Vaccines during pregnancy: pertussis, flu, Covid 19 and RSV, what are the 2026 recommendations?

Short answer: in France, four vaccinations are currently specifically recommended during pregnancy: pertussis, seasonal influenza, Covid 19 and, depending on the situation, respiratory syncytial virus or RSV to protect the infant against severe RSV disease. They do not follow the same timetable. Pertussis vaccination is recommended during every pregnancy, preferably between 20 and 36 weeks of amenorrhoea. Influenza vaccination can be given during any trimester while the seasonal campaign is running. Covid 19 vaccination is recommended for pregnant women regardless of trimester. For RSV, the French strategy includes maternal vaccination between 32 and 36 weeks of amenorrhoea during the recommended seasonal period, or infant immunisation with a monoclonal antibody according to current guidance.

These principles are easy to list but less easy to organise when several vaccines become relevant at the same time. It is also useful to distinguish vaccinations that primarily reduce maternal risk from those designed to transfer antibodies to the baby, vaccinations repeated during every pregnancy, and vaccinations whose timing depends on the respiratory virus season. In September 2026, this is particularly timely because autumn and winter respiratory prevention is becoming relevant again. As of 7 September 2026, the French official pages checked for this article describe influenza and Covid 19 campaigns beginning around mid October in mainland France, but they do not yet display a precise start date for the 2026 to 2027 campaign. This article therefore does not invent one.

This guide is written for pregnancies followed in France. It does not replace advice from the midwife, doctor, obstetrician or pharmacist who knows your medical history. A known severe allergy to a vaccine component, a serious previous vaccine reaction, specific treatment, an acute illness or a pregnancy requiring specialist monitoring may change the practical plan.

Why vaccination during pregnancy can protect two people at once

Some maternal vaccines have a dual purpose. They can reduce the mother's risk of disease or complications and can also lead to maternal antibodies crossing the placenta. The newborn therefore receives passive protection during a period when they are particularly vulnerable and before their own vaccination schedule is complete.

This mechanism is central to pertussis and RSV prevention. Pertussis can be particularly severe in young infants. Maternal vaccination aims to generate enough antibodies at the appropriate time for efficient transfer before birth. Maternal RSV vaccination works on a similar principle: antibodies generated in the mother cross the placenta and help protect the baby during the first months of life.

Influenza and Covid 19 also address maternal risk. Pregnancy is among the situations associated with an increased risk of severe disease from some respiratory infections. French guidance therefore does not ask pregnant women to wait until the third trimester for influenza or Covid 19 vaccination when a campaign is underway.

A practical table of the four vaccinations recommended in France

This table is not an individual prescription. The actual plan depends on gestational age, expected date of birth, the campaigns currently running and vaccination history. RSV prevention in particular requires checking whether maternal RSV vaccination was given during a previous pregnancy.

Pertussis: why vaccination is recommended during every pregnancy

The French Haute Autorité de santé recommends pertussis vaccination during every pregnancy, even when the woman was vaccinated recently or during a previous pregnancy. The purpose is not simply to maintain the mother's long term protection. It is to generate maternal antibodies at the right stage of pregnancy so that an effective amount can cross the placenta to the baby.

The preferred French window is between 20 and 36 weeks of amenorrhoea. Discussing the vaccine from the second trimester reduces the chance of leaving it until the last days before birth. If delivery follows very soon after vaccination, there may be less time for antibody transfer. Healthcare professionals may then consider whether vaccination of close contacts, sometimes called cocooning, is relevant.

Pertussis vaccination is also recommended after a previous history of pertussis. A past infection does not guarantee that enough antibody will be available for transfer to a future baby. This is one reason the pregnancy vaccination schedule cannot be reduced to the adult booster schedule.

Influenza: pregnancy itself places women in the target group

Seasonal influenza vaccination is recommended during pregnancy regardless of trimester. When the seasonal campaign is open, there is no need to wait for a particular month of pregnancy. Influenza can cause more serious complications in some pregnant women, while maternal vaccination can also provide temporary infant protection through transferred antibodies.

Influenza vaccination is repeated each season because circulating strains are reviewed and because protection decreases over time. A vaccine received during a previous pregnancy does not replace the following seasonal vaccination if another pregnancy overlaps with the next campaign.

As of 7 September 2026, Assurance Maladie states that the campaign normally starts around mid October in mainland France and includes pregnant women among the target groups. The exact 2026 to 2027 start date should be checked when arranging vaccination because it has not yet been published on the official sources verified for this article.

Covid 19: recommendation applies in every trimester

The Assurance Maladie page updated in April 2026 lists pregnant women, regardless of trimester, among those at increased risk of severe disease for whom the annual autumn Covid 19 dose is strongly recommended. France's Vaccination Info Service likewise recommends mRNA Covid 19 vaccination during pregnancy.

The autumn Covid 19 campaign is coordinated with the influenza campaign. Both vaccines may be given on the same day at different injection sites. If they are not given together, current French recommendations do not require a mandatory interval between them.

The vaccine formulation used in a campaign may be adapted to circulating variants. For this reason, it is more reliable to check the official campaign page at the time of vaccination than to keep the name of a vaccine found in an older article.

RSV and bronchiolitis: maternal vaccination or infant immunisation

RSV is a major cause of bronchiolitis and other respiratory disease in infants. The French prevention strategy allows protection to be provided before or soon after birth. One option is maternal vaccination during pregnancy with the vaccine indicated for this purpose. The other is administration of a monoclonal antibody to the infant according to the recommendations for the season.

For maternal vaccination, the French sources checked for this guide use a window of 32 to 36 weeks of amenorrhoea during the recommended seasonal prevention period. The objective is to allow sufficient antibody transfer before birth. This window is narrower than the pertussis window, which makes planning especially useful when a woman reaches 32 weeks near the beginning of autumn.

There is an important nuance for later pregnancies. HAS does not recommend simply repeating maternal RSV vaccination automatically during every pregnancy. Because evidence on an additional dose during a subsequent pregnancy remains limited, HAS has recommended preferential use of passive infant immunisation when maternal RSV vaccination was already given during an earlier pregnancy. Assurance Maladie also describes maternal vaccination as available for pregnant women who have not previously been vaccinated. Previous RSV vaccination should therefore be checked with the healthcare professional.

Can several vaccines be given on the same day?

It depends on the vaccines involved. Influenza and Covid 19 vaccines can be administered on the same day. Pertussis vaccination can also be administered at the same visit as influenza or Covid 19 vaccination under French recommendations. Maternal RSV vaccination is different: an interval of at least two weeks is recommended between the RSV vaccine and a vaccine containing diphtheria, tetanus and acellular pertussis components.

The RSV vaccine may be given at the same time as influenza or Covid 19 vaccination. A woman in late pregnancy at the start of the respiratory season may therefore sometimes receive RSV and influenza vaccines during the same visit, while pertussis vaccination needs to be separated from RSV. The professional can build the sequence around expected date of birth and vaccines already received.

An example timetable without turning pregnancy weeks into a rigid rule

Imagine a pregnancy reaching 22 weeks of amenorrhoea in September. If pertussis vaccination has not yet been given, it can be scheduled within the recommended window. If the pregnancy reaches 32 weeks while seasonal RSV prevention is active, the clinician checks previous RSV vaccination and discusses the relevant strategy. When the influenza and Covid 19 campaign begins, those vaccinations can be given according to current recommendations even if the third trimester has already started.

In another pregnancy beginning in October, influenza or Covid 19 vaccination may be offered during the first trimester while the campaign is underway. Pertussis vaccination will be considered later, from the second trimester, and the RSV question may arise much later depending on the season in which weeks 32 to 36 fall.

The useful way to think about vaccination is therefore to follow two clocks: the pregnancy clock and the seasonal clock. This is why a fixed checklist copied from social media may not fit an individual pregnancy.

What about live vaccines during pregnancy?

Live attenuated vaccines are generally contraindicated during pregnancy because of a theoretical fetal risk. This includes measles, mumps and rubella vaccination and varicella vaccination. Their status is different from the four vaccines specifically recommended during pregnancy discussed in this guide.

However, an accidental live vaccination before pregnancy was recognised does not mean pregnancy termination is indicated. Vaccination Info Service states that available pharmacovigilance data are reassuring and that inadvertent vaccination alone is not an indication for terminating a pregnancy. The exposure should be reported to the professional following the pregnancy.

After birth, some vaccines that could not be given during pregnancy can be updated. Depending on the vaccine, vaccination can also be compatible with breastfeeding.

International travel: do not use the routine French schedule without considering the destination

International travel can add vaccination indications or precautions that do not arise in daily life in France. Some inactivated vaccines may be considered if the infectious risk at the destination justifies them. Conversely, some live vaccines are normally avoided and require an individual benefit risk assessment if travel cannot be postponed.

Our guide to travelling while pregnant by car, train or plane covers the other factors to check before travelling. For international destinations, arrange a travel health consultation early enough to change the plan if necessary.

Why maternal vaccination does not replace the baby's schedule

Maternal vaccination provides temporary passive protection, but it does not replace the infant's own vaccinations. Transferred antibodies gradually decline, so the baby still needs to follow the recommended childhood vaccination schedule.

This is particularly important for pertussis. Maternal vaccination helps protect the period before and around the beginning of the infant schedule, but it does not replace the baby's doses. For RSV, infant protection also needs to be decided with reference to maternal vaccination and the recommendations for the current season.

After maternity discharge, our guide to organising the first week at home with a newborn can help centralise appointments, contact details and documents without turning the first days into a rigid timetable.

What if a recommended vaccine was missed?

The answer depends on the vaccine and gestational age. With pertussis, very late vaccination may leave less time for antibody transfer before delivery. The healthcare professional can assess what remains useful and whether close contacts should have their vaccination status reviewed. For influenza and Covid 19, vaccination may remain relevant while the campaign is running if the pregnant woman remains in the target group.

The maternal RSV window is limited. If that window has passed or maternal vaccination is not chosen, infant immunisation may provide the alternative strategy. Missing the maternal window therefore does not mean all RSV prevention has been lost.

How to prepare for a vaccination appointment during pregnancy

• Know your current gestational age in weeks of amenorrhoea.
• Bring your vaccination record or the information available in your French digital health record if applicable.
• Mention vaccines received during a previous pregnancy, especially RSV vaccination.
• Report any severe allergic reaction or serious adverse event after a previous vaccine.
• Tell the professional if you have an acute febrile illness on the day.
• Ask which vaccines can be administered together and which need spacing.
• If the birth is approaching, ask how the expected delivery date changes the baby's prevention strategy.

This preparation reduces errors caused by incomplete recall and makes shared decision making easier. It also helps prevent contradictory advice when several professionals are involved but do not all know which vaccines have already been given.

Side effects: what can generally be expected

As in other adults, common vaccine reactions are usually local or short lived: pain at the injection site, fatigue, headache or mild fever depending on the vaccine. Exact frequency varies by product and campaign. Most resolve spontaneously within a few days.

A serious allergic reaction is uncommon but needs urgent assessment. Difficulty breathing, swelling of the face or throat, severe faintness or a rapidly generalised reaction after injection requires emergency care. Unusual obstetric symptoms should be assessed according to the maternity unit's usual advice rather than automatically attributed to vaccination.

What the scientific evidence can support, and what it cannot promise

French recommendations draw on clinical trials, pharmacovigilance and observational evidence. A systematic review published in 2025 reported broadly reassuring safety and effectiveness data for the maternal vaccines it evaluated, including influenza, pertussis, Covid 19 and RSV maternal vaccination. That does not mean any vaccine can be described as completely free of possible adverse events, nor does it mean all vaccine candidates are interchangeable.

This distinction is particularly important for RSV. A maternal RSV vaccine candidate from another manufacturer had its development stopped after a preterm birth safety signal in a trial. That candidate is not the vaccine currently recommended in France. By contrast, the RSVpreF vaccine used in the present strategy was evaluated in the MATISSE trial and subsequent follow up. A French nationwide real world study published in 2026 has also provided effectiveness data against RSV hospitalisation in infants born to vaccinated mothers.

The correct conclusion is therefore neither “all vaccines during pregnancy are identical” nor “a problem with one candidate makes all maternal vaccination unsafe”. Evidence needs to be matched to the actual product, indication, gestational timing and population.

When should you ask for individual advice before vaccination?

Individual discussion is particularly important after anaphylaxis or another severe reaction to a previous dose, during a significant acute febrile illness, with some immunosuppressive treatments, with a bleeding disorder or in a high risk pregnancy that requires coordination with the maternity team. Contraindications are vaccine specific and should be checked for the actual product being considered.

If essential travel requires a vaccine that is normally avoided during pregnancy, the decision should be individualised. In some circumstances, the infection risk at the destination can outweigh a theoretical vaccine risk, but this balance should not be improvised from an online article.

Key points

• Four vaccinations are specifically recommended during pregnancy in France: pertussis, influenza, Covid 19 and RSV according to the seasonal strategy.
• Pertussis vaccination is recommended during every pregnancy, preferably between 20 and 36 weeks of amenorrhoea.
• Influenza and Covid 19 vaccines can be given during any trimester while the relevant campaigns are running.
• Maternal RSV vaccination is given between 32 and 36 weeks of amenorrhoea and must be coordinated with infant immunisation and previous maternal RSV vaccination.
• Influenza and Covid 19 vaccines can be given on the same day. RSV vaccination should be separated by at least two weeks from a vaccine containing pertussis.
• Maternal vaccination does not replace the infant's vaccination schedule.
• Live attenuated vaccines are generally avoided during pregnancy, but inadvertent vaccination alone is not an indication for pregnancy termination.

Frequently asked questions

Can I have the influenza vaccine during the first trimester?

Yes. In France, influenza vaccination is recommended to pregnant women during any trimester while the seasonal campaign is running. There is no general requirement to wait until the second or third trimester.

Is pertussis vaccination useful if I had a booster recently?

Yes. French guidance recommends vaccination during each pregnancy so that maternal antibody levels are optimised for transfer to the baby.

Why is pertussis repeated during each pregnancy while RSV vaccination may not be?

The evidence and strategies are different. Pertussis vaccination is explicitly recommended during every pregnancy. For RSV, HAS has recommended preferential infant immunisation during a later pregnancy when maternal RSV vaccination was already given during a previous pregnancy because repeat dose data remain limited.

Can influenza and Covid 19 vaccines be given on the same day?

Yes. French recommendations allow simultaneous administration at different injection sites.

Can pertussis and RSV vaccines be given on the same day?

Not under current French recommendations. An interval of at least two weeks is recommended between maternal RSV vaccination and a vaccine containing diphtheria, tetanus and acellular pertussis components.

When is RSV vaccination given during pregnancy?

The recommended maternal window is 32 to 36 weeks of amenorrhoea during the relevant seasonal prevention period. The exact campaign dates should be checked each season.

If I do not have maternal RSV vaccination, can my baby be protected another way?

Yes. The French strategy also includes infant immunisation with a monoclonal antibody according to current seasonal recommendations. The choice depends on gestational timing, season and maternal vaccination history.

Is Covid 19 vaccination still recommended during pregnancy in 2026?

Yes. Assurance Maladie guidance updated in April 2026 includes pregnant women in any trimester among those for whom the annual autumn dose is strongly recommended.

When does the 2026 to 2027 influenza campaign begin in France?

As of 7 September 2026, the official sources checked for this article describe the usual mainland French campaign as beginning around mid October but do not yet publish a precise 2026 to 2027 start date. Check Assurance Maladie or the Ministry of Health when arranging vaccination.

If MMR was accidentally given during pregnancy, is pregnancy termination recommended?

No. MMR is contraindicated during pregnancy, but Vaccination Info Service states that inadvertent vaccination by itself is not an indication for pregnancy termination. Report it to the healthcare professional following the pregnancy.

Who can vaccinate a pregnant woman in France?

Depending on the vaccine and current rules, vaccination may be provided by professionals including doctors, midwives, pharmacists and nurses. Prescription and reimbursement arrangements should be checked for the relevant campaign.

Does the whole family need a pertussis booster if the mother was vaccinated during pregnancy?

Maternal vaccination is the priority strategy for newborn protection. Reviewing close contacts remains relevant in some situations, particularly when maternal vaccination was not given or occurred very shortly before birth. Ask a healthcare professional to check the household's vaccination status.

Are the vaccines recommended during pregnancy live vaccines?

The routinely recommended influenza, Covid 19, pertussis and maternal RSV vaccines discussed here are not live attenuated vaccines of the type generally contraindicated during pregnancy.

What if I am already 37 weeks and have not had maternal RSV vaccination?

The recommended maternal window has passed. Discuss the infant protection strategy, including passive immunisation according to the recommendations for the season.

Can vaccination during pregnancy replace the baby's vaccinations?

No. Maternal antibodies provide temporary protection. The infant should still follow the recommended childhood vaccination schedule.

Conclusion

Vaccination during pregnancy is not one fixed schedule spread over nine months. It combines pregnancy specific windows with seasonal campaigns. In France in 2026, pertussis, influenza, Covid 19 and maternal RSV prevention are the four main vaccination topics to review. The professional following the pregnancy can arrange them efficiently while accounting for expected delivery date and previous injections.

A useful approach is to review vaccination status early, then revisit it in the second trimester and again as the third trimester approaches. Families also preparing for the baby's first weeks may find our guide to first outings with a newborn useful for infection prevention without trying to isolate the baby from normal family life.

Verified sources and bibliography

1. Vaccination Info Service, Femmes enceintes, updated 15 June 2026, accessed 7 September 2026. French source.
2. Haute Autorité de santé, Grossesse : les vaccins recommandés, 2025, accessed 7 September 2026. French source.
3. Assurance Maladie, Prévenir la coqueluche par la vaccination, accessed 7 September 2026. French source.
4. Assurance Maladie, Prévenir la bronchiolite, updated 2026, accessed 7 September 2026. French source.
5. Assurance Maladie, Campagnes de vaccination contre le Covid 19, 8 April 2026, accessed 7 September 2026. French source.
6. Haute Autorité de santé, maternal RSV vaccination recommendation, accessed 7 September 2026. French source.
7. Safety and Efficacy of Vaccines During Pregnancy: A Systematic Review, 2025.
8. MATISSE maternal RSV vaccine trial final analysis, 2025.
9. Maternal RSVpreF Immunisation Against Infant RSV Hospitalisation, French nationwide effectiveness study, 2026.

General information based on recommendations available on 7 September 2026. This article does not replace medical advice, an individual vaccination record review or updated guidance for the current vaccination campaign.