Vaccines in pregnancy

Whooping cough, flu and RSV vaccines have different timing in pregnancy. COVID advice also differs between countries and organisations. Advice has changed recently. Ask your midwife or doctor which recommendations apply where you receive care. A vaccine calendar from another country may differ.

Whooping cough: protecting the baby after birth

Whooping cough is also called pertussis. Vaccination during pregnancy helps pass protection to your baby through the placenta, covering the early period before the baby can begin their own vaccinations. It does not replace the baby’s vaccination programme.

In the UK, it is usually offered around the 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 that point has passed, ask your maternity team. NHS guidance allows it to be given later.

In the US, CDC recommends Tdap during each pregnancy. Its preferred timing is between 27 and 36 weeks, with earlier vaccination within that window helping maximise antibody transfer. Tdap covers tetanus, diphtheria and pertussis.

Flu: a seasonal offer at any pregnancy stage

The NHS offers flu vaccination in autumn or winter, and you are eligible if you are pregnant. You can have it at any stage of pregnancy. US CDC guidance also allows vaccination at any time in pregnancy during the influenza season. There is no need to use the whooping cough window to time a flu appointment.

The type of flu vaccine matters. ACOG recommends inactivated or recombinant influenza vaccines in pregnancy. The live flu vaccine is not used during pregnancy under CDC guidance. Tell the vaccination service that you are pregnant so it can offer a suitable vaccine.

RSV: different UK and US windows

RSV can cause serious breathing illness in babies. Vaccinating during pregnancy allows protective antibodies to pass across the placenta. In the UK, the programme runs throughout the year, from week 28 or soon afterwards, and the vaccine is offered again in each pregnancy.

US CDC guidance lists Abrysvo during gestational weeks 32 – 36, between September and January in most of the continental US. It does not currently recommend repeating RSV vaccination in later pregnancies. Its guidance describes antibody protection for the baby if you were vaccinated in an earlier pregnancy.

ACOG’s September 2026 update extends its seasonal window from September 1 through March 1, instead of through January 31. It recommends vaccination between 32 0/7 and 36 6/7 weeks of gestation for people without a planned delivery within two weeks. These recommendations differ from the CDC seasonal window. Ask your obstetric team which guidance and local arrangements they are following.

WHO recommends maternal RSV vaccination from week 28 onwards. It recommends that countries introduce either maternal vaccination or infant protection with the monoclonal antibody nirsevimab, depending on their health system and programme. Ask your maternity team how protection after birth is arranged locally.

COVID: ask about the current local position

In England, pregnancy alone is not an eligibility group for the autumn 2026 NHS COVID programme. The government’s eligibility list instead includes older adults, older-adult care-home residents and immunosuppressed people. You may be eligible because of immunosuppression; ask your clinician to check your circumstances. Confirm the offer with your own NHS service elsewhere in the UK.

In the US, CDC’s pregnancy vaccination table lists COVID as “No guidance/not applicable.” Its separate clinical page asks clinicians to discuss the known and unknown risks and benefits with pregnant and breastfeeding people. ACOG continues to recommend COVID vaccination during pregnancy. Advice differs between countries and within US guidance; discuss the 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 timing or a missing offer. In the UK, the NHS advises contacting the midwife or GP surgery if you are 20 weeks pregnant and have not been offered whooping cough vaccination.

Bring any vaccination record you have and ask the team to write down the agreed plan. Ask which vaccine is being offered and why that timing applies to you. Check where to book it and who to contact if you need to rearrange.