Travel Vaccinations and Pregnancy

What you need to know about travel health before, during, and after pregnancy.

General Advice

Travel during pregnancy requires extra health planning. Some vaccines are safe during pregnancy, some are not, and certain destinations carry risks that are especially dangerous for pregnant women. Always consult your obstetrician or GP in addition to a travel health doctor before travelling overseas while pregnant.

Safe Vaccines During Pregnancy

The following vaccines are generally considered safe during pregnancy: Influenza (recommended), dTap (recommended in the third trimester in Australia), Hepatitis A, Hepatitis B, and Meningococcal vaccines. These are inactivated vaccines and do not contain live virus.

Vaccines to AVOID During Pregnancy

Live vaccines should generally NOT be given during pregnancy. These include: Yellow Fever (live vaccine — avoid unless travel to a high-risk area is unavoidable), MMR, Varicella (chickenpox), and oral typhoid. If Yellow Fever is required for your destination and you're pregnant, discuss the risks versus benefits with your doctor — a medical exemption letter may be an option.

Malaria and Pregnancy

Malaria is extremely dangerous during pregnancy — it can cause miscarriage, premature birth, low birth weight, and maternal death. Pregnant women should strongly consider avoiding malaria-endemic areas altogether. If travel is unavoidable, malaria prophylaxis and rigorous bite prevention are essential. Mefloquine is considered the safest antimalarial during the second and third trimesters. Doxycycline is contraindicated during pregnancy. Discuss options carefully with your doctor.

Zika Virus

Zika virus can cause severe birth defects. Pregnant women should avoid travel to areas with active Zika transmission, including parts of Southeast Asia, the Pacific, Central and South America, and the Caribbean. If your partner has travelled to a Zika-affected area, barrier contraception is recommended for at least 3 months after return. Check Smartraveller for current Zika risk areas.

How ATAGI Classifies Vaccines in Pregnancy

The Australian Immunisation Handbook (ATAGI) classifies vaccines into three groups for pregnancy decision-making: routinely recommended, considered case-by-case, and contraindicated. The classification is based on whether the vaccine is live-attenuated (carries theoretical fetal risk) or inactivated (broadly safe), and on the balance of disease risk versus vaccination risk.

Routinely recommended in pregnancy

Influenza vaccine: Recommended in any trimester for all pregnant women, regardless of travel. Influenza in pregnancy carries elevated risk of severe disease, hospitalisation, and adverse fetal outcomes.

Pertussis (whooping cough, in dTpa form): Recommended between 20–32 weeks of every pregnancy. Provides passive antibody protection to the newborn before they can be vaccinated themselves.

COVID-19 vaccine: Recommended at any stage of pregnancy.

Considered case-by-case (inactivated travel vaccines)

Inactivated travel vaccines are generally considered safe in pregnancy if the destination presents meaningful exposure risk. ATAGI's case-by-case category includes:

• Hepatitis A: Inactivated, generally safe; offered if travel to a high-risk area is unavoidable.
• Hepatitis B: Inactivated, recommended if exposure risk is high (medical work, blood exposure, sexual contact in high-prevalence areas).
• Typhoid (injectable Vi): Inactivated injectable form is preferred over the live-attenuated oral form (Ty21a) which is contraindicated.
• Japanese Encephalitis: Inactivated, used when travel to a JE-endemic rural area cannot be deferred.
• Meningococcal ACWY: Conjugate vaccines are inactivated and considered safe; required for Hajj travel.
• Rabies pre-exposure: Inactivated, offered when travel to high-risk areas with limited post-exposure access.

Contraindicated in pregnancy (live-attenuated)

Live-attenuated vaccines are generally contraindicated in pregnancy because of theoretical fetal risk:

• MMR (measles, mumps, rubella): Defer until after delivery; women planning pregnancy should ensure MMR status before conception.
• Varicella (chickenpox): Same as MMR.
• Yellow Fever: Generally avoided. If travel to a yellow-fever endemic area is unavoidable, the vaccine may be given after a careful risk-benefit discussion — and the clinic must be an approved Yellow Fever centre.
• BCG: Live attenuated, contraindicated.
• Oral typhoid (Ty21a): Use injectable form instead.

Antimalarial Prophylaxis in Pregnancy

Malaria in pregnancy is dangerous — both for the woman (severe anaemia, hypoglycaemia) and the fetus (miscarriage, prematurity, low birth weight). Travel to malaria-endemic areas during pregnancy is generally not recommended. If unavoidable, prophylaxis options include:

• Chloroquine and proguanil: Considered safe at all stages of pregnancy. Limited use because of widespread resistance — only effective for the few remaining chloroquine-sensitive areas.
• Mefloquine (Lariam): Considered safe in second and third trimesters; first-trimester use is generally avoided unless no alternative.
• Atovaquone-proguanil (Malarone) and doxycycline: Generally avoided in pregnancy due to limited safety data (atovaquone-proguanil) or known fetal effects (doxycycline causes dental staining and bone effects).

Zika Virus and Pregnancy

Zika virus infection during pregnancy can cause serious birth defects including microcephaly. Australian government advice is that pregnant women should avoid travel to areas with active Zika transmission or recent outbreaks. If travel cannot be avoided, strict mosquito-bite prevention is essential. Zika can be transmitted sexually as well as by mosquito; partners returning from Zika-affected areas should use barrier protection for the duration of pregnancy. Smartraveller maintains an updated list of countries with current Zika advice.

Talk to Your Obstetrician and a Travel-Medicine Specialist

Decisions about vaccination during pregnancy are individualised — they depend on your destination, itinerary, gestational age, baseline health, and the specific disease epidemiology in the country you are visiting. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends consultation with both an obstetrician and a travel-medicine specialist for any non-essential travel during pregnancy to a destination with active vaccine-preventable disease risk.

Last updated: May 2026