# Vaccines in pregnancy and the RSV route

**Which vaccines should we have in pregnancy, and how do we protect the baby from RSV?**

Vaccines in pregnancy (flu, COVID-19, whooping cough) pass protection to the baby. RSV is a common virus that can cause serious breathing illness in young babies; you can protect the baby either with an RSV vaccine in late pregnancy or with an antibody injection given to the baby after birth. The decision is which of these you want.

In short: Parents choose between 4 main approaches: All recommended (flu, COVID-19, Tdap, RSV); Tdap and flu only; Skip the maternal RSV vaccine and give the baby an RSV antibody at birth instead; Decline both. Evidence: well established. Guidance and evidence agree. The real question is whether you'll follow it. Best settled: during pregnancy.

- Area: Pregnancy, birth and arrival
- Evidence: Well established
- Best settled: During pregnancy
- First published: 2026-10-03
- Last updated: 2026-10-05
- Page: https://www.raisingyourchild.com/topics/pregnancy-birth-and-arrival--vaccines-in-pregnancy-and-the-rsv-route

## Vaccines in pregnancy and the RSV route: what are the options?

1. **All recommended (flu, COVID-19, Tdap, RSV)**: You get every vaccine recommended in pregnancy: flu, COVID-19, whooping cough (Tdap) and RSV.
2. **Tdap and flu only**: You get the whooping cough and flu vaccines and skip the others.
3. **Skip the maternal RSV vaccine and give the baby an RSV antibody at birth instead**: You skip the RSV vaccine in pregnancy, and the baby gets an RSV antibody injection after birth.
4. **Decline both**: You decline both the RSV vaccine and the baby's antibody.

## Vaccines in pregnancy and the RSV route: what does the evidence say?

**Well established.** Guidance and evidence agree. The real question is whether you'll follow it. (Settled on whether; route is preference)

ACOG 2026-27: one RSV vaccine dose (Abrysvo) at 32-36 weeks of pregnancy in season, or an infant monoclonal antibody (nirsevimab or clesrovimab) at birth if it was not given. The CDC likewise says either maternal vaccination or an infant antibody is recommended; babies born at least 14 days after the maternal dose usually need no antibody, antibody is given October through March in most of the continental US, and RSV vaccines themselves are not approved for infants. The AAP recommends antibody for babies under 8 months whose birth parent was not vaccinated and does not prefer one product over another

Sources:

- [Contemporary OB/GYN](https://www.contemporaryobgyn.net/view/acog-2026-27-respiratory-virus-immunization-recommendations-pregnancy)
- [CDC](https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/infants-young-children.html)
- [Guideline Central summary](https://www.guidelinecentral.com/guideline/5257391/)

## What else is worth knowing?

Vaccines given in pregnancy protect you and pass antibodies to the baby for the first months, before the baby can be vaccinated. For RSV there are two routes to the same goal, a vaccine for you late in pregnancy or an antibody for the baby, and you usually need only one. Timing matters, so raise it with your provider well before the third trimester.

## Questions to ask each other

- What do we each already know or believe about vaccines in pregnancy?
- Whose advice will we rely on to decide, our doctor or midwife, or something else?
- Would we choose the maternal vaccine or the baby's antibody for RSV, and why?

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General information, not medical advice. Two parents can each answer this and compare: https://www.raisingyourchild.com/explore?cat=pregnancy-birth-and-arrival&topic=pregnancy-birth-and-arrival--vaccines-in-pregnancy-and-the-rsv-route