Vaccination

Can I get vaccinated while I’m pregnant? 

There are two types of vaccines: 

• Inactivated vaccines (such as influenza and Tdap), which contain killed bacteria or viruses that cannot cause a disease; and 

• Live–attenuated vaccines (such as varicella and measles, mumps, rubella) which contain weakened bacteria or viruses that cannot cause a disease in healthy people. 

Inactivated vaccines are considered safe to use in pregnancy. Live-attenuated vaccines are not recommended during pregnancy due to the potential of some risk to the developing baby. If possible, you should get these vaccines at least 4 weeks before becoming pregnant. In rare cases, such as during an outbreak (increased risk of an infection in the area at the time), it may be safer to get one of these vaccines than to risk infection. Your health care provider will review your immunization status and recommend a strategy to make sure you are up to date with all of your vaccines.  

Immunization is very safe. Some common side effects of immunization include pain, redness, and swelling of the injection site, muscle or joint pain, fever, and/or chills. Many people do not experience any side effects. Severe side effects related to immunization, like anaphylaxis (severe allergic reaction), are extremely rare. 

Which vaccines should I get while I’m pregnant? 

The following vaccinations are recommended for all pregnant women: the COVID-19 vaccine, the tetanus, diphtheria, pertussis (Tdap) vaccine and the influenza (flu) vaccine.  

COVID-19 Vaccination

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Tetanus, Diphtheria, Pertussis (Tdap) Vaccine 

All pregnant women, regardless of vaccination history, should receive the Tdap vaccine between 21 and 32 weeks of gestation in each pregnancy. This vaccine protects against tetanus, diphtheria, and pertussis (whooping cough) and is safe to receive during pregnancy. Whooping cough is a very contagious illness that poses a serious risk to young babies. Once you are vaccinated, your body will make antibodies (allows your body to defend against the illness) against whooping cough that are passed on to your developing baby, providing protection until they are able to receive their own vaccine at two months of age. Since the amount of whooping cough antibodies in your body decreases over time, you should be vaccinated with Tdap in every pregnancy.  

Influenza (Flu) Vaccine 

Pregnant women should get a flu shot during flu season. Symptoms of the flu tend to be more severe during pregnancy, and can be harmful to a developing baby. Women who get the flu during pregnancy are also at higher risk of serious complications, making it even more important to get vaccinated. The flu shot is safe for use in pregnancy, and is the single best way to help protect yourself and your baby from the flu. Once you are vaccinated, your body will make antibodies against the flu that are passed along to your developing baby, providing some protection until they are able to receive their own vaccine at six months of age. Basic preventive and healthy measures like washing your hands and avoiding contact with people who are sick are also important. If you do get the flu during pregnancy, you should be treated with an anti-viral medication like oseltamivir (Tamiflu®).  

There is lots of evidence to support the safety of the flu shot during pregnancy. However, the live-attenuated nasal spray flu vaccine (FluMist®) is not recommended during pregnancy due to the potential risk to the developing baby. Some studies have shown an extremely small risk (about 1-2 cases per million people vaccinated) of Guillain-Barré syndrome following influenza immunization.  

Some people have concerns about the preservative thimerosal that is used in small amounts in the flu vaccine to prevent contamination. Thimerosal in the flu vaccine is not harmful to the human body.  

It is also important that people who are often in contact with pregnant women and infants, including family members, are up to date on their vaccinations.  

What about other vaccines? 

While not routinely given during pregnancy, your health care provider may recommend other immunizations if you are at higher risk of getting certain diseases. These include the vaccines against hepatitis B, meningococcal infection, rabies, and polio. These vaccines are safe to get during pregnancy. Some travel vaccines are also recommended during pregnancy (see below). 

The vaccines against human papillomavirus (HPV), measles, mumps, and rubella (MMR), chicken pox, shingles, and tuberculosis (TB) are not recommended during pregnancy due to lack of safety data and/or potential risk to the developing baby. However, the decision to terminate a pregnancy should not be based only on receiving these immunizations during pregnancy (for instance, before you knew you were pregnant). 

What about travel vaccines? 

If you are planning to travel to another country while pregnant, your health care provider can help you determine which travel vaccines you may need. The immunizations against hepatitis A and typhoid fever (inactivated formulation only) are recommended during pregnancy if you are travelling to a country where these infections are common. You may also want to consult the government of Canada’s travel health and safety tool to find out which immunizations are recommended for the country to which you plan to travel, and discuss these with your health care provider.    

Some countries have specific entrance requirements that include immunization against yellow fever. In some cases, this requirement is put in place as a precaution because of outbreaks of yellow fever in neighbouring countries. If you are travelling while pregnant to a country with an entrance requirement of immunization against yellow fever, but where the disease is not endemic (disease is very common in this area), your health care provider can give you a letter of exemption, meaning you may not have to get the vaccine at this time. The yellow fever vaccine is not generally recommended in pregnancy, unless there is an outbreak and the risk of infection is high.   

In general, only inactivated vaccines are considered safe for use in pregnancy. In rare cases, if you are at very high risk of getting an infection (e.g. yellow fever) that could be extremely harmful to your health or to the health of your baby, a live-attenuated vaccine may be recommended. In such a situation, your health care provider can help you decide if the real risk of getting the disease outweighs the potential risk of harm from the vaccine.  

The table below provides a good summary of vaccines and pregnancy.