Vaccines: During Pregnancy and the First Shots

One thread I kept accurate on purpose, from the shots I got while pregnant to the first needles our baby ever had.

During pregnancy

I spent my evenings and weekends building a vaccine-tracking app, so this was the one part of pregnancy where I walked in with homework done. Here's what I got, when, and the one concept that makes all of it make sense.

The one concept that matters

The vaccines offered in pregnancy contain no live, weakened virus. Flu shots are inactivated. Tdap is a toxoid vaccine. The COVID-19 mRNA vaccines contain no virus at all. Live vaccines, like MMR and chickenpox, are the ones generally deferred until after birth. So the question I learned to ask about anything offered in pregnancy is simple. Is this a live vaccine? The ones given while pregnant are not.

What I got

• Influenza. Mine was in December, mid-pregnancy. Flu hits harder in pregnancy, and the protection passes to the baby.
• COVID-19, recommended, and the reasoning convinced me: the baby is born with your antibodies, and can't receive these vaccines themselves until at least six months old. Your dose covers their most vulnerable stretch.
• Tdap (tetanus, diphtheria, pertussis), recommended between weeks 27 and 32, timed so peak antibodies transfer before birth. Pertussis, better known as whooping cough, is the main target, and it's most dangerous to newborns.

My Tdap side effects, honestly

Backache, sore glutes, and leg cramps for a few days. For the cramps: pull your toes up toward you, it works mid-cramp. All of it passed; none of it changed my mind.

Our experience at the 2-month shots

I thought I was prepared. The nurse had briefed us before every appointment, what vaccines were being given, what to expect after, what was normal. She was thorough and kind and I appreciated every word of it.

And still. Nothing quite prepares you for watching your baby get that first needle.

My husband held our baby during the shots. I stood and watched. That was harder than I expected, being the one watching. Our baby cried the moment the needle went in and didn't stop while we were inside that clinic. It wasn't an inconsolable cry. Just a real, this-hurts cry that every parent in that waiting room completely understood.

We walked outside.

Within a minute or two the crying stopped. Just like that. Fresh air, familiar arms, and the worst of it was over, at least for that day.

What came after

The rest of that day our baby ran a mild fever and slept more than usual. Every little movement made it clear the injection site was sore, that little flinch, that uncomfortable shift. It was hard to watch even after the crying had stopped.

The fever and soreness lasted about a day. We didn't need Tylenol. By the next day, our baby was back to usual.

What I wish someone had told me before that appointment

Bring milk. If you're pumping or bottle feeding, bring a bottle with you. Feeding immediately after the shot is one of the most effective ways to soothe a baby, the sucking reflex is calming and the milk is comforting. We exclusively pumped, and having that bottle ready made a real difference.

Massage gently before the shot, never after. A gentle massage on the injection site before the needle helps. After the shot the area is sore and tender, leave it alone.

Step outside as soon as you can. Something about fresh air and a change of environment helped our baby calm down faster than anything we did inside the clinic.

The part that surprised me most

It didn't get easier with later rounds. If anything it got harder in a different way.

By the third or fourth visit our baby had started recognizing the clinic. We would walk through the door and the tensing-up would begin before anyone had even come close. Babies know.

Our baby was scared just entering the building.

And yet, once it was done, our baby recovered faster each time. The recognition cut both ways: knowing the place, but also seeming to understand it would be over soon. Within minutes of finishing, calm and back to normal.

So it gets harder emotionally and easier practically. Nobody told me that either.

Quick reference, what's normal after 2-month shots

• Crying during and immediately after, completely normal.
• Calming quickly once outside or once feeding, very common.
• Mild fever for up to 24 hours, normal, monitor it.
• Extra sleepiness that day, normal.
• Soreness and discomfort at the injection site, normal, do not massage after.
• No Tylenol needed unless fever is high, always check with your doctor first.

A timing suggestion, from my experience

If you have any choice in booking the appointment, I'd suggest later afternoon or evening. In our experience, the baby needs rest afterward, and night sleep turned out to be the best stretch for that. The fussiness and soreness had somewhere to land instead of running into the middle of a day.

That said, it could go the other way for a different baby. One who reacts more strongly, or takes longer to settle, might do better with a morning slot, so you have daylight hours to watch and respond. This is only a suggestion from what worked for us.

What we brought

• Pumped milk or formula in a bottle, for immediate soothing after.
• Comfortable clothing with easy leg access, shots go in the thighs.
• Your immunization record card, every single time.

The nurse will always brief you before the appointment begins. Don't hesitate to ask questions before the needles come out, that's exactly the right time.