Is it safe to get vaccinations during pregnancy or breastfeeding?
Getting certain vaccinations during pregnancy or breastfeeding, such as the flu, COVID, RSV, or Hepatitis vaccines, provides increased protection for both the mother and the baby. They help prevent serious illnesses that could otherwise cause significant health problems for both of them. However, expectant mothers must be cautious about getting immunized.
FirstMed’s experienced pediatrician and lactation consultant, Dr. Erika Bodnár, explains the safety and protective benefits of recommended vaccines for pregnant women. Find out which vaccines are beneficial during this pivotal period and which ones to avoid. Gain the knowledge to safeguard your family’s health!
Table of Contents
How do vaccines taken during pregnancy protect the developing babies?
Vertical antibody transfer
The placenta, a vital organ that develops during pregnancy, connects the mother’s blood supply to the fetus’s tissues. Through immunization, immunoglobulin (IgG) antibodies produced by the mother cross the placenta to the fetus. This natural process, called vertical antibody transfer, helps the baby develop immunity to pathogens after birth by providing maternal antibodies, making it a crucial part of immune system development.
Immunoglobulin transfer begins as early as the 13th week of pregnancy, with levels peaking in the third trimester. Between weeks 17 and 22, the fetuses absorb about 5-10% of the maternal IgG, increasing to 50% by weeks 28-32. At birth, fetal IgG can even surpass the mother’s level by 20-30%. This timeline indicates when the baby starts receiving these essential antibodies.
In simple terms, this means that as the baby develops after conception, it begins to receive essential antibodies from the mother that help protect it against infections. Since immunity transfer mainly occurs in the later stages of pregnancy, premature birth may result in lower immunity for the baby. This mechanism underscores the critical role of vaccinations in the baby’s ability to combat disease after birth.
The mother’s vaccination also protects the baby after birth
The newborn’s immune system is underdeveloped in the first months after birth and depends heavily on the mother’s antibodies. Being vaccinated during pregnancy also supports the baby’s health. By boosting maternal antibody levels, these vaccinations provide better protection for the baby against illnesses like seasonal influenza, RSV (respiratory syncytial virus), and pertussis (whooping cough).
Until when is it safe to get vaccinated during pregnancy?
Generally, during pregnancy, certain vaccinations are safe to receive until the 36th week plus 6 days (i.e., before the 37th week), and should not be administered within 2 weeks of childbirth. If you are planning to conceive, try to get the recommended vaccines and catch up on any missed vaccinations beforehand.
This helps to avoid infections and prevent diseases during pregnancy, which can pose a higher risk to the expectant mother and may lead to serious illnesses and developmental abnormalities in the baby.
Vaccination of family members, “nest protection”
Vaccinations can also enhance the protection of family members and their community. Beyond the standard immunizations recommended for particular ages, everyone in the family aged 6 months or older is advised to get the seasonal flu shot. Furthermore, getting protected against whooping cough with a DTap booster is recommended for all family members aged 16 or older, and all family members who are susceptible to chickenpox (i.e., those who have not had chickenpox) should also be vaccinated.
Getting travel vaccinations during pregnancy
Travelling to certain destinations and the vaccinations required to avoid virus infections in these areas may pose risks during pregnancy. When you’re pregnant, avoid traveling to countries or regions that require travel vaccinations, if possible. If you must travel, consult a travel medicine specialist before your trip to ensure the safety of the necessary vaccinations.
How do vaccinations protect when taken after childbirth?
Vaccinations taken shortly after childbirth safeguard mothers and, through breastfeeding, transfer protective antibodies to their infants. This postpartum approach is especially vital for mothers who did not receive the necessary vaccines before or during their pregnancy.
However, keep in mind that protective antibodies don’t form instantly—usually, it takes about 2 weeks after vaccination for the body to produce them. During this period, both mothers and babies are building their own immunity, with the baby beginning to receive their own vaccines to stay protected against serious childhood diseases.
Vaccinations during breastfeeding
During breastfeeding, you can safely receive the recommended vaccinations if you did not receive them during pregnancy, especially the flu shot, the whooping cough vaccine, and the chickenpox vaccine. The sole exception is the yellow fever vaccine, which may be administered only when necessary. On the other hand, your family members can receive the recommended vaccinations while you are pregnant or nursing, adding extra protection for the entire family.
How vaccination during pregnancy protects mom and baby (ECDC Video)
List of vaccinations safe to get during pregnancy and ones to avoid
While some vaccines are strongly recommended during pregnancy, some are discouraged. For general guidance, check the summary table below, but always consult your doctor before receiving any vaccination.
Recommended vaccinations during pregnancy
| Vaccine | Recommendation | Comment |
|---|---|---|
| Influenza | • During the flu season, regardless of the trimester | For every family member over 6 months. |
| Dtap (diphtheria - tetanus - pertussis) | • Recommended in weeks 26-32 (no later than week 36). | Recommended for all family members over 16, every 5 years. |
| Covid-19 | • At any stage of pregnancy.* | For every family member over 6 months. |
| Tetanus | • For post-exposure prophylaxis (in case of potential exposure to infection), at any stage of pregnancy. | Combined dTap-IPV vaccination is recommended. |
| RSV | • Recommended in weeks 24-36 (also possible in 30-32 weeks) | Vertical antibody transport for newborns (i.e. directly from the mother to the baby) |
| Rabies | • For post-exposure prophylaxis, at any stage of pregnancy. | Contraindication: previous anaphylactic reaction to vaccine. |
| Hepatitis-A | • Not recommended routinely.** • Active immunization as post-exposure prophylaxis for epidemiological reasons. • In case of unavoidable travel to an endemic area. | Recommended during family planning. |
| Hepatitis B | • Not recommended routinely. • Active/passive immunization is required for previously unvaccinated pregnant women after exposure to hepatitis B. • In case of prolonged exposure, the vaccination series should be started before pregnancy and completed during pregnancy. | HBsAg screening does not indicate immunity status. |
| Meningococcus | • Not recommended routinely. • In case of unavoidable travel to an endemic area. | For post-exposure prophylaxis, an antibiotic (ceftriaxone) is necessary. |
| Abdominal typhus | • Not recommended routinely. • In case of unavoidable travel to an endemic area. | It can be used as post-exposure prophylaxis for epidemiological reasons. |
| Pneumococcus | • Not recommended routinely. | |
| Polio | • Not recommended routinely. • In case of unavoidable travel to an endemic area. | Use of dTap-IPV is recommended. |
Vaccines to be avoided during pregnancy or breastfeeding
| Vaccine | Recommendation | Comment |
|---|---|---|
| HPV | Not recommended | The vaccination series started before pregnancy should be completed during breastfeeding. |
| Yellow fever | Contraindicated | When traveling to endemic areas, individual consideration is necessary. |
| MMR (against measles, mumps, and rubella) | Contraindicated | Accidental vaccination does not justify the termination of pregnancy |
| Varicella (VZV) | Contraindicated | Accidental vaccination does not justify the termination of pregnancy |
| Japanese encephalitis | Not recommended routinely | When traveling to endemic areas, individual consideration is necessary. |
*Time limit: Any vaccination can be given only until the 36th week of pregnancy.
*Not recommended routinely: Some vaccines, such as those against hepatitis, consist of multiple doses administered at intervals of several months. It is therefore possible that a vaccination series started during pregnancy cannot be completed during this period. (For example, hepatitis B routinely consists of three vaccinations, administered at 0, 1, and 6 months. Hepatitis A consists of two vaccinations, with the second vaccination given 6 months after the first.)
Summary
Vaccinations during pregnancy play a crucial role in safeguarding the health of mothers and their babies. Immunization enhances maternal antibody levels, providing essential protection against various infections even for the newborn. Getting vaccinated before or during pregnancy can protect against common illnesses such as influenza and whooping cough; therefore, specific vaccines are recommended for administration at appropriate stages of pregnancy. Additionally, missed vaccinations can still be safely administered during breastfeeding.
At the same time, we also encourage family members to stay up to date with their immunizations to create a protective environment for the mother and child. During pregnancy, avoid visiting countries that require travel vaccinations; if unavoidable, consult a travel medicine specialist about the risks.
Request the recommended vaccinations at FirstMed in Budapest to enhance your and your baby’s protection against illnesses during pregnancy. If you have any questions, contact us to schedule a consultation with Dr. Erika Bodnár, who is happy to offer personalized advice and guidance regarding vaccinations.
Read more on this topic:
- Vaccination before and during pregnancy – WHO Fact Sheet (downloadable)
- Vaccine Resources for Pregnant Women | Pregnancy & Vaccines | CDC (U.S. Centers of Disease Control and Prevention)
- Oltások a várandósság alatt (Vaccinations during pregnancy) (Healthline – Hungarian National Center for Public Health and Pharmacy, NNGYK)
Edited by: Dorottya Fekete