Vaccines in pregnancy

Whooping cough, flu and RSV vaccines are given at different times in pregnancy. Advice on COVID also differs between countries and organisations. This advice changed recently. Ask your midwife or doctor which recommendations apply where you get care. A vaccine calendar from another country may be different.

Whooping cough: protecting the baby after birth

Whooping cough is also called pertussis. Having the vaccine during pregnancy passes protection to your baby through the placenta. This covers the early weeks before your baby can start their own vaccines. It doesn’t replace your baby’s vaccines.

In the UK, it’s usually offered around the time of your mid-pregnancy scan at 20 weeks, and can be given from 16 weeks. The NHS advises having it before 32 weeks for the best protection. If you’re past that point, ask your maternity team. NHS guidance allows it to be given later.

In the US, CDC recommends the Tdap vaccine in every pregnancy. It’s best given between 27 and 36 weeks, and having it earlier in that window helps pass on as many antibodies as possible. Tdap protects against tetanus, diphtheria and pertussis.

Flu: a seasonal offer at any pregnancy stage

The NHS offers the flu vaccine in autumn or winter, and you’re eligible if you’re pregnant. You can have it at any stage of pregnancy. US CDC guidance also allows the vaccine at any time in pregnancy during flu season. You don’t need to time your flu vaccine around the whooping cough window.

The type of flu vaccine matters. ACOG recommends inactivated or recombinant flu vaccines in pregnancy. CDC guidance says the live flu vaccine isn’t used during pregnancy. Tell the vaccine service you’re pregnant so they can offer a suitable one.

RSV: different UK and US windows

RSV can cause serious breathing illness in babies. Having the vaccine during pregnancy lets protective antibodies pass across the placenta. In the UK, it’s offered all year round, from week 28 or soon after, and again in each pregnancy.

US CDC guidance lists Abrysvo during weeks 32 – 36 of pregnancy, between September and January in most of the mainland US. It doesn’t currently recommend having the RSV vaccine again in later pregnancies. Its guidance describes how your baby gets antibody protection if you had the vaccine in an earlier pregnancy.

ACOG’s September 2026 update extends its season window to run from September 1 through March 1, instead of through January 31. It recommends the vaccine between 32 0/7 and 36 6/7 weeks of pregnancy for people who aren’t planning to give birth within two weeks. These recommendations differ from the CDC season window. Ask your obstetric team which advice and local arrangements they follow.

WHO recommends the RSV vaccine in pregnancy from week 28 onwards. It recommends that countries offer either the vaccine in pregnancy or protection for babies with an antibody medicine called nirsevimab, depending on their health system and programme. Ask your maternity team how your baby will be protected after birth where you live.

COVID: ask about the current local position

In England, being pregnant doesn’t on its own make you eligible for the autumn 2026 NHS COVID programme. The government’s list instead includes older adults, older adults living in care homes, and people with a weakened immune system. You may be eligible if your immune system is weakened. Ask your clinician to check. Elsewhere in the UK, confirm the offer with your own NHS service.

In the US, CDC’s table of vaccines in pregnancy lists COVID as “No guidance/not applicable.” Its separate page for clinicians asks them to talk through the known and unknown risks and benefits with pregnant and breastfeeding people. ACOG still recommends the COVID vaccine during pregnancy. Advice differs between countries and within US guidance. Talk about your current options with your maternity clinician.

Getting help with an offer or a missed appointment

Contact your midwife or GP surgery in the UK, your obstetric clinician in the US, or your doctor or midwife elsewhere to check the timing, or if you think you’ve missed an offer. In the UK, the NHS advises contacting your midwife or GP surgery if you’re 20 weeks pregnant and haven’t been offered the whooping cough vaccine.

Bring any vaccine record you have, and ask the team to write down the plan you agree. Ask which vaccine you’re being offered and why that timing applies to you. Check where to book it and who to contact if you need to change the date.