Vaccines in pregnancy in Australia

What you are offered, and what it costs

Australia funds three vaccines in pregnancy through the National Immunisation Program: whooping cough, influenza and RSV. All three are free if you hold, or are eligible for, a Medicare card. None of them is a live vaccine, and all three exist principally to protect the baby in the months before they can be vaccinated themselves.

The mechanism is the same in each case. You produce antibodies, those antibodies cross the placenta, and the baby is born already carrying protection. That is why the timing windows are specific rather than approximate.

Whooping cough (dTpa) — 20 to 32 weeks, every pregnancy

The Australian Immunisation Handbook recommends a single dose of a pertussis-containing vaccine (dTpa) between the mid second trimester and the early third trimester, ideally at 20 to 32 weeks, in every pregnancy regardless of how recently you were vaccinated. Vaccination in pregnancy reduces the risk of pertussis in the mother and in young infants by about 90%.

Optimal protection comes from vaccinating soon after 20 weeks. It can still be given later, right up to delivery, but antibody transfer is lower if the vaccine is given within two weeks of the birth. Babies cannot have their own first pertussis dose until 6 weeks of age, and whooping cough is at its most dangerous before then.

Influenza — any stage, every pregnancy

Inactivated influenza vaccine is recommended as a single dose at any stage of pregnancy, and particularly for anyone who will be in their second or third trimester during flu season. Pregnancy increases the risk of severe influenza, and babies under 6 months are too young to be vaccinated, so maternal vaccination is the only protection available to them. The live attenuated nasal influenza vaccine is not used in pregnancy.

RSV (Abrysvo) — from 28 weeks, preferably by 36

The maternal RSV vaccine became free under the National Immunisation Program on 3 February 2025. Only Abrysvo is recommended in pregnancy. It is given as a single dose from 28 weeks gestation, preferably between 28 and the end of 36 weeks, in each pregnancy, and is usually offered at the 28-week antenatal appointment.

The Department of Health's own figure is that vaccination in pregnancy reduces the risk of severe RSV disease in infants under 6 months by about 70%. The registration trial found 57% efficacy against RSV hospitalisation up to 6 months, and post-licensure data from the UK and Argentina show a 72% to 82% reduction in RSV-related lower respiratory tract hospitalisation in the first six months of life.

Vaccination before 28 weeks is deliberately not recommended. That is a precaution following an imbalance in preterm births seen in a different, discontinued maternal RSV vaccine trial in low- and middle-income countries. Vaccination beyond 36 weeks is permitted but gives less protection if given within two weeks of birth. Separately, state and territory programs supply RSV monoclonal antibody immunisation for infants; ask your provider which applies where you live.

Getting them together

Influenza, dTpa and RSV vaccines can be given at the same visit or separately. If given together they should go into different injection sites. A COVID-19 vaccine can also be given at the same visit if your provider recommends it.

COVID-19: read this part carefully

Australia's position is not the same as the position in Canada or the United States, and it is not the same as it was in 2021. The Immunisation Handbook lists COVID-19 among vaccines that are not routinely recommended in pregnancy for women who have been vaccinated previously, though it can be considered on an individual basis. Women who are unvaccinated are recommended to receive a COVID-19 vaccine, and it can be given at any stage of pregnancy. Safe use of mRNA COVID-19 vaccines in pregnancy has been demonstrated, so this is an assessment of marginal benefit rather than a safety finding.

If you are reading North American advice that recommends COVID-19 vaccination in every pregnancy, that advice does not describe what an Australian provider will routinely offer you.

Vaccines you should not have while pregnant

Live attenuated vaccines are contraindicated:

• MMR and MMRV (measles, mumps, rubella, varicella)
• Varicella (chickenpox)
• BCG
• Oral typhoid (Vivotif) and live oral cholera (Vaxchora)
• Imojev, the live Japanese encephalitis vaccine — the inactivated JEspect can be used if the risk is high

The Handbook is careful about how it frames this: for MMR the risk is described as hypothetical, and women who receive rubella vaccine inadvertently during pregnancy do not need to consider terminating the pregnancy. Advise your provider if you are planning a pregnancy, and avoid conceiving for 28 days after a live vaccine.

Yellow fever vaccine is not recommended, but if travel to a transmission area is unavoidable, pregnant women should receive it. HPV vaccine is not recommended in pregnancy; if you fall pregnant part-way through a course, stop and finish it after the birth.

Before you conceive, and after the birth

A pre-conception check is the right moment to sort out hepatitis B, measles, mumps, rubella, varicella and COVID-19 vaccination, because several of those cannot be given once you are pregnant. Serology can confirm immunity to hepatitis B, measles, mumps and rubella if your history is uncertain. Varicella serology is less reliable as a measure of vaccine-induced immunity, though it does indicate past infection.

If you are found to be non-immune to rubella or varicella during pregnancy, the vaccine is given after the birth. Breastfeeding is not a barrier.

How and where to get vaccinated

Whooping cough and RSV vaccines are usually given by your midwife at an antenatal appointment or by your GP. Influenza vaccination is available from GPs, community pharmacies and many antenatal clinics during the season. None of the three costs you anything under the National Immunisation Program.

If you were not offered a vaccine at the appointment where you expected it, ask. Gaps are usually administrative. If you have passed the usual window for whooping cough, still request it — later vaccination transfers fewer antibodies but is not pointless.

Where to get help

The Australian Government Department of Health, Disability and Ageing is the governing authority, and its immunisation-for-pregnancy page carries the current windows. The Australian Immunisation Handbook holds the detailed recommendations and states the date of its last update on every chapter. For a decision that does not fit the standard advice — immunosuppression, a previous severe reaction, travel to a yellow fever or Japanese encephalitis area — speak to your GP or a travel health clinic rather than working from general guidance.