No Pregnancy-Related Contraindications to Inactivated Flu Vaccine
There are no pregnancy-related contraindications to the inactivated influenza vaccine (IIV), which can be safely administered during any trimester of pregnancy. 1, 2 In fact, pregnancy is an indication for vaccination, not a contraindication.
Key Contraindication: Live Attenuated Vaccine Only
The only pregnancy-related contraindication is the live attenuated influenza vaccine (LAIV/nasal spray), which should not be given during pregnancy but can be administered postpartum. 1, 2, 3
- Inactivated influenza vaccines (IIV) are recommended and safe during any trimester 1, 2
- Recombinant influenza vaccines (RIV) are acceptable, though experience in pregnancy is more limited 1, 2
- Live attenuated vaccine (LAIV) is contraindicated during pregnancy 1, 3
Standard Contraindications Apply (Not Pregnancy-Specific)
The only other contraindications are the same as for any vaccine recipient:
- Anaphylactic hypersensitivity to eggs or vaccine components (though egg allergy alone is no longer considered a contraindication or precaution) 1
- Acute febrile illness - defer until symptoms resolve 1
- History of severe allergic reaction to a previous dose of influenza vaccine 1
Why Vaccination Is Strongly Recommended
Pregnancy actually increases the urgency for vaccination rather than creating contraindications:
- Pregnant women face 1.4 to 4.7 times higher risk of hospitalization from influenza, with risk increasing throughout pregnancy 3
- Vaccination protects both mother and infant through transplacental antibody transfer, providing protection for the first 6 months of life when infants cannot yet be vaccinated 1, 2
- Infants born to vaccinated mothers have up to 72% risk reduction for laboratory-confirmed influenza hospitalization 2, 3
- No increased risk of congenital malformations has been demonstrated, even with first-trimester vaccination 2, 3
Common Pitfall to Avoid
Do not delay vaccination waiting for a specific trimester. The vaccine should be given as soon as it becomes available during pregnancy, regardless of trimester. 1, 2 This misconception that first-trimester vaccination should be avoided is not supported by evidence and represents an unnecessary barrier to protection. 2
The American College of Obstetricians and Gynecologists, ACIP, and American Academy of Family Physicians all consistently recommend influenza vaccination during any trimester of pregnancy. 1, 2