The American College of Nurse-Midwives (ACNM) strongly recommends that all individuals who are pregnant, planning pregnancy, or postpartum receive the recommended vaccines to protect themselves and their babies from serious illness. Maternal immunization is one of the safest, most effective ways to reduce the risk of life-threatening infections in both pregnant individuals and newborns, particularly in the first few vulnerable months of life.
There are four vaccines that are critically important during pregnancy:
- Tdap (Tetanus, Diphtheria, and Pertussis) Vaccine
The Tdap vaccine is recommended during every pregnancy, ideally between 27 and 36 weeks gestation. This vaccine provides critical protection against whooping cough (pertussis), which can be life-threatening for newborns. Vaccination during pregnancy helps pass protective antibodies to the baby, reducing the risk of severe illness in the first few months of life. Pertussis (whooping cough) poses a significant threat to newborns, who are too young to be vaccinated at birth.
- Data shows that maternal Tdap vaccination reduces the risk of pertussis in infants under 2 months by up to 78%.
- Whooping cough can cause severe breathing problems, pneumonia, and even death in newborns. Between 2000 and 2021, more than 50% of infants under 1 year with pertussis required hospitalization.
- Tdap vaccination in pregnancy is safe, with studies of over 500,000 pregnant individuals showing no increased risk of adverse pregnancy outcomes.
- Influenza (Flu) Vaccine
The seasonal flu vaccine is recommended for all pregnant individuals during any trimester of pregnancy. Influenza can lead to serious complications during pregnancy, including hospitalization and preterm birth. Vaccination not only protects the pregnant person but also offers passive immunity to the newborn, who cannot be vaccinated until six months of age.
- The flu vaccine is safe during any trimester and reduces the risk of flu-associated hospitalization by approximately 40% in pregnant individuals.
- Infants born to vaccinated mothers have a 72% lower risk of being hospitalized with flu in their first six months.
- Decades of global data show that flu vaccination in pregnancy does not increase risks of miscarriage or birth defects.
- COVID-19 Vaccine
COVID-19 vaccination is recommended for all individuals who are pregnant, planning pregnancy, or postpartum. Pregnant individuals are more likely to experience severe COVID-19 illness, including intensive care admission, need for mechanical ventilation, and pregnancy complications such as preterm birth or stillbirth. The vaccine is safe and effective, with growing evidence demonstrating protective benefits for both the pregnant person and the newborn.
- COVID-19 vaccination during pregnancy reduces the risk of severe disease and hospitalization in pregnant individuals by over 80%.
- Babies born to vaccinated individuals receive protective antibodies, with studies showing an 85% reduction in infant hospitalization due to COVID-19 in the first 6 months of life.
- Extensive monitoring involving hundreds of thousands of pregnant individuals globally confirms the vaccine is safe, with no increased risk of miscarriage, preterm birth, or other adverse outcomes.
- RSV (Respiratory Syncytial Virus) Vaccine
RSV is a common virus that can cause severe respiratory illness in infants. The RSV vaccine is recommended during pregnancy, typically between 32 and 36 weeks gestation, to help protect newborns from RSV-related hospitalizations in the first months of life. This vaccine has been shown to be both safe and effective in preventing RSV illness in infants. RSV is a leading cause of hospitalization in infants, particularly during the first months of life.
- Maternal RSV vaccination between 32 and 36 weeks gestation can reduce the risk of severe RSV-related lower respiratory tract disease in infants by up to 82% in the first 3 months of life.
- RSV is responsible for an estimated 58,000 hospitalizations of infants under 12 months in the U.S. each year.
- Clinical trials demonstrate that RSV vaccination during pregnancy is safe, with no increased risk of preterm birth or other complications.
The Impact of Maternal Immunization
Vaccination during pregnancy saves lives. Estimates suggest:
- Maternal Tdap and flu vaccination together prevent thousands of infant hospitalizations and hundreds of deaths annually in the U.S.
- COVID-19 vaccination during pregnancy has prevented tens of thousands of severe maternal infections and hundreds of infant hospitalizations since its introduction.
- RSV immunization during pregnancy is projected to prevent over 30,000 infant hospitalizations each year in the U.S. alone.
Our Commitment to Families
The American College of Nurse-Midwives is dedicated to evidence-based care that safeguards the health of pregnant individuals and their newborns. Vaccines recommended during pregnancy undergo rigorous testing and ongoing monitoring, with extensive global data confirming their safety and effectiveness.
We urge all pregnant individuals to discuss vaccination options with their midwife or healthcare provider. Protecting yourself through vaccination is one of the most important steps you can take to ensure your baby’s healthy start in life.
The American College of Nurse-Midwives stands with the American Academy of Family Physicians, American College of Obstetricians and Gynecologists, Association of Women’s Health, Obstetric and Neonatal Nurses, The National Association of Nurse Practitioners in Women’s Health; and the Society for Maternal-Fetal Medicine as an active member of the Maternal Immunization Task Force. As a body of professional organizations representing clinicians who care for pregnant people, the Maternal Immunization Task Force reaffirms the importance of recommending and advocating for an evidence-based approach to maternal immunization, which includes continuing to recommend COVID-19, flu, Tdap and RSV vaccines during pregnancy. Vaccines are the most efficacious public health tool available in preventing infectious diseases and their related adverse maternal, fetal, and infant health outcomes, and will continue to protect and uphold our recommendations for routine maternal immunization.
References:
Centers for Disease Control and Prevention (CDC). (2022a). Influenza (flu) vaccination coverage and effectiveness. Retrieved from https://www.cdc.gov/flu/highrisk/pregnant.htm
Centers for Disease Control and Prevention (CDC). (2022b). Pertussis (whooping cough) vaccination for pregnant women. Retrieved from https://www.cdc.gov/pertussis/vaccines/tdap-vaccination-during-pregnancy.html?CDC_AAref_Val=https://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html
Centers for Disease Control and Prevention (CDC). (2023a). RSV in infants and young children. Retrieved from https://www.cdc.gov/rsv/infants-young-children/?CDC_AAref_Val=https://www.cdc.gov/rsv/high-risk/infants-young-children.html
Centers for Disease Control and Prevention (CDC). (2023b). COVID-19 vaccines while pregnant or breastfeeding. Retrieved fromhttps://www.cdc.gov/covid/vaccines/pregnant-or-breastfeeding.html?CDC_AAref_Val=https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html
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