Pregnancy Immunization Recommendations
Whether your office provides immunizations or you refer out for them, vaccines play an important role in keeping a pregnant woman and her baby healthy before, during, and after pregnancy.
Before becoming pregnant, a woman should be up-to-date on routine adult immunizations. The Centers for Disease Control and Prevention’s Immunizations and Pregnancy Vaccines Chart outlines recommendations that can be used to help assess the immunizations your patient needs. You may want to check if your patient has a yellow immunization record of her immunization history.
Of particular importance are:
- MMR (measles, mumps, rubella)
- influenza – especially important if your patient might be pregnant during flu season but recommended for everyone 6 months of age and older
- hepatitis B if indiciated
Live vaccines (including MMR and varicella) should be given a month or more before pregnancy. Inactivated vaccines can be given before or during pregnancy, as needed. HPV vaccine is recommended through age 26 years. If a woman finds out she is pregnant after she has started getting the HPV vaccine series, she should wait until her pregnancy is over before finishing the three-dose series.
Flu vaccine is recommended for everyone annually. It is safe and, and very important, for a pregnant woman to receive the inactivated flu vaccine. A pregnant woman who gets the flu is at risk for serious complications and hospitalization. Pregnant women should not be vaccinated with live, attenuated influenza vaccine (LAIV), the influenza nasal spray vaccine.
Learn more about pregnancy and influenza vaccine recommendations.
Pertussis (whooping cough)
- Infants too young to be fully immunized are most likely to be hospitalized or die from pertussis.
- Pregnant women should get a pertussis booster shot (Tdap) with EACH pregnancy, irrespective of their prior history of receiving Tdap.
- Immunize between 27 and 36 weeks gestation (at the earliest opportunity during this window) to maximize the transfer of maternal antibody to the infant.
- Infants most often contract pertussis from family members. Make sure that all potential contacts of the newborn are protected against pertussis at least two weeks prior to close contact with the infant.
Learn more about the updated Tdap immunization recommendation during pregnancy, information for providers on Tdap use in pregnant women, guidelines for vaccinating pregnant women and pertussis resources for providers and patients.
Many vaccine-preventable diseases, rarely seen in the United States, are still common in other parts of the world. Information about travel vaccines can be found at CDC’s traveler’s health website.
Some immunizations should be given in the hospital before discharge to protect your patient from diseases that can be dangerous if spread to her newborn or to future babies. It is safe for a woman to receive vaccines right after giving birth, even while she is breastfeeding.
Pertussis (whooping cough) and Influenza
Infants too young to be fully immunized are most likely to be hospitalized or die from pertussis and influenza.
A woman who has not received Tdap for the prevention of tetanus, diphtheria, and pertussis should be vaccinated immediately following delivery. Vaccinating a new mother against pertussis (whooping cough) also reduces the risk to her infant. Learn more about the new Tdap recommendations on preventing tetanus, diphtheria, and pertussis among your pregnant and postpartum patients and their infants.
In order to further protect your patient’s newborn, Tdap and influenza vaccines are needed for anyone who lives with or takes care of a baby.
MMR and Varicella
A woman who is not immune to measles, mumps, or rubella should be vaccinated with MMR before leaving the hospital. Your patient should also receive varicella vaccine before discharge if she does not have evidence of immunity.
If the first-ever dose of MMR or varicella vaccine is given after delivery, then the 2nd doses should be given 4-8 weeks later.
California Vaccines for Children (VFC) Program
CDC's Vaccines for Children (VFC) program helps families by providing vaccines at no cost to doctors who serve eligible children through age 18 years. That way, children can get the routine immunizations they need at little or no out-of-pocket cost to the family.
California Thimerosal (Mercury) Law
The Mercury-Free Act took effect on July 1, 2006. The Act prohibits administering vaccines containing more than traces of thimerosal preservative to pregnant women or to children younger than three years of age. Due to limited supplies of seasonal influenza vaccine, however, an exemption to this law has been granted through June 30, 2013.