Travel Vaccinations in Pregnancy

Vaccines fall into two broad groups, and this distinction shapes almost every decision about vaccination in pregnancy. Inactivated (non-live) vaccines contain killed organisms, fragments of them, or manufactured proteins, and cannot cause the infection they protect against. Because they cannot replicate in the body, they are generally considered safe to give in pregnancy when there is a real risk of exposure. Live attenuated vaccines contain a weakened form of a living organism. There is a theoretical concern that the weakened organism could affect the developing baby, so as a precaution live vaccines are usually avoided during pregnancy. In practice, decisions are never made on this rule alone: a clinician weighs the likelihood and seriousness of the disease at your destination against the theoretical risk of the vaccine.

When travel to a higher-risk area is unavoidable, several inactivated travel vaccines can be offered in pregnancy. The aim is always to protect the mother from infections that could themselves be dangerous in pregnancy. Hepatitis A and hepatitis B vaccines (separately or as the combined Twinrix) may be given where there is exposure risk. The combined tetanus, diphtheria and polio booster (Revaxis) can be used if protection is needed. Injected typhoid vaccine and rabies vaccine — including after a possible exposure, when rabies vaccination should never be withheld — are also options. Japanese encephalitis, cholera, meningitis ACWY and tick-borne encephalitis vaccines may be considered where the itinerary warrants them. Each of these is an individual decision based on your destination, activities and stage of pregnancy.

Live vaccines such as yellow fever, MMR, the oral typhoid capsules, BCG and chickenpox (varicella) are normally postponed until after pregnancy. Yellow fever raises a particular dilemma because some countries require proof of vaccination for entry, and because yellow fever itself is a serious, potentially fatal disease. If travel to a genuine yellow fever risk area cannot be avoided or postponed, a yellow fever centre will carry out a careful risk-benefit assessment; vaccination may occasionally be recommended, or alternatively a medical exemption (waiver) letter may be issued where the country accepts one. For MMR, the priority is to ensure women are protected before pregnancy where possible, since rubella in particular can harm a developing baby. Wherever a live vaccine is avoided, your clinician will discuss alternative protection such as strict mosquito-bite avoidance.

Two vaccines are actively recommended in pregnancy for every expectant mother, whether or not she is travelling. The whooping cough (pertussis) vaccine is offered from around 16 weeks of pregnancy; the antibodies a mother makes pass across the placenta and protect her newborn in the first vulnerable weeks before the baby can be vaccinated. The seasonal flu vaccine is recommended at any stage of pregnancy because pregnant women are at higher risk of serious complications from flu, and the jab also protects the baby for the first months of life. Both are inactivated vaccines with a strong safety record in pregnancy. If you are travelling, these are sensible to keep up to date — flu circulates year-round in many parts of the world and seasonally in both hemispheres. The COVID-19 vaccine is also recommended in pregnancy in line with current national guidance.

Some of the biggest travel-health risks in pregnancy are not vaccine-preventable, so they deserve special attention. Malaria can be far more severe in pregnant women and is dangerous for the baby, yet not every antimalarial tablet is suitable in pregnancy and choice depends on the trimester and destination. Many specialists advise pregnant women to avoid travel to malaria-risk areas where possible; if travel is essential, scrupulous mosquito-bite avoidance and an appropriate, pregnancy-safe antimalarial are essential. Zika virus is a particular concern because infection in pregnancy can cause serious birth defects. Current advice is that pregnant women should avoid non-essential travel to areas with a risk of Zika transmission, and use rigorous insect-bite precautions if travel cannot be avoided. We can help you understand these risks as part of your overall plan.

Every pregnant traveller is different, which is why a personal pre-travel assessment matters more than any general rule. At Crewe Travel Clinic — serving Crewe, Nantwich, Sandbach, Alsager and the wider Cheshire and Stoke-on-Trent area — our clinical team reviews your destination, planned activities, how long you will be away, your stage of pregnancy and your existing vaccination history. We then explain which vaccines are advisable, which are best deferred, and what non-vaccine precautions you should take. We work alongside your midwife or GP rather than replacing their advice, and we will always recommend confirming the plan with your maternity team. Booking early gives the most flexibility to schedule any course comfortably within your pregnancy.