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Immunizations that may be administered before, during, and after pregnancy[1,2]

Immunizations that may be administered before, during, and after pregnancy[1,2]
Vaccine Before pregnancy During pregnancy After pregnancy Type of vaccine
Hepatitis A Yes, if indicated Yes, if indicated Yes, if indicated Inactivated
Hepatitis B Yes, if indicated Yes, if indicated* Yes, if indicated Inactivated
Human papillomavirus (HPV) Yes, if indicated No, delay until after pregnancy, if indicated Yes, if indicated Inactivated
Influenza IIV Yes Yes Yes Inactivated
Influenza LAIV Yes, if less than 50 years of age and healthy; avoid conception for 4 weeks No Yes, if less than 50 years of age and healthy; avoid conception for 4 weeks Live
MMR Yes, if indicated, avoid conception for 4 weeks No Yes, if indicated, give immediately postpartum if susceptible to rubella Live
Meningococcal:
  • Quadrivalent conjugate (MenACWY)
 Yes, if indicated Yes, if indicated Yes, if indicated Inactivated
  • Serogroup B (MenB)
 Yes, if indicated No, delay until after pregnancy, if indicatedΔ Yes, if indicated Inactivated
Pneumococcal:
  • Conjugate
 Yes, if indicated Yes, if indicated Yes, if indicated Inactivated
  • Polysaccharide
 Yes, if indicated Yes, if indicated Yes, if indicated Inactivated
Tdap Yes, if indicated Yes, vaccinate during each pregnancy ideally between 27 and 36 weeks of gestation Yes, immediately postpartum, if not received previously Toxoid/inactivated
Tetanus/diphtheria Td Yes, if indicated Yes, if indicated, Tdap preferred Yes, if indicated Toxoid
Varicella Yes, if indicated, avoid conception for 4 weeks No Yes, if indicated, give immediately postpartum if susceptible Live
LAIV: Live attenuated influenza vaccine; MMR: Measles, mumps, and rubella vaccine.
* Conventional recombinant hepatitis B vaccines should be used during pregnancy. Administration of the adjuvanted recombinant hepatitis B vaccine is not recommended during pregnancy because of lack of safety data.
¶ Confirm that LAIV is a recommended option for influenza vaccination each season.
Δ Delay MenB until after pregnancy unless at increased risk and vaccination benefit outweighs uncertain risks.
References:
  1. Vaccines for Pregnant Women. Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html (Accessed on March 19, 2015).
  2. Kim DK, Hunter P, et al. Recommended Adult Immunization Schedule, United States, 2019. Ann Intern Med 2019; 170:182.
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