine
  • PCV: Pneumococcal conjugate vaccine
  • RV: Rotavirus vaccine

4 months

  • DTaP
  • Hib
  • IPV
  • PCV
  • RV

6 months

  • DTaP
  • Hib: This third dose may be needed, depending on the brand of vaccine used in previous Hib immunizations.
  • PCV
  • RV: This third dose may be needed, depending on the brand of vaccine used in previous RV immunizations.

6 months and annually

  • Influenza (Flu): The flu vaccine is recommended every year for children 6 months and older:
    • Kids younger than 9 who get the flu vaccine for the first time (or who have only had one dose before July 2021) will get it in 2 separate doses at least a month apart.
    • Those younger than 9 who have had at least 2 doses of flu vaccine previously (before July 2021) will only need 1 dose.
    • Kids older than 9 need only 1 dose.
  • The vaccine is given by injection with a needle (the flu shot) or by nasal spray. Both types of vaccine can be used this flu season (2021–2022) because they seem to work equally well. Your doctor will recommend which to use based on your child’s age and general health. The nasal spray is only for healthy people ages 2–49. People with weak immune systems or some health conditions (such as asthma) and pregnant women should not get the nasal spray vaccine.

6–18 months

  • HepB
  • IPV

12–15 months

  • Hib
  • MMR: Measles, mumps, and rubella (German measles) vaccine. Sometimes given together with the varicella vaccine and called MMRV.
  • PCV
  • Varicella (chickenpox)

12–23 months

  • HepA: Hepatitis A vaccine; given as 2 shots at least 6 months apart

15–18 months

  • DTaP

4–6 years

  • DTaP
  • MMR
  • IPV
  • Varicella

9–16 years

  • Dengue vaccine: This vaccine is given in 3 doses to children who have already had dengue fever and who live in areas where it is common (such as Puerto Rico, American Samoa, and the U.S. Virgin Islands). 

11–12 years

  • HPV: Human papillomavirus vaccine, given in 2 shots over a 6- to 12-month period. It can be given as early as age 9. For teens and young adults (ages 15–26), it is given in 3 shots over 6 months. It’s recommended for both girls and boys to prevent genital warts and some types of cancer.
  • Tdap: Tetanus, diphtheria, and pertussis booster. Also recommended during each pregnancy a woman has.
  • MenACWYMeningococcal vaccine. Protects against meningococcal bacteria types A, C, W, and Y. A booster dose is recommended at age 16.

16–18 years

  • MenBMeningococcal vaccine. Protects against meningococcal bacterium type B. The MenB vaccine may be given to kids and teens in 2 or 3 doses, depending on the brand. Unlike the meningococcal conjugate vaccine, which is recommended for all, the decision to get the MenB vaccine is made by the teens, their parents, and the doctor. It is only recommended as routine for kids 10 years and older who have specific conditions that weaken their immune system, or during an outbreak.

Other Things to Know

  • The HepA vaccine can be given as early as 6 months of age to babies who will travel to a place where hepatitis A is common (they will still need routine vaccination after their first birthday). It’s also recommended for older kids who did not get it in the past.
  • The MMR vaccine can be given to babies as young as 6 months old if they will be traveling internationally. These children should still get the recommended routine doses at 12–15 months and 4–6 years of age, but can get the second dose as early as 4 weeks after the first if they will still be traveling and at risk.
  • The flu vaccine is especially important for kids who are at risk for health problems from the flu. High-risk groups include, but aren’t limited to, kids younger than 5 years old and those with chronic medical conditions, such as asthma, heart problems, sickle cell disease, diabetes, or HIV.
  • Pneumococcal vaccines can be given to older kids (age 2 and up) who have conditions that affect their immune systems, such as asplenia or HIV infection, or other conditions, like a cochlear implant, chronic heart disease, or chronic lung disease.
  • The meningococcal vaccines can be given to kids as young as 8 weeks old (depending on the vaccine brand) who are at risk for a meningococcal infection, such as meningitis. This includes children with some immune disorders. Kids who live in (or will travel to) countries where meningitis is common, or where there is an outbreak, also should get the vaccine.
  • Safe and effective COVID-19 vaccines are available for adults and all children ages 5 and older. Booster shots are recommended for adults and kids 12 and older. Everyone who is eligible should get the COVID-19 vaccine and booster shot as soon as possible.

Note: An outbreak is when a disease happens in greater numbers than expected in a particular area. If you have questions about vaccinating your family during an outbreak, ask your health care provider or contact your state or local health department.

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