Which vaccines should be avoided during pregnancy?

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Last updated: June 8, 2025View editorial policy

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From the Guidelines

Live attenuated vaccines, including the measles-mumps-rubella (MMR) vaccine, varicella (chickenpox) vaccine, live attenuated influenza vaccine (LAIV) nasal spray, and yellow fever vaccine, should be avoided during pregnancy due to the theoretical risk of harm to the developing fetus. The smallpox vaccine and BCG (tuberculosis) vaccine should also be avoided. However, inactivated vaccines are generally considered safe during pregnancy. In fact, some vaccines are specifically recommended during pregnancy, including the Tdap vaccine (tetanus, diphtheria, and pertussis) between 27-36 weeks of each pregnancy to protect the newborn from whooping cough, and the seasonal inactivated influenza vaccine to protect both mother and baby from flu complications, as supported by studies such as 1 and 1. If a pregnant woman has a specific exposure risk or medical condition, the benefits of vaccination, even with some live vaccines, may outweigh the theoretical risks, as noted in 1 and 1. Always consult with your healthcare provider before receiving any vaccine during pregnancy, as individual circumstances may affect recommendations.

Some key points to consider:

  • Live attenuated vaccines pose a theoretical risk to the fetus, but inactivated vaccines are generally safe, as stated in 1 and 1.
  • The benefits of vaccinating pregnant women usually outweigh potential risks when the likelihood of disease exposure is high, as noted in 1 and 1.
  • Certain vaccines, such as Tdap and inactivated influenza vaccine, are specifically recommended during pregnancy to protect the mother and baby from serious diseases.
  • Pregnant women should consult with their healthcare provider before receiving any vaccine to determine the best course of action based on their individual circumstances.

It's also important to note that the risk of disease exposure and the potential consequences of infection should be taken into account when deciding whether to vaccinate a pregnant woman, as discussed in 1 and 1. Ultimately, the decision to vaccinate during pregnancy should be made in consultation with a healthcare provider, as they can provide personalized guidance and recommendations based on the latest evidence and guidelines, such as those outlined in 1 and 1.

From the FDA Drug Label

Pregnancy: Do not administer VARIVAX to females who are pregnant. Pregnancy should be avoided for 3 months following vaccination with VARIVAX. (4.5,8.1,17)

The varicella vaccine should be avoided during pregnancy. According to the drug label, females who are pregnant should not be administered VARIVAX, and pregnancy should be avoided for 3 months following vaccination with VARIVAX 2, 2, 2.

  • Key points:
    • Do not administer VARIVAX to pregnant females
    • Avoid pregnancy for 3 months after VARIVAX vaccination
  • Main idea: VARIVAX is contraindicated in pregnancy due to the potential risk of fetal harm.

From the Research

Vaccines to Avoid During Pregnancy

  • Live-attenuated vaccines (LAV) are currently contraindicated during pregnancy due to uncertain safety records for the mother-infant pair 3
  • Specific live vaccines that should be avoided during pregnancy include:
    • Smallpox vaccine, as it has been associated with increased odds of malformations and miscarriage after first trimester immunization 3
    • Other live vaccines such as rubella, poliovirus, yellow fever, and dengue vaccines may be safe, but the quality of evidence is very low 3
  • In general, vaccines that are not live-attenuated, such as inactivated or toxoid vaccines, are considered safe during pregnancy 4

Special Considerations

  • Pregnant women with certain health conditions or compromised immune systems may need to take extra precautions when receiving vaccines 4
  • The benefits of vaccination during pregnancy should be weighed against the potential risks, and healthcare providers should consult with pregnant women to determine the best course of action 3

Vaccine Safety

  • Most vaccines are considered safe for use in healthy individuals, including pregnant women, and the risks of serious sequelae are rare 4
  • However, it is essential to follow recommended vaccination schedules and guidelines to minimize potential risks and maximize benefits 5, 6, 7

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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