Dr. Vaccines
Vaccinations During Pregnancy
Which vaccines protect you and your baby, which must wait until after delivery, and when to have each one.
Pregnancy changes how your immune system behaves, which makes some infections more dangerous than they would otherwise be, influenza in particular carries a higher risk of severe illness during pregnancy. At the same time, antibodies you make cross the placenta, so vaccinating you also protects your baby through their first vulnerable months, before they are old enough for their own vaccines.
The dividing line that matters is live versus inactivated. Inactivated vaccines, toxoids and mRNA vaccines contain nothing that can replicate, and the ones below are given routinely in pregnancy. Live attenuated vaccines are avoided as a precaution, and are given before conception or after delivery instead.
At a glance
Discuss all of these with your obstetrician as well. They will know your specific history.
| Vaccine or test | Status | Schedule | Detail |
|---|---|---|---|
| Tdap (tetanus, diphtheria, pertussis) | Recommended | One dose between 27 and 36 weeks, in every pregnancy | Given in the third trimester specifically so that pertussis antibodies transfer to your baby at the highest possible level. Newborns cannot start their own pertussis vaccines until 6 weeks, and whooping cough is at its most dangerous in exactly that window. A fresh dose is advised in each pregnancy, however close together. |
| Influenza (inactivated) | Recommended | Any trimester, once per flu season | Only the inactivated injectable vaccine is used, not the live nasal spray. Pregnancy raises the risk of severe influenza and hospitalisation, and the antibodies also protect your infant for several months after birth. |
| COVID-19 | Recommended | As per current national guidance | Recommended in pregnancy where indicated. Requirements and available formulations change, so we confirm the current national position at your appointment. |
| Tetanus toxoid / Td | Routine | Per national schedule if Tdap is not being used | The Indian national programme has long included tetanus protection in pregnancy. Tdap is generally preferred where available because it adds pertussis cover, which tetanus toxoid alone does not. |
| Hepatitis B | Conditional | If you are at risk and not already immune | Not a live vaccine and can be given in pregnancy where there is a clear indication, for example a household or occupational exposure risk, or a partner who is positive. |
| MMR (measles, mumps, rubella) | Not advised | Before conception, or immediately after delivery | A live vaccine, so it is avoided during pregnancy. Rubella in early pregnancy can cause serious birth defects, which is why checking rubella immunity before conception is worthwhile. If you are found to be non-immune, the dose is given after delivery. It is safe while breastfeeding. |
| Varicella (chickenpox) | Not advised | Before conception, or after delivery | Also live attenuated. If you have no history of chickenpox, a serology test before conception tells you whether you need it. |
| HPV | Not advised | Postpone remaining doses until after delivery | Not recommended in pregnancy. If you started the course and then conceived, the remaining doses are simply deferred, no intervention is needed and the series does not restart. |
Why the third trimester matters for Tdap
Antibody transfer across the placenta is not constant through pregnancy. It accelerates sharply in the third trimester. Vaccinating between 27 and 36 weeks means your antibody levels peak while that transfer is most efficient, giving your baby the highest starting level of protection.
This is also why the dose is repeated in every pregnancy rather than relying on one given years earlier. Pertussis antibody levels fall over time, and it is the level at the moment of transfer that determines how much your baby receives.
Planning a pregnancy: what to do beforehand
The vaccines that cannot be given during pregnancy are exactly the ones worth sorting out before you conceive. A short pre-conception appointment can save a lot of worry later.
- Check rubella immunity with an MMR serology test, rubella infection in the first trimester is the one with serious consequences for the baby.
- Check varicella immunity if you have never had chickenpox or are unsure.
- Complete a hepatitis B course if you are at risk and not already immune.
- Finish an HPV course if you are within the eligible age range and partway through.
- Allow at least one month between a live vaccine and conception.
Vaccines and breastfeeding
Breastfeeding is not a reason to avoid vaccination. Both inactivated and live vaccines can be given to a mother who is breastfeeding, including MMR and varicella if those were deferred from pregnancy. Yellow fever is the one situation that warrants a specific conversation, and only if you are travelling somewhere that requires it.
If you were vaccinated before you knew you were pregnant
This happens often and is very rarely a problem. Inactivated vaccines carry no concern at all. Even with a live vaccine given inadvertently in early pregnancy, the theoretical risk has not translated into observed harm in follow-up studies, but it is worth telling your obstetrician so it is on record. It is not considered a reason to end a pregnancy.
Frequently asked questions
Which vaccines are safe during pregnancy?
Inactivated vaccines are used routinely: Tdap between 27 and 36 weeks, the inactivated influenza vaccine in any trimester, and COVID-19 vaccination where indicated. Hepatitis B can be given if there is a clear risk. Live vaccines such as MMR and varicella are avoided until after delivery.
When should I get the Tdap vaccine in pregnancy?
Between 27 and 36 weeks, and in every pregnancy. This timing maximises the pertussis antibodies transferred to your baby before birth, covering the gap before they can start their own vaccines at 6 weeks.
Can I have the flu vaccine while pregnant?
Yes: the inactivated injectable influenza vaccine is recommended in any trimester. The live nasal spray formulation is not used in pregnancy. Influenza is more likely to cause severe illness during pregnancy, so this is one of the more clearly beneficial vaccines.
Why can I not have the MMR vaccine while pregnant?
MMR is a live attenuated vaccine, and live vaccines are avoided in pregnancy as a precaution. Because rubella infection in early pregnancy can seriously harm a developing baby, the better approach is to check your rubella immunity before conceiving and vaccinate then if needed.
I had a vaccine before I knew I was pregnant. Should I worry?
Almost certainly not. Inactivated vaccines pose no concern. For live vaccines given inadvertently in early pregnancy, follow-up studies have not shown harm, though you should mention it to your obstetrician so it is documented.
Can I be vaccinated while breastfeeding?
Yes. Breastfeeding does not restrict vaccination, including live vaccines such as MMR and varicella that were deferred during pregnancy. Yellow fever is the one that warrants a specific discussion if travel requires it.
Book your pregnancy vaccination appointment
Our doctors will confirm your Tdap timing, arrange your flu vaccine and check rubella and varicella immunity if you are still planning. Bring any records you have.
Before you rely on this page
This page is general health information, not personal medical advice. Vaccine schedules depend on your age, medical history, pregnancy status, medications and previous immunisations. Our doctors will confirm what is right for you at your appointment. National recommendations are also revised periodically. We review these pages against current Indian and WHO guidance.
Last reviewed: 2026-09-01
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