From 1 September 2026, pregnant women across the UK become eligible for this season's flu vaccine — a month ahead of the general NHS programme. It is a natural moment to step back and look at maternal vaccination as a whole, because the flu jab is one of three vaccines the NHS recommends — and provides free — in pregnancy: flu, whooping cough (pertussis) and, since September 2024, RSV.
Three different diseases, one shared idea: a newborn baby cannot be vaccinated against any of them in their first weeks, so the vaccine is given to you instead. This article explains how that works, what each vaccine protects against, and when in pregnancy each one is offered.
First things first: all three are free on the NHS
Every pregnant woman in the UK is offered all three vaccinations free on the NHS — usually through her GP surgery, and for the flu jab through many pharmacies and some maternity services as well. Nobody needs to pay for any of them, and if the NHS route is convenient for you, take it: you lose nothing clinically. We offer the same vaccines privately purely as a matter of convenience — the same visit as a scan, no GP appointment to arrange, a week and time of your choosing. The vaccine in the syringe is no better for being paid for, and we will happily say so on the phone.
Why vaccinate the mother to protect the baby?
The logic behind all three programmes is the same, and it is worth understanding because it explains the timing of each vaccine.
Babies are most vulnerable to these infections in their first weeks and months — yet that is precisely when they cannot be protected directly. No flu vaccine is licensed for babies under six months. A baby cannot receive their own first whooping cough vaccine until 8 weeks old, and needs three doses — at 8, 12 and 16 weeks — for full protection. Vaccination in pregnancy closes that gap: the jab raises your antibody levels, the placenta actively transfers those antibodies to your baby through the third trimester, and your baby is born carrying ready-made protection until their own immunity can take over.
One injection, two patients protected — and the evidence below shows it works for all three diseases.
The flu vaccine: any stage of pregnancy, every season
Pregnancy changes how your immune system, heart and lungs work, and those changes make true influenza harder to handle. In the 2009 swine-flu pandemic, pregnant women were found to be four times as likely to develop serious illness as the general population, and between 2009 and 2012 flu caused 36 maternal deaths in the UK — an estimated half of them preventable by vaccination. That is why the JCVI added pregnancy to the flu risk groups in 2010.
The flu vaccine in pregnancy is an inactivated vaccine: it contains no live viruses and cannot give you flu. The NHS advises it can be given safely at any stage, from the first few weeks up until labour, and the protection reaches your baby too — in a randomised trial, vaccination in pregnancy cut laboratory-confirmed flu in babies under six months by 63% (95% CI 5–85). Because the vaccine is re-formulated each year as strains change, you need the current season's jab in every pregnancy that spans a flu season, whatever you had last winter.
The whooping cough vaccine: from 16 weeks
Whooping cough is most dangerous in the first weeks of life — before that first baby vaccine at 8 weeks old. The disease can lead to pneumonia, permanent brain damage and, in the worst cases, death, and it has not gone away: England confirmed 14,879 cases in 2024, against 857 the year before — the largest outbreak since enhanced surveillance began in 1994. Of the 32 infant deaths between the programme's start in 2012 and the end of 2024, 26 were babies whose mothers were not vaccinated in pregnancy.
The UK has offered the whooping cough vaccine in pregnancy since October 2012, and its effectiveness is measured from the programme itself rather than a manufacturer's trial: UKHSA's latest estimate is 89% against confirmed whooping cough in infants, and around 91% against infant death. You can have it from 16 weeks, and most women have it at around 20 weeks — often in the same week as the mid-pregnancy anomaly scan. For the best protection, the aim is to be vaccinated before 32 weeks, though a later jab is still worth having: it can be given right up to birth.
The RSV vaccine: from 28 weeks
Respiratory syncytial virus usually feels like a cold in adults, but in small babies it can inflame the tiniest airways — bronchiolitis — or cause pneumonia. It accounts for roughly 33,500 hospital admissions a year in UK children under five, and the riskiest period is a baby's first six months — exactly the window a maternal vaccine covers.
The RSV vaccine in pregnancy is the newest of the three: since September 2024 the NHS has offered every pregnant woman a single dose of Pfizer's Abrysvo, a non-live protein vaccine, from 28 weeks. The evidence is already strong on both fronts.
In its international trial of around 7,400 pregnant women, efficacy against severe RSV disease in babies was 81.8% (99.5% CI 40.6–96.3) in the first 90 days of life; and in the NHS programme's first season, UK data showed babies of mothers vaccinated at least 14 days before birth were 72% less likely to be admitted to hospital with RSV.
Unlike the flu jab it is given year-round, because babies are born in every month and RSV returns every winter.
Timing at a glance
Put the three together and a simple gestational map emerges:
- From 16 weeks — the whooping cough vaccine, ideally before 32 weeks; most women have it at around 20 weeks, near the anomaly scan
- From 28 weeks — the RSV vaccine, ideally in week 28 or soon after, and you stay eligible up to delivery
- Any stage, in season — the flu vaccine, from the start of September (this season from 1 September 2026), before flu circulates from December
The vaccines can be combined: UKHSA supports giving the flu jab together with the whooping cough vaccine and, past 28 weeks, with the RSV vaccine. The one rule of thumb that matters is not to delay any of them just to bundle appointments — have each as soon as it is offered.
A word on safety
These are among the better-studied interventions in maternity care. The flu vaccine has been offered to every pregnant woman in the UK since 2010; a US study comparing over 52,000 babies exposed in the first three months of pregnancy with over 370,000 who were not found no increased risk of birth defects, and the review cited in UKHSA's Green Book concluded it can be safely given in any trimester.
For whooping cough, the UK regulator's study of 20,074 vaccinated pregnant women found no increased risk of stillbirth or of any of an extensive predefined list of pregnancy complications. The RSV vaccine is newer — UK experience spans two winters rather than a decade — and it was examined closely on one specific question, premature birth: its trial recorded a small numerical excess of preterm births in the vaccinated group (5.7% versus 4.7%, not statistically significant) that was confined to non-high-income trial countries, while in high-income countries rates were identical at 5.0% in both arms.
The JCVI weighed exactly this evidence before recommending the UK programme, and no serious safety signal has emerged in pregnant women since.
None of the three can cause the infection it protects against: the injected flu and whooping cough vaccines are inactivated, and Abrysvo contains no whole virus. Expected side-effects are the ordinary ones — a sore arm, sometimes a slightly raised temperature or tiredness — settling within a day or two.
COVID-19 vaccination in pregnancy is a separate topic with its own evidence base, and we cover it in a dedicated article: the COVID-19 vaccine and pregnancy.
How London Pregnancy Clinic can help
To repeat the important part: all three vaccines are free on the NHS, and for most women that is the sensible route. Where we help is convenience. We offer all three at our City of London clinic — flu at £45, whooping cough at £95 and RSV at £290, all listed openly on our fees page — given by a clinician, usually in the same visit as a scan or midwife appointment, with a written record for your maternity notes.
If you are not registered with a UK GP, are new to London, or simply want a specific week, email or call us and we will find you a time. We vaccinate pregnant women only, so partners and other relatives who want a flu jab cannot have one here — our partner clinic Spital Clinic, a private GP practice in the City of London, offers it to adults.
This article is for general information only and is not a substitute for professional medical advice. Always speak to your midwife, GP or obstetrician about your own pregnancy.
