You are at higher risk for serious health problems from influenza when you are pregnant. If you get influenza while pregnant, you are at higher risk of being admitted to hospital. The illness may result in your baby being born too soon.

Protection

Getting the influenza vaccine will protect you and your baby while you are pregnant. The protection you get from the vaccine may transfer across the placenta and remain with your baby for a short time after birth.

When you’re immunized against influenza, your baby is less likely to:

• be born too soon
• be small for their gestational age
• have a low birth weight

When to get the vaccine

The influenza vaccine is recommended every year because the influenza virus changes. You can get the influenza vaccine at any time during your pregnancy, but the best time is October or November, before the influenza season begins. You can still get the vaccine at any time during the influenza season, which usually starts in late fall and lasts through the winter.

Standard-dose and high-dose influenza vaccine

There are 2 strengths of inactivated (killed) influenza vaccine: standard-dose and high-dose. The virus these vaccines contain cannot cause influenza. They are given by injection.

The standard-dose influenza vaccine is for most healthy people age 6 months to 64 years. Studies show that the standard-dose influenza vaccine will not harm you or your baby if you get it while you are pregnant.

The high-dose influenza vaccine has more of the inactivated influenza virus than the standard-dose. It gives more protection against influenza for people with a higher risk of getting very sick. People age 18 to 64 years who have had CAR T-cell therapy, who have had a stem cell transplant, or who have had or will have an organ transplant are recommended to get the high-dose influenza vaccine.

Using the high-dose influenza vaccine in people under age 65 years is called “off-label use”. Off-label use means the vaccine is used differently than the way it was originally approved. Vaccine experts support this off-label use and have no safety concerns.

If you are pregnant and have had CAR T-cell therapy, a stem cell transplant, or have had or will have an organ transplant, talk to your healthcare provider about which influenza vaccine is recommended for you.

Nasal spray

The nasal spray influenza vaccine is a live vaccine with a weakened living virus. It is not recommended if you are pregnant.

It is safe for you and your baby to have contact with someone who gets the nasal spray influenza vaccine.

Breastfeeding/chestfeeding

The injected standard-dose and nasal spray influenza vaccines are safe to get when breastfeeding/chestfeeding.

If you have had CAR T-cell therapy, a stem cell transplant, or have had or will have an organ transplant, talk to your healthcare provider about which influenza vaccine is recommended for you.

Learn more about the influenza vaccine.

While you’re pregnant, you have a higher risk of getting very sick from COVID-19 and being admitted to hospital. COVID-19 could also cause a problem for your baby, such as being born too soon, having a low birth weight, and your baby needing to stay in the hospital after being born. Getting a COVID-19 vaccine lowers your risk of getting seriously ill from the virus and helps protect your baby.

You can get any COVID-19 vaccine if you’re pregnant or breastfeeding/chestfeeding. However, research shows that mRNA vaccines are the safest type of COVID-19 vaccines to get during pregnancy, which includes the bivalent mRNA vaccines.

Learn more about the mRNA COVID-19 vaccine.

The Tdap vaccine (previously called dTap) protects against tetanus, diphtheria, and pertussis (whooping cough). It is recommended in every pregnancy, even if you have had the vaccine before.

Babies are more likely to have serious health problems from whooping cough. In Canada, 1 to 4 deaths are related to whooping cough each year. These deaths are most often in infants who are too young to be immunized or children who are not fully immunized.

By getting the Tdap vaccine during pregnancy, you are giving your baby early protection in their first few months of life. The Tdap vaccine is usually given between 27 and 32 weeks of pregnancy, because this is the best time to transfer immunity to your baby. If you are outside of this time, talk to your healthcare provider about when you should get your Tdap vaccine.

Learn more about the Tdap vaccine.

Live vaccines—such as measles, mumps and rubella (MMR) and varicella (chicken pox)—are not routinely given during pregnancy.

If you need these vaccines, it’s recommended that you get these vaccines after you have your baby. If you need other vaccines, your healthcare provider will talk to you about the risks and benefits to you and your baby.