Priority populations

Immunisation during pregnancy

During pregnancy there is an increased risk from certain vaccine preventable diseases. Immunisations recommended during pregnancy can offer protection for the mother and their unborn baby against influenza, pertussis and respiratory syncytial virus (RSV). The protection extends from pregnancy and into the babies’ first few weeks and even months of life.

Pre- conception immunisation

When planning a pregnancy, it is recommended immunisation needs are assessed as part of routine pre-conception checks. The Australian Immunisation Handbook recommends checking immunisation status for the following:

hepatitis B
measles
mumps
rubella
varicella
COVID-19.

Immunisations during pregnancy

Recommended immunisations should be offered as soon as eligible to help ensure optimal protection. However, if an immunisation is missed at the recommended time, it can still be given later. Every effort should be made to identify and support those who have missed immunisations, and all immunisations can be safely given on the same day.

Pertussis

Pertussis (whooping cough) immunisation is recommended during pregnancy, between 20–32 weeks gestation. Immunisation is recommended in each pregnancy, including those closely spaced, to provide maximum protection to every infant.

If the pertussis immunisation is not administered between the recommended interval of 20–32 weeks, it can be given after 32 weeks. If it is administered between 13 and 20 weeks, it does not need to be readministered. Pertussis immunisation comes as combination diphtheria-tetanus-pertussis formulation.

Influenza

Influenza immunisation is recommended during each pregnancy, at any stage of pregnancy. If the previous year’s seasonal influenza immunisation was given early in pregnancy it is recommended to receive the current seasonal influenza immunisation (when it becomes available) later in the same pregnancy. If an influenza immunisation was given before becoming pregnant re-immunisation is recommended during pregnancy to protect the unborn infant. All recommended immunisations during pregnancy can safely be given on the same day.

Respiratory Syncytial Virus (RSV)

Respiratory Syncytial Virus (RSV) immunisation is recommended during each pregnancy from 28 weeks gestation (ideally before 36 weeks) to protect the infant from birth for up to 6 months.

Abrysvo is the only RSV immunisation approved for use during pregnancy. If the RSV immunisation is administered before 28 weeks, it does not need to be readministered. If immunisation was within 2 weeks of the baby being born, the baby may not be adequately protected and may be eligible for nirsevimab at birth.

For more information refer to Queensland Paediatric Respiratory Syncytial Virus Prevention Program

Nirsevimab (monoclonal antibody) is recommended at birth only for infants with high-risk medical conditions or who were not protected by RSV immunisation administered during pregnancy (i.e. immunisation not given; birthing occurred within 2 weeks of vaccination; mother with severe immunocompromise; infant received exchange transfusion; etc). Refer to the Australian Immunisation Handbook RSV chapter and your local health authority for recommendations for nirsevimab use in infants, as well as information about eligibility and availability.

Find out more about the Queensland Paediatric Respiratory Syncytial Virus Prevention Program

COVID-19

A primary course is recommended for those who are unvaccinated. Further doses are not routinely recommended for those who are healthy and previously immunised. A further dose is recommended for those who have been previously immunised with severe immunocompromise and can be considered for those who have been previously immunised.

Co-administration

All immunisations routinely recommended during pregnancy can be co-administrated. They should be administered in alternate sites.

For optimal protection the immunisations should be given when recommended, however they can be given up until the baby is born.

For more information refer to the NCIRS Immunisation recommendations for pregnant women- a guide for health professionals

Cost

Influenza, Pertussis (whooping cough) and RSV immunisations are free for those who are eligible for Medicare. COVID-19 immunisations are free for everyone in Australia, including during pregnancy regardless of Medicare or visa status. Patients may be required to pay a consultation fee.

Immunisations not recommended during pregnancy

For further information please refer to:

Immunisations and breastfeeding

The benefits of breastfeeding are well known, and immunisations routinely recommended during pregnancy are safe when breastfeeding.

If additional immunisations are recommended, you should refer to the Australian Immunisation Handbook: Women who are breastfeeding for additional information.

For information on breastfeeding and immunity, visit Australian Breastfeeding Association- Breastfeeding and Immunity

Immunisations for people in contact with infants

Adult household contacts and carers (e.g. partners and grandparents) of infants <6 months of age should ideally receive a dTpa immunisation at least 2 weeks before beginning close contact with the infant. A booster dose of the dTpa immunisation is recommended for those who have not received one in the previous 10 years. For more information, please see Pertussis factsheet_3 March 2025.pdf

During pregnancy, close contacts are strongly recommended to check they are up to date for other recommended immunisations such as influenza, measles, mumps, rubella and varicella.