Are vaccines safe in pregnancy?
Certain vaccines are offered during pregnancy to protect against diseases that can pose a risk in pregnancy. Vaccines recommended for use in pregnancy undergo thorough testing in clinical trials. Many years of research show that vaccines against influenza; diphtheria, tetanus and whooping cough (DTaP); respiratory syncytial virus (RSV); and COVID-19 are all safe when given during pregnancy. They are also continually monitored once in use, through regular reporting of any side-effects, which allows regulators and manufacturers to detect any potential safety issues during pregnancy.
Vaccines against whooping cough and respiratory syncytial virus (RSV), for example, are offered during pregnancy to help protect the baby in the first few months of life. Both these diseases can lead to serious illnesses in young babies, who may require hospital treatment. The vaccines allow the generation of antibodies that can be passed to the baby across the placenta so they can protect the baby in the first three to six months of life.
Studies have found that the RSV vaccine, for example, is 72% effective at preventing infants from being hospitalised if it is given to the mother more than 14 days before birth. There were some concerns that the RSV vaccine might lead to a small increase in the risk of premature birth when give early in pregnancy, based on clinical trial data from South Africa but the trial also found that when the vaccine was given in high income countries there was no risk of prematurity. This led to regulators in the UK recommending the vaccine be given from 28 weeks of pregnancy (in Europe it is given from 24 weeks). Subsequent studies have found no increase in the rate of premature birth in the UK when the vaccine is given during this period of pregnancy.
Flu also poses an increased risk to a pregnant person in the last few months of pregnancy as your immune system can become weaker than it would normally be. Studies have found that catching flu during pregnancy can lead to a 3-4% increased risk of stillbirth compared with those who are not infected. To help protect against this, flu vaccines are offered during pregnancy. Large studies involving many thousands of women have shown flu vaccines to be extremely safe with no difference in pregnancy outcomes between those who are vaccinated and those who are not.
Some vaccines are not recommended for use in pregnancy, which is why the healthcare system will not give them to you during this period. These include those containing live viruses or bacteria; such as the BCG vaccine against tuberculosis, the MMR vaccine, the live vaccines against polio (which are not used in the UK) and against chickenpox. This is because there is a potential risk that even though the live microbe in these vaccines has been weakened, it could infect the unborn baby and lead to complications or possibly miscarriage.