Immunisation And Pregnancy

Overview

Immunisation in pregnancy means having vaccines while you are pregnant. A vaccine is an injection that teaches your body's immune system (your natural defence against infection) how to fight a particular germ. When you have a vaccine in pregnancy, your body makes protective antibodies (infection-fighting proteins), and some of these pass through the placenta to your baby. This means you are protected during pregnancy, and your baby has some protection during their first weeks and months of life, when they are too young to be vaccinated themselves.

Yes. Vaccination in pregnancy is a routine part of antenatal care in many countries, including the UK. Millions of pregnant women have had these vaccines, and they are monitored closely for safety.

Anyone who is pregnant, at any age and in any pregnancy. The vaccines recommended may differ slightly depending on where you live, your health, your job, and the season. Your midwife or doctor will tell you what is offered and when.

Symptoms

Common symptoms

• A sore, heavy or slightly swollen arm where the injection went in
• Feeling tired or achy for a day or two
• A mild fever or feeling shivery
• Headache or muscle aches
• Feeling a little flushed or off your food
• These are normal signs that your immune system is responding, and they usually settle within a few days

Symptoms in children

• This topic is about pregnancy, so this section does not apply. If you are looking for information about your child's own vaccinations, speak to your child's health visitor, nurse or doctor.

Symptoms in older adults

• This topic is about pregnancy, so this section does not apply. If you are asking about vaccines for an older adult, your pharmacist or doctor can advise.

Causes

Main causes

• Pregnancy changes how your body fights infection. Your immune system works slightly differently, and your heart and lungs work harder. This can make infections like flu more serious for you than they would be when you are not pregnant.
• A newborn baby's immune system is not yet mature, and babies cannot have most vaccines in their first weeks. Protection passed from you during pregnancy helps cover that gap.
• Some infections, such as whooping cough, are much more dangerous for a very young baby than for an older child or adult.

Risk factors

• Being in the second half of pregnancy, when lung infections can be harder to cope with
• Having a health condition such as asthma, diabetes, heart disease or a weakened immune system
• Working in healthcare, childcare or another job with close contact with people who are unwell
• Living with or caring for young children, who often bring infections home
• Having had a premature baby before, or having complications in a previous pregnancy
• Where you live and the time of year — some infections are more common in winter

When to see a doctor

See a doctor urgently if:

• You have a fever after a vaccination that is not settling, or you feel very unwell
• The injection site becomes very painful, red, hot or swollen
• You have any signs of an infection — a cough, chest pain, a rash, or feeling short of breath
• You feel dizzy or unwell, or you faint
• You are worried about anything at all after your vaccination

Book a routine appointment if:

• You want to check whether a vaccine is right for you, or when to have it
• You have allergies, a weakened immune system, or have had a reaction to a vaccine before
• You have missed a vaccine that was offered and want to know if you can still have it
• You are planning a pregnancy and want to check which vaccines you may need beforehand
• You need a record of your vaccinations for work or travel

Diagnosis

There isn't a test that tells you whether you need a vaccine in pregnancy. Instead, your midwife or doctor reviews your vaccination history, your health and any allergies, and then talks with you about what is offered and when. They will explain the benefits and answer your questions so you can make an informed choice.

Tests that may be done

• A review of your vaccination record — it helps to bring any card, app record or letter you have
• Routine blood tests offered in early pregnancy, which usually include a check of your immunity to rubella (German measles) and screening for hepatitis B, HIV and syphilis
• A conversation about your general health, medicines you take, allergies and any past reactions to injections

What to expect at your appointment

The appointment is short. You will be asked a few questions, then given the injection in your upper arm. You will usually be asked to wait for about 10 to 15 minutes afterwards so staff can check you are well before you go. You can carry on with your day as normal, though some people prefer an easy evening if their arm feels sore.

Treatment

Immunisation itself does not need treatment — it is a preventive step, not an illness. Any side effects are usually mild and settle on their own within a few days with rest, fluids and a cool compress on the arm. Your midwife or pharmacist can advise on what is safe to take for discomfort during pregnancy.

Self-care at home

• Rest your arm and gently move it — gentle movement can ease stiffness
• Drink plenty of fluids and eat normally
• Try a cool compress on a sore or swollen arm
• Wear loose sleeves so nothing rubs the injection site
• Take it easy for the rest of the day if you feel tired
• Ask your midwife, GP or pharmacist before taking any medicine, including painkillers, while pregnant

Medical treatments

The vaccines given in pregnancy are carefully chosen to be safe for both you and your baby. They are non-live vaccines, which means they contain no live germs and cannot cause the infection. They work by showing your immune system a harmless part of a virus or bacteria, so your body learns to recognise and fight it. Which vaccines are offered depends on your local programme, the season and your own health. Your midwife or doctor will explain the options and the timing that suits your pregnancy.

Living with this condition

Having a vaccine does not change your daily routine. Most people carry on with work, school runs and normal life straight away, sometimes with a mildly sore arm for a day or two. You do not need to isolate or avoid anything afterwards.

Lifestyle tips

• Keep your vaccination record somewhere easy to find — you may be asked for it later in pregnancy or after birth
• Wash your hands often, especially before preparing food and after being around anyone who is unwell
• Avoid close contact with people who have a fever, cough or rash, where you reasonably can
• Ask visitors to wash their hands before holding your newborn, and ask anyone with a cough to stay away until they are better
• Keep up with your antenatal appointments so you can ask questions as they come up

Diet and exercise

There is no special diet or exercise plan needed after a vaccination. Normal healthy eating and gentle activity in pregnancy — such as walking, swimming or antenatal classes — are good for you and your baby. If you have been advised to limit activity for another reason, follow that advice.

Mental health and emotional wellbeing

It is very common to feel unsure about vaccines during pregnancy. You may worry about what goes into your body, or feel overwhelmed by conflicting information online. Some people also find needles frightening or feel anxious about any medical appointment. These feelings are normal, and you deserve to have them heard. Talking it through with your midwife or GP often helps — they can explain the evidence in plain terms and respect your decision. If anxiety or low mood is affecting your sleep, appetite or daily life, please tell someone. You do not have to cope alone, and support is available. If you ever feel you cannot keep yourself safe, contact your local emergency number or a crisis line straight away.

Prevention

Immunisation is itself a way of preventing serious illness. Staying up to date with the vaccines offered in pregnancy is the single most effective step you can take to protect yourself and your baby from infections like flu, whooping cough, COVID-19 and RSV. Hand hygiene, avoiding people who are clearly unwell, and keeping your newborn away from anyone with a cough also lower the risk.

Vaccines

Which vaccines are recommended depends on where you live and the time of year, but commonly offered in pregnancy are: the flu vaccine (at any stage of pregnancy, ideally before winter); the whooping cough vaccine, which also protects against tetanus and diphtheria (usually offered from around the middle of pregnancy onwards); the COVID-19 vaccine, if you are eligible; and the RSV vaccine (offered in later pregnancy, often seasonally). Live vaccines — such as the combined measles, mumps and rubella vaccine, the chickenpox vaccine, and the nasal flu spray — are not given during pregnancy, but can be given before you conceive or after your baby is born. If you are planning a pregnancy, it is worth checking your vaccination history with your GP first.

Screening programmes

Routine antenatal blood tests in early pregnancy check your immunity to rubella and screen for hepatitis B, HIV and syphilis. These results help your team decide whether any extra vaccines or treatments are needed during or after pregnancy. Newborn screening and the baby's own vaccination schedule start after birth — your midwife will explain the timetable.

Complications

If left untreated

• Flu in pregnancy can be more severe than usual and may lead to chest infections, hospital admission, or premature birth
• High fever and serious infection can increase the risk of complications for both mother and baby
• Whooping cough in a very young baby can be severe, sometimes needing hospital care, because babies are not protected until they start their own vaccinations
• RSV can cause breathing problems in young babies and is a common reason for infant hospital admission
• COVID-19 in pregnancy can be more serious, particularly in later pregnancy

Long-term outlook

The outlook is very good. Most pregnant women who have the recommended vaccines have no problems at all, and both mother and baby benefit. Vaccination in pregnancy is one of the best-studied areas of preventive care, and the evidence is reassuring. If you are unsure, talking it through with your midwife or GP can help you feel confident in your decision, whatever you choose.

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