Table 1.

Recommendations for vaccination during pregnancy^5,6

Vaccine	General recommendation for use in pregnancy	Timing of vaccination	Vaccine formulation	Exceptions/contraindications
Influenza (inactivated)	Recommended during each pregnancy	Preconception or as early in pregnancy as possible during influenza season	IIV (IIV3 or IIV4)	Prior severe allergic reaction to influenza vaccine; individuals with history of severe allergic reactions to eggs should be assessed by a physician with expertise in management of allergic conditions
Influenza (LAIV)	Not recommended	n/a	n/a	n/a
Tdap	Recommended during each pregnancy	Optimal timing is between 27–36 wk gestation (but may be given at any time)	Tdap	Prior severe allergic reaction to Tdap vaccine, encephalopathy not due to other causes within 7 d of Tdap administration; neurologic reactions to Tdap should be considered on a case by case basis with a physician.
Td	Used if otherwise indicated (i.e., for wound management if at least 5 y since the previous Td booster)	When indicated	If Td is indicated for a pregnant woman, administer Tdap	As above for Tdap

*Abbreviations: LAIV, live attenuated inactivate influenza vaccine; IIV, inactivated influenza vaccine; IIV3, trivalent formulation; IIV4 quadrivalent formulation; Tdap, tetanus toxoid, reduced diphtheria toxoid and acellular pertussis; Td, tetanus and diphtheria;**Other vaccines not routinely recommended for pregnant women but safe to administer during pregnancy when a clinical indication exists include: hepatitis B, hepatitis A, pneumococcal, meningococcal, yellow fever, rabies and anthrax vaccines.^102-105 Of note, the live attenuated MMR vaccine is contraindicated during pregnancy, but recommended for postpartum administration to rubella nonimmune pregnant women.¹⁰² The live attenuated Typhoid vaccine is not recommended during pregnancy due to lack of available data.¹⁰⁶