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Summary for primary care

Vaccination During and After Pregnancy


This Guidelines summary covers part six of the Public Health England (PHE) UK immunisation schedule, which was last updated by PHE in December 2019.

Vaccination During and After Pregnancy

  • In 2010, routine influenza immunisation of individuals was extended to include all pregnant women. This was based on evidence of the increased risk from influenza to the mother and to infants in the first few months of life. Vaccination therefore protects the woman herself and provides passive immunity to the infant following birth. Preventing infection in the mother will also reduce the risk of her transmitting influenza to her newborn baby
  • Inactivated influenza vaccine should therefore be offered to pregnant women at any stage of pregnancy (first, second or third trimesters), ideally before influenza viruses start to circulate. Influenza vaccination is usually carried out between October and January, but clinical judgement should be used to assess whether a pregnant woman should be vaccinated after this period
  • A programme for the vaccination of pregnant women against pertussis was introduced in October 2012. The purpose of the programme is to boost antibodies in these women so that high levels of passive antibody are transferred from mother to baby. This should protect the infant against pertussis infection until they can be vaccinated at eight weeks of age. Pregnant women should be offered dTaP/IPV vaccine from week 16 of each pregnancy (for operational reasons, vaccination is probably best offered at, or after the fetal anomaly scan at around 20 weeks). This programme is described in more detail in Chapter 24
  • The current level and severity of influenza activity, the presence of other risk factors and the availability of inactivated influenza vaccine may form part of the consideration for late vaccination. Influenza vaccine can be given at the same time as pertussis vaccine but influenza vaccination should not be delayed in order to administer the two vaccines together
  • Inactivated influenza vaccines are preferred to the live attenuated vaccine for pregnant women (see Chapter 19)
  • Pertussis vaccine can be given at the same time as influenza vaccine but, to avoid compromising the passive protection to the infant, this should not be used as a reason to give pertussis vaccination outside of the recommended period
  • From 2016, the routine antenatal testing of women for rubella susceptibility ceased. Pregnant women should have their vaccine status checked during or after pregnancy, for example at the post-natal check, and be offered any outstanding doses of MMR soon after delivery
  • MMR vaccine should not be offered in pregnancy.