The Importance of Vaccinations and Immunity and Your Pregnancy

By Joanne Stone, Keith Eddleman, Mary Duenwald

People are immune to all kinds of infections, for one of two reasons: They’ve suffered through the disease, or they’ve been vaccinated. Many vaccines are safe, and in fact recommended, while you’re pregnant. (See the table for information on several vaccines.)

Safe and Unsafe Vaccines before or during Pregnancy
Disease Risk of Vaccine to Baby during Pregnancy Immunization Recommendations Comments
Cholera None confirmed Same as in nonpregnant women
Hepatitis A (inactivated) None confirmed Okay if high risk for infection or for prevention due to recent
exposure
Hepatitis B None confirmed Okay if high risk for infection Used with immunoglobulins for acute exposure; newborns need
vaccine
Human papilloma virus None confirmed, but little data If found to be pregnant after initiating series, give remaining
doses postpartum
Influenza (inactivated) None confirmed Recommended
Measles None confirmed No Vaccinate postpartum
Mumps None confirmed No Vaccinate postpartum
Plague None confirmed Selected vaccination if exposed
Pneumococcus None confirmed Okay if high risk
Poliomyelitis None confirmed Only if exposed Get if traveling to endemic area
Rubella None confirmed No Vaccinate postpartum
Rabies Unknown Indication same as for nonpregnant women Consider each case separately
Smallpox Possible miscarriage No, unless emergency situation arises or fetal infection
Tetanus, diphtheria, and pertussus (Tdap) None confirmed Recommended for each pregnancy between 27 and 36 weeks
Typhoid None confirmed Only for close, continued exposure or travel to endemic
area
Varicella (chicken pox) None confirmed Immunoglobulins recommended in exposed nonimmune women; should
be given to newborn if around time of delivery
If nonimmune, vaccinate postpartum (second dose four to eight
weeks later)
Yellow fever Unknown No, unless exposure is unavoidable

Here is some further information on some common vaccinations:

  • Rubella: Your practitioner tests to see whether you’re immune to rubella (also known as German measles) by drawing a sample of blood and checking to see whether it contains antibodies to the rubella virus. (Antibodies are immune system agents that protect you against infections.)

    If you are not immune to rubella, your practitioner is likely to recommend that you be vaccinated against rubella at least three months before becoming pregnant. Getting pregnant before the three months are over is highly unlikely to be a problem. No cases have been reported of babies born with problems due to the mother having received the rubella vaccine in early pregnancy.

    If you are already pregnant when you learn that you are not immune to rubella, your practitioner will recommend that you get the vaccine after you deliver your baby, just before you go home from the hospital.

  • Flu: The influenza vaccine is safe and recommended during pregnancy. Pregnant women who get the flu are at increased risk of complications as a result of it. The vaccine poses no harm to your developing baby.

  • Tetanus, diphtheria, and pertussis: It is recommended that women get an adult tetanus, diphtheria, and pertussis (Tdap) vaccine during each pregnancy, ideally between weeks 27 and 36 of pregnancy.

  • Measles, mumps, and poliomyelitis: Most people are immune to measles, mumps, and poliomyelitis, and your practitioner is unlikely to check your immunity to all these illnesses. Besides, these illnesses aren’t usually associated with significant adverse effects for the baby.

  • Chicken pox: Chicken pox carries a small risk that the baby can contract the infection from her mother. If you’ve never had chicken pox, tell your practitioner so you can discuss possible vaccination before you get pregnant, or if you are already pregnant, after delivery before you go home.

  • Human papilloma virus: Vaccines are available for the human papilloma virus (HPV), which is associated with some kinds of abnormal pap smears, genital warts, and cervical cancer. Studies suggest it’s similar to other vaccinations that are safe in pregnancy; however, it is still recommended that you not receive this vaccination during pregnancy.

    If you inadvertently got vaccinated before realizing that you were pregnant, the risk to your developing baby is very low, but you should not get subsequent doses until after delivery.