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Vaccinations in pregnancy - Vaccination information in pregnancy for health and social care professionals

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

Background

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

Midwives and other health and social care professionals play a key role as trusted voices in maternity care. They are important sources of information and are central to promoting maternal vaccination and supporting pregnant women and their families to make informed decisions. 

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

Why vaccinate during pregnancy? 

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

Vaccination during pregnancy can help by: 

  • Preventing maternal morbidity and mortality by protecting 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.

Information:

Please note that from Autumn 2025, COVID-19 vaccination is no longer 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.
Vaccine  When is the vaccine offered 
Whooping cough (pertussis)  Offered from 16 weeks. 

See ‘Pertussis (whooping cough) vaccine’ below for more information. 
RSV (respiratory syncytial virus) Offered from 28 weeks. 

See ‘Respiratory syncytial virus (RSV) vaccine’ below for more information.  
Flu (influenza virus)  Offered during flu season, between September and March.

See ‘Influenza (flu) vaccine’ below for more information. 
Pertussis (whooping cough) vaccine

The pertussis (whooping cough) vaccine protects against pertussis and is offered year-round. It should be offered with each pregnancy.

The pertussis 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, which enables the mother to transfer pertussis antibodies across the placenta to her 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 their 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, especially if they are 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 about the vaccine, visit the whooping cough vaccine information for health and social care professionals page.

Respiratory syncytial virus (RSV) vaccine

The respiratory syncytial virus (RSV) vaccine protects against RSV infection and is offered year-round. It should be offered in each pregnancy.

The vaccine is recommended between 28 and 36 weeks gestation but can be given up to discharge from midwifery services.

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 the inflammation and narrowing of the small airways in the lungs which can cause breathing and feeding difficulties.

The RSV vaccine is recommended in week 28 or soon after. 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.

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 about the vaccine, visit the RSV vaccine information for health professionals page.

Influenza (flu) vaccine 

The influenza (flu) vaccine protects against seasonal flu. The flu vaccine is recommended during the flu season, between September and March. The vaccine can safely be given at any gestation 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 in pregnancy. However, a study of inadvertent Live Attenuated Influenza Vaccine (LAIV) administration 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 about the vaccine, visit the flu vaccine guidance for health and care professionals page.

Can vaccines in pregnancy be co-administered? 

Yes, recommended maternal vaccination of 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 response made 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). 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. 

Guidance 

All healthcare professionals involved in maternity care have an opportunity to make a difference by supporting vaccination in pregnancy. By sharing clear, trusted information and supporting access to vaccination, professionals can play a vital role in protecting the health of mothers and their babies. 

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.

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.

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.

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 having meaningful conversations about making positive choices about their health and wellbeing, including decisions about vaccination. 

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. 

Maternal vaccines poster for midwives

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.   

Local contacts  

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

Data and surveillance

Page last reviewed: 15th May 2026