If you were pregnant during the pandemic, you will remember how often the advice on COVID-19 vaccination changed. It has changed again since. This article sets out the current UK position: who can have a COVID-19 vaccine on the NHS, what the safety evidence shows in pregnancy, and how the advice has moved on since we first wrote about it in January 2021.

The short answer

Pregnancy on its own no longer makes you eligible for an NHS COVID-19 vaccine. In the autumn 2026 programme it is offered to adults aged 75 and over, residents of care homes for older adults, and anyone aged 6 months or over who is immunosuppressed.
If you are in one of those groups, being pregnant or breastfeeding does not stop you having it. The NHS says most people who are eligible can have the vaccine while pregnant or breastfeeding.
The safety evidence is reassuring. Large studies of vaccination in pregnancy have found no increase in miscarriage, stillbirth or preterm birth.

Who is eligible on the NHS now?

COVID-19 vaccination is now a targeted seasonal programme for the people at highest risk of serious illness. Following advice from the Joint Committee on Vaccination and Immunisation (JCVI), the groups eligible in autumn 2026 are:

adults aged 75 and over
residents in a care home for older adults
people aged 6 months and over who are immunosuppressed, for example because of chemotherapy, an organ transplant or long-term immunosuppressive medicines

NHS appointments for the autumn 2026 programme take place from 1 October 2026. If you are pregnant and think you may be eligible because of a condition or treatment that weakens your immune system, check the NHS COVID-19 vaccine page or ask your GP or the specialist team who look after your condition.

How the advice has changed since 2021

The original version of this article, written in January 2021, reflected the very first advice. The vaccines had not yet been studied in pregnancy, so they were offered only to pregnant women at higher risk, such as health and social care workers. That advice is now out of date. In summary:

April 2021: after real-world data from around 90,000 vaccinated pregnant women in the United States raised no safety concerns, the JCVI advised that pregnant women should be offered the vaccine at the same time as the rest of the population, based on their age and clinical risk group, with the Pfizer-BioNTech or Moderna vaccines preferred.
December 2021: after the Delta wave showed that pregnancy increased the risk of severe COVID-19 and poor pregnancy outcomes, pregnancy was added to the clinical risk groups for vaccination.
Autumn 2024: pregnant women were still included in the seasonal programme as a clinical risk group, although the JCVI noted that the risk of severe COVID-19 in pregnant women and newborns had become substantially lower.
From 2025: the JCVI narrowed the programme to older adults, care home residents and people who are immunosuppressed. It noted that serious illness in pregnancy had fallen sharply in the Omicron period, and advised that routinely vaccinating pregnant women was highly unlikely to be cost-effective.

In other words, pregnancy was removed from the programme because the risk from COVID-19 in pregnancy has fallen, not because of any new concern about the safety of the vaccine.

Is the vaccine safe in pregnancy?

The COVID-19 vaccines used in the UK do not contain live virus, so they cannot give you or your baby COVID-19. A 2022 review that pooled 23 studies, including more than 117,000 vaccinated pregnant women (almost all given mRNA vaccines), found no higher risk of miscarriage, preterm birth or other adverse pregnancy outcomes, and stillbirth was slightly less common among vaccinated women.

You do not need a pregnancy test before a COVID-19 vaccine. If you had one before you knew you were pregnant, UK guidance is that this is not a reason to consider ending the pregnancy.

Fertility and breastfeeding

There is no evidence that COVID-19 vaccines affect fertility. A study of more than 2,000 women trying to conceive in the United States and Canada found that vaccination in either partner was not linked to lower chances of conceiving.

If you are breastfeeding and in an eligible group, you can have the vaccine. There is no known risk from non-live vaccines while breastfeeding, and studies have found protective antibodies, but not the vaccine's mRNA, in the breast milk of vaccinated women.

What if I am not eligible but would like the vaccine?

If you are not in an eligible group, the vaccine is not available to you on the NHS. Some pharmacies offer COVID-19 vaccination privately. If you are considering this, talk it through with your midwife or GP first so you can weigh up your own circumstances, and tell the pharmacist that you are pregnant. London Pregnancy Clinic does not offer COVID-19 vaccination.

If you are pregnant and become unwell with COVID-19, or you are worried about your baby's movements, contact your midwife or maternity unit.

The vaccines every pregnant woman is offered

While COVID-19 vaccination is now limited to specific groups, three vaccines are recommended for every pregnant woman in the UK, and all three are free on the NHS:

The flu vaccine: during flu season, at any stage of pregnancy.
The whooping cough (pertussis) vaccine: from 16 weeks, usually around 20 weeks, and ideally before 32 weeks.
The RSV vaccine: from 28 weeks, in every pregnancy.

Our guide to vaccines in pregnancy explains how each one protects your baby and how the timings fit together.