Vaccination during pregnancy also protects your newborn
Pregnancy is a period when a woman naturally becomes more cautious about everything that enters her body. Vitamins, food, medications – everything goes through more thorough consideration than before. And vaccination? That is a topic capable of sparking heated debates on parenting forums, in gynaecology waiting rooms, and within family circles. Yet precisely when emotions play the greatest role, it is most important to have sober, factual information available. This article does not aim to persuade or frighten – it is simply about what science currently says and what leading health organisations recommend.
The fundamental question troubling many pregnant women is: is it even safe to get vaccinated when I am expecting a child? The answer is neither simple nor straightforward, because it depends on the specific vaccine, the trimester of pregnancy, and the woman's health status. Generally speaking, however, some vaccines are not only permitted during pregnancy but actively recommended – and this is based on extensive clinical data and long-term monitoring.
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What global health organisations say
The World Health Organization (WHO) and the American Centers for Disease Control and Prevention (CDC) are among the most trusted sources in the field of vaccination. Both institutions regularly issue updated recommendations that take into account the latest research. According to current CDC guidelines, vaccines against influenza and pertussis (whooping cough) are routinely recommended during pregnancy, with their timing throughout pregnancy having a rationale supported by immunological data.
The Czech Republic follows WHO recommendations in this area while also issuing its own national vaccination schedule through the Ministry of Health. The Czech Gynaecological and Obstetrical Society also plays a key role, regularly updating its positions. It is therefore important to monitor not only foreign sources but also the domestic expert community, which takes into account the specifics of the Czech population and epidemiological situation.
The topic of vaccination during pregnancy is particularly sensitive because it concerns two individuals simultaneously – the mother and the unborn child. The immune system of a pregnant woman undergoes specific changes that may make her more vulnerable to certain infections. At the same time, antibodies that the mother produces following vaccination can cross the placenta to the foetus and provide protection during the first months of life, when the child cannot yet be vaccinated itself. This mechanism, referred to as passive immunisation of the newborn, is one of the main reasons why doctors under certain conditions not only tolerate but actively recommend vaccination during pregnancy.
The influenza vaccine is probably the best-known and most widely administered vaccine given to pregnant women. Influenza during pregnancy is not merely an unpleasant runny nose and fatigue – it can lead to serious complications such as premature birth or hospitalisation. Inactivated influenza vaccines, meaning those that do not contain a live virus, are considered safe in all trimesters of pregnancy. Conversely, live attenuated vaccines, such as the nasal spray influenza vaccine, are not recommended during pregnancy.
The second pillar of routine vaccination for pregnant women is the vaccine against pertussis, or whooping cough. This disease is extremely dangerous for newborns – their airways are too small and coughing fits can be life-threatening. Because newborns cannot be vaccinated immediately after birth, protection is transferred to them precisely through maternal antibodies. The recommended window for this vaccine is generally between weeks 27 and 36 of pregnancy, when the transfer of antibodies across the placenta is most efficient. The vaccine is administered in the TDaP combination, which simultaneously protects against tetanus and diphtheria.
Which vaccines are unsuitable during pregnancy
Just as important as knowing what is recommended is knowing what to avoid. Live attenuated vaccines are generally contraindicated during pregnancy because there is a theoretical risk that the attenuated virus could cause infection in the foetus. This category includes, for example, the MMR vaccine (measles, mumps, rubella) or the chickenpox vaccine. If a woman is planning to become pregnant and knows she lacks these vaccines or is facing travel to high-risk areas, it is ideal to get vaccinated before conception – and then wait the recommended period before becoming pregnant, which is generally around four weeks.
An interesting case is presented by the hepatitis B vaccine. Although it is inactivated and therefore considered safe during pregnancy, it is only administered when there is a specific risk of infection. The same applies to the hepatitis A or meningococcal vaccines – their administration during pregnancy is discussed individually with a doctor based on the woman's risk profile.
Travel vaccines represent a special chapter. If a pregnant woman is planning travel to tropical regions where yellow fever or Japanese encephalitis pose a threat, she finds herself in a difficult situation – these vaccines are either live or insufficiently researched for pregnant women, yet the diseases themselves can be fatal to the pregnancy. In such cases, thorough consultation with a travel medicine specialist and gynaecologist is always necessary.
It is impossible to overlook how strongly social media and unverified information influence the decision-making of pregnant women. Studies published in the BMJ repeatedly highlight that misinformation about vaccines during pregnancy can lead to preventable complications. As immunologist and science communicator Paul Offit once aptly remarked: "The greatest risk of vaccines is not using them." This statement applies doubly in the context of pregnancy, where the stakes are highest.
A real-life example from practice can illuminate matters better than any statistic. Imagine a woman in her third trimester who hesitates about getting the influenza vaccine because she read on a forum that the vaccine "harms the baby." She ultimately decides not to get vaccinated. Shortly before giving birth, she develops severe influenza, ends up in hospital with complications, and the child is born prematurely. This scenario is not invented – doctors are familiar with similar stories. Meanwhile, vaccination with an inactivated influenza vaccine has decades of safety data behind it and is monitored in extensive registries of pregnant women worldwide.
Decision-making about vaccination during pregnancy should never be based on emotions or forum discussions, but on an individual conversation with an obstetrician or general practitioner. Every woman has a different health status, different travel habits, different contact with potential carriers of disease. What applies to one may not apply to another – and that is precisely the reason why specialists exist.
An interesting question remains how recommendations have evolved in recent years. The COVID-19 pandemic brought new dynamics to the field of vaccination in pregnant women. mRNA vaccines were initially tested predominantly on adult populations excluding pregnant women, which led to uncertainty. Gradually, however, data accumulated from registries such as the CDC's V-safe monitoring system, which showed that mRNA vaccines are safe during pregnancy and even protect newborns through maternal antibodies. This example well illustrates how scientific consensus evolves and how important it is to follow current rather than outdated recommendations.
How to approach the topic practically
If a woman has just found out she is pregnant, or is only planning to become pregnant, it makes sense to conduct a kind of "vaccination audit." This means checking what vaccines are recorded in her vaccination booklet and potentially having antibody levels tested for selected diseases. Rubella is a classic example – if a woman does not have sufficient immunity, the MMR vaccine is administered before conception, not during pregnancy.
During pregnancy itself, the influenza vaccine then comes into play, ideally at the start of the influenza season, and the TDaP vaccine in the third trimester. These two vaccines form the foundation of what the Czech and international expert community recommends to pregnant women as a standard of care. Everything else is addressed individually.
It is also important to mention the so-called "cocoon" or nesting strategy. The idea is that not only the mother, but also the father, grandparents, and other people who will be in close contact with the newborn should have up-to-date vaccination – particularly against pertussis. The newborn is most vulnerable in the first weeks of life, when it has not yet been immunised itself. This strategy has proven to be very effective in preventing serious illness in infants.
Pregnancy is an exceptional period that deserves exceptional care – and this includes informed decisions about vaccination. There is no need to be afraid or to succumb to panic. It is enough to ask your doctor, bring questions to the consultation, and be open to scientifically grounded answers. The good news is that most recommended vaccines during pregnancy have extensive safety data behind them and their benefits significantly outweigh the potential risks. Science in this field does not stand still – and neither should recommendations for pregnant women be accepted once and for all, but rather followed and updated alongside it.
