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Vaccines in pregnancy - Vaccinations in Pregnancy – Information for health and social care professionals 

Background

Vaccinations save lives and are one of the most effective public health interventions globally.  

Vaccination during pregnancy marks the beginning of a baby’s immunisation journey. It is a safe and effective way to help protect both mother and baby from the risk of vaccine preventable diseases. This protection extends from pregnancy and into the baby’s first few weeks of life before beginning routine vaccinations at eight weeks of age. 

Midwives, obstetricians and other health and social care professionals play a key role as trusted voices in maternity care and have a valuable opportunity to support vaccination in pregnancy. By sharing clear, reliable information and supporting access to vaccination, they help pregnant women and their families make informed decisions to protect their health.  

Recommended vaccines should be offered as soon as a woman becomes eligible to help ensure best protection for her and her baby. However, if a vaccine is missed at the recommended time, it may still be available later. Every effort should be made to identify eligible women and support women who have missed vaccinations.  

Why vaccinate during pregnancy? 

During pregnancy, the immune system undergoes changes to support the development of the baby. These changes can make the mother more vulnerable to infection during pregnancy. This can negatively impact both the mother and the baby.  

Vaccination during pregnancy can help by: 

  • Preventing the mother from serious illness or death caused by infectious diseases. 
  • Preventing poor pregnancy and foetal outcomes, such as premature birth and low birth weight, linked to infectious diseases.  
  • Providing passive immunity to the baby, as antibodies from the mother pass through the placenta, helping to protect babies during the first weeks of life. 

Vaccines recommended in pregnancy: 

In Wales, three vaccinations are routinely offered during pregnancy.  
Vaccine  When is the vaccine offered 
Pertussis (whooping cough)  Offered from 16 weeks gestation.   
 
See ‘Pertussis (whooping cough) vaccine’ for more information.    
Respiratory syncytial virus (RSV) Offered from 28 weeks gestation.   
 
See ‘Respiratory syncytial virus (RSV) vaccine’ for more information.  
Influenza (flu) Offered during flu season, between September 2026 and March 2027. Vaccination is recommended at any stage of pregnancy.  
 
See ‘Influenza (flu) vaccine’ for more information.  

Please see below for guidance on vaccination late in pregnancy. 

Please note that, COVID-19 vaccination is no longer routinely offered to pregnant women unless they are immunosuppressed due to disease or treatment. More information about this is available in the JCVI statement on COVID-19 vaccination (external site). 

Pertussis (whooping cough) vaccine

Pertussis (whooping cough) typically circulates during the autumn, but the vaccine is offered year-round. It should be offered in each pregnancy. The vaccine is recommended from 16 to 32 weeks gestation.  

The recommended vaccine for pertussis is a combined vaccine that protects against tetanus and diphtheria too.  

Pertussis most commonly affects babies, and very young babies under the age of 6 months are at highest risk of serious complications, hospitalisation, or death. Maternal vaccination against pertussis protects babies until they receive a pertussis-containing vaccine at 8 weeks of age.  

The vaccine protects babies by boosting pertussis immunity in pregnant women, enabling the transfer of pertussis antibodies across the placenta to the baby before birth. Although most women will have been vaccinated, or exposed to, natural pertussis in childhood, receiving a pertussis-containing vaccine from week 16 of pregnancy will boost their antibody levels. 

The vaccine is recommended to be given before 32 weeks of pregnancy to maximise the likelihood that the baby will be protected from birth. However, vaccination can still be given later in pregnancy and up to 8 weeks postpartum. While this may not provide as much protection to the baby, particularly if the baby is born prematurely, it still offers direct protection to the mother, reducing the risk of passing the infection to the baby. 

For more information about the pertussis vaccine, including disease background and details about the vaccine, visit Pertussis (whooping cough) vaccination – Information for health professionals – Public Health Wales.

Respiratory syncytial virus (RSV) vaccine

Respiratory syncytial virus (RSV) infection occurs in autumn and winter, but the vaccine is offered year-round. It should be offered in each pregnancy.  

While RSV can occur at any age, babies under one year of age are at the greatest risk of severe illness and hospitalisation. This includes bronchiolitis, which is inflammation and narrowing of the small airways in the lungs. Bronchiolitis can cause breathing and feeding difficulties. 

The vaccine is recommended from 28 to 36 weeks gestation. This allows sufficient time for the mother to produce high levels of antibodies and for these to transfer across the placenta, including if the baby is born prematurely. However, the vaccine can be given up to discharge from midwifery services. 

Women can still receive the vaccine later in pregnancy, including after 36 weeks of pregnancy, although this may provide lower levels of passive protection to the baby. Vaccines given to the mother close to delivery, including soon after delivery, may still offer indirect protection by preventing maternal infection and by allowing antibodies to transfer through breastmilk.  

For more information the RSV vaccine, including disease background and details about the vaccine, visit Respiratory syncytial virus (RSV) vaccination information – Public Health Wales 

Influenza (flu) vaccine

The influenza (flu) vaccine protects against seasonal flu. The flu vaccine is recommended during the flu season, between September and March for the 2026-27 flu season. It can safely be given at any stage of pregnancy and should be offered in each pregnancy.  

Flu infection during pregnancy is linked to increased risks of perinatal death, premature birth, low birth weight, and smaller infant size, as well as serious complications and intensive care admission for both mother and baby. 

 

Inactivated influenza vaccines are recommended during pregnancy. However, a study of inadvertent administration of Live Attenuated Influenza Vaccine (LAIV) to pregnant women showed no evidence of harm. The viruses in LAIV are weakened and adapted to replicate only in the cooler temperatures of the nose, so they cannot multiply effectively elsewhere in the body. As a result, there is no theoretical risk to the unborn baby or the mother. However, inactivated vaccines remain the preferred option during pregnancy. 

For more information about the flu vaccine, including disease background and details about the vaccine, visit Influenza (flu) – Information for health and social care workers eligible for the vaccine – Public Health Wales.

Can vaccines in pregnancy be co-administered? 

Yes. The recommended maternal vaccines for pertussis, RSV and flu can be co-administered if needed.  

Pregnant women who are eligible for COVID-19 vaccination because they are immunosuppressed (due to disease or treatment) can receive the COVID-19 vaccine at the same time as the other recommended vaccines in pregnancy.  

Some evidence suggests that giving RSV at the same time as pertussis-containing vaccines may reduce the immune response to the pertussis components. However, the clinical significance is unclear and impact on protection is likely to be small.  

To optimise the immune response, vaccines should be given at their recommended times where possible, to avoid potential weakening of antibody response. However, if a pregnant woman has not received a pertussis vaccine by the time she presents for the RSV vaccine they can, and should, be given at the same time. 

Is breastfeeding after maternal vaccination safe? 

All recommended maternal vaccines can safely be given to women who are breastfeeding.  

The antibodies produced through vaccination may be passed to the baby, providing protection against pertussis, RSV, and flu.  

Women should not stop breastfeeding before their vaccination and can continue to breastfeed following vaccination.  

Safety of maternal vaccines 

Maternal vaccines offered in Wales follow national and international evidence-based recommendations. They are safe to give in pregnancy and have undergone rigorous and thorough testing for safety by the Medicines and Healthcare products Regulatory Agency (MHRA) (external site). They do not contain live viruses, so they cannot cause the diseases they are protecting against.  

Side effects are usually mild and only last a few days. For more information about side effects see:  

Vaccination before and after pregnancy 

Health and social care professionals are recommended to consider the impact of vaccine preventable diseases before as well as during pregnancy.  

At every appropriate opportunity, women of childbearing age who are planning pregnancy or undergoing fertility treatment should have their vaccination history reviewed to ensure they have received two doses of an MMR-containing vaccine, given at least 4 weeks apart. Women without documented evidence of two doses should be offered MMR-containing vaccination before pregnancy.  

For further information about MMR-containing vaccines see MMR vaccine information for HCP – Public Health Wales.

Some pregnant women and newborn babies may be eligible for additional vaccines to protect them against serious infections. This may include:  

  • Hepatitis B for pregnant women who are at high risk of hepatitis B infection and for babies born to mothers with hepatitis B infection, and   
  • BCG for babies at increased risk of exposure to tuberculosis (TB).   

Healthcare professionals should identify eligible infants and ensure vaccination is offered in line with national recommendations. 

Guidance 

Green Book chapters 

‘Immunisation Against Infectious Disease,’ also known as The Green Book, provides information on vaccines for vaccine preventable diseases. You can read the relevant chapters at Immunisation against infectious disease (external site).

Joint Committee on Vaccination and Immunisation (JCVI) 

The Joint Committee on Vaccination and Immunisation (JCVI) is an expert scientific advisory committee, which advises the UK government on vaccination and immunisation matters. Read JCVI publications and statements at Joint Committee on Vaccination and Immunisation (external site).

Welsh Health Circulars and Welsh Government letters  

Welsh Health Circulars provide guidance and instructions to health and care organisations in Wales on various aspects of healthcare delivery and policy. Read publications at Health circulars: 2024 to 2027 (external site).

Make Every Contact Count (MECC) 

Using the Making Every Contact Count (MECC) approach can support conversations about vaccination during pregnancy. MECC is an approach to behaviour change that encourages professionals to have meaningful conversations with patients about their health and wellbeing. This includes supporting patients to make positive choices for their health and wellbeing, such as decisions about vaccination. 

For more information about MECC, go to Making Every Contact Count – Public Health Wales.

Other sources of information and guidance 

Clinical resources and information 

Public Health Wales provides a range of materials to support conversations about vaccination in pregnancy including leaflets, posters, and videos. 

Training resources and events 

Online courses and training materials can be accessed via the  E-learning page.  

Further immunisation training information and resources are provided on the Training Resources and Events page.  

If you are new to immunising you will need to complete the Immunisation programme for new immunisers, available at Immunisation eLearning and Appendix A: Vaccinator competency assessment tool (external site).

Local contacts

You can find support locally via local vaccine teams. For vaccine contacts in your health board, visit Vaccine contacts.

Data and surveillance

Page last reviewed: 20th August 2026