Before Pregnancy

Learn more about vaccine recommendations as you begin the first step in your pregnancy journey.

Planning a Pregnancy

Getting vaccinated is one of many routine steps you can take to support a healthy pregnancy, just like eating a healthy diet, taking prenatal vitamins, and staying physically active. Some vaccines are recommended during pregnancy, while others are recommended outside of pregnancy. Talk with your healthcare provider to make sure you are up to date on your vaccination schedule.

Staying updated on your vaccinations has important benefits for you and your baby. Getting vaccinated helps lower the risk of complications (problems) during pregnancy and also lowers the chance of passing an infection to your developing baby. Remember, protection for you is protection for two!

  • There are different types of vaccines that you'll want to be familiar with as you begin planning your pregnancy. These include:

    • Inactivated vaccines are made using a dead germ (or parts of it) called antigens. These antigens can’t make you sick because they aren’t alive. You can think of them as being “switched off” (killed). Inactivated vaccines are considered safe for use during pregnancy. Examples of inactivated vaccines include the influenza (flu) and Tdap (tetanus, diphtheria, pertussis) vaccines.

    • Live and live-attenuated vaccines are made using germs that are still alive but have been weakened. Generally, these weakened germs won't cause diseases in healthy individuals. However, these vaccines are not routinely recommended during pregnancy because of a small theoretical risk to developing babies. The risk to developing babies is ‘theoretical’ because real-life data shows that babies born to a parent who got a live or live-attenuated vaccine during pregnancy (often without knowing they were pregnant) don’t have higher rates of birth defects or infections related to the vaccine. Getting a live or live-attenuated vaccine during pregnancy is not a reason to consider terminating (ending) a pregnancy.

    • mRNA vaccines work differently than inactivated or live vaccines. Instead of giving you a weakened or dead version of the virus, mRNA vaccines give your body the instructions for making antigens on its own. The Pfizer-BioNTech and Moderna COVID-19 vaccines are examples of mRNA vaccines. These vaccines are considered safe for use during pregnancy.

    Inactivated flu and Tdap vaccines and mRNA COVID-19 vaccines are considered safe to get during pregnancy. However, live-attenuated vaccines are not recommended during pregnancy because of the possible (theoretical) risk to developing babies.¹ Live-attenuated vaccines should be given at least 4 weeks before becoming pregnant.

  • When planning a pregnancy, it’s a good idea to check if you’re up-to-date on all your vaccines. Your healthcare provider and/or your local healthcare centre can review your vaccine records and might suggest blood tests to see if you're protected against certain diseases. You may need some new or additional vaccines, depending on your vaccination history. Since the protection offered by vaccines can decrease over time, your healthcare provider may recommend getting additional ‘booster’ doses of vaccines you had in childhood to keep your protection strong. Staying up-to-date with your vaccinations helps to:

    • Protect you from getting sick

    • Lower the risk of complications (problems) during pregnancy

    • Lower the risk of passing infections to your developing baby

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Vaccines to Consider Before Pregnancy

  • Measles, mumps, and rubella are all serious viral infections that can cause pregnancy complications such as miscarriage, stillbirth, premature birth (birth before 37 weeks of pregnancy) and low birth weight in newborn babies.²⁻³ While all three of these infections are harmful, rubella (also known as ‘German Measles’) is particularly dangerous during pregnancy. The rubella virus can be passed from an infected birth parent to their developing baby during pregnancy, causing health problems in the eyes, ears, and heart, known as congenital rubella syndrome.¹⁻³

    The best way to protect you and your developing baby from measles, mumps, and rubella is by getting vaccinated. Protection against all three of these diseases is provided in one vaccine known as the MMR (measles, mumps, rubella) vaccine. Many adults received the MMR vaccine as children. However, as protection can decrease over time, your healthcare provider may still recommend a blood test to make sure your body has immunity (protection) against these infections before getting pregnant.

    The MMR vaccine is especially important to consider before pregnancy because it is a live-attenuated vaccine. You should receive the MMR vaccine at least 4 weeks before becoming pregnant.

    Live-attenuated vaccines like MMR are not routinely recommended in pregnancy because of a small theoretical risk to developing babies. This risk is ‘theoretical’ because real-life data shows that babies born to a parent who got a live or live-attenuated vaccine during pregnancy (often without knowing they were pregnant) don’t have higher rates of birth defects or infections related to the vaccine. Getting a live or live-attenuated vaccine during pregnancy is not a reason to consider terminating (ending) a pregnancy.

  • Varicella or ‘Chickenpox’ is a very contagious infection caused by the varicella-zoster virus (VZV) and can lead to serious illness and pregnancy complications.4 The virus can be passed from an infected birth parent to their developing baby during pregnancy, causing a condition known as congenital varicella syndrome. This condition involves health problems that affect the head, muscles, bones, eyes, and cognitive (brain) function.⁵

    Many adults already have immunity (protection) against the varicella virus because they either had chickenpox as a child or received the vaccine. However, protection can decrease over time. Your healthcare provider may still recommend a blood test to make sure you are immune to the virus before getting pregnant. If not, the chickenpox vaccine is highly recommended before pregnancy because it is a live-attenuated vaccine and not recommended during pregnancy. Like the MMR vaccine, the chickenpox vaccine should be given at least 4 weeks before becoming pregnant.

  • Hepatitis B is a serious infectious disease caused by the hepatitis B virus (HBV). It mainly affects the liver. It passes from person to person through blood and body fluids. Hepatitis B can pass from mother to baby during birth, which is the most common way for babies to get hepatitis B early in life.

    It’s very important to prevent newborn babies from getting hepatitis B. The younger a person is when they catch HBV, the greater their chances of developing a chronic (long-term) infection.⁶ 9 out of 10 babies who catch hepatitis B at birth will develop a lifelong, chronic infection.⁶

    The hepatitis B vaccine is recommended for anyone who hasn’t received the vaccine in the past. Your healthcare provider should perform a blood test to check if you are already immune (protected against) hepatitis B. If you are not immune, getting the hepatitis B vaccine is recommended. This vaccine is also safe to get during pregnancy.¹

  • There may be specific situations that require you to get additional vaccines. For example, your healthcare provider may recommend other vaccines if you are traveling to parts of the world where diseases like typhoid fever or hepatitis A are more common. It's a good idea to talk to your healthcare provider to find out if there are any additional vaccinations that would be beneficial for you.

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    1. PregnancyInfo.ca. (n.d.). Before you conceive. https://www.pregnancyinfo.ca/before-you-conceive/your-health-prior-to-pregnancy/vaccinations/

    2. National Health Service (NHS). (2022). Measles. https://www.nhs.uk/conditions/measles/

    3. Rubella (German measles) in pregnancy. (2007). Paediatrics & Child Health, 12(9), 798-802. https://doi.org/10.1093/pch/12.9.798

    4. Stanford Children's Health. (2023). Chickenpox (Varicella) and pregnancy. https://www.stanfordchildrens.org/en/topic/default?id=varicella-and-pregnancy-90-P02161

    5. Shrim, A., Koren, G., Yudin, M. H., Farine, D., Gagnon, R., Hudon, L., & Senikas, V. (2012). Management of varicella infection (chickenpox) in pregnancy. Journal of Obstetrics and Gynaecology Canada, 34(3), 287-292.

    6. Centres for Disease Control and Prevention. (2023, March 9). Hepatitis B. https://www.cdc.gov/hepatitis/hbv/index.htm