Pregnancy in the 2025–2026 Respiratory Season: What to Know About RSV, Flu, and COVID-19 Vaccines

Practical takeaway: For the 2025–2026 respiratory virus season, federal health officials continue to recommend specific vaccines during pregnancy—most notably the RSV vaccine between 32 and 36 weeks, plus seasonal flu and updated COVID-19 vaccines. These shots are designed to protect both the pregnant person and their newborn during the first vulnerable months of life.

As respiratory viruses circulate each fall and winter, pregnancy adds another layer of concern. Physiologic changes in the heart, lungs, and immune system can make pregnant people more likely to become seriously ill from infections like influenza and COVID-19. Newborns, especially in their first six months, are also at higher risk of complications from RSV (respiratory syncytial virus).

RSV Vaccine During Pregnancy: What Changed in Recent Years

The RSV vaccine given during pregnancy is still relatively new. In 2023, the U.S. Food and Drug Administration (FDA) approved a maternal RSV vaccine (Pfizer’s Abrysvo) for use at 32–36 weeks of pregnancy to help protect infants from severe RSV disease in their first months of life. The Centers for Disease Control and Prevention (CDC) and its advisory committee recommended seasonal use, generally September through January in most of the United States.

The approval was based on a large randomized clinical trial published in the New England Journal of Medicine. In that study, maternal vaccination reduced the risk of severe RSV-related lower respiratory tract illness in infants during the first months of life. Because it was a randomized trial, it provides stronger evidence than observational studies. However, like all trials, it had limits: it followed infants for a defined period and was conducted before widespread real-world use, so ongoing monitoring continues.

For the 2025–2026 season, CDC guidance continues to recommend:

One dose of RSV vaccine during weeks 32–36 of pregnancy during RSV season.
Coordination with pediatric care, since infants may also be eligible for a monoclonal antibody (nirsevimab) if maternal vaccination was not given.

Why this matters: RSV is a leading cause of hospitalization in infants under 6 months. Maternal vaccination allows protective antibodies to cross the placenta before birth.

Flu Vaccination Remains a Core Recommendation

CDC continues to recommend seasonal influenza vaccination for anyone who is pregnant or will be pregnant during flu season. This guidance has been in place for years and is supported by extensive observational data and safety monitoring.

Pregnant people are at higher risk of hospitalization from influenza, according to CDC data. Vaccination during pregnancy has also been shown to reduce flu illness in infants during their first several months of life, when they are too young to be vaccinated themselves.

The flu vaccine used in pregnancy is the inactivated (non-live) vaccine. Live attenuated nasal spray vaccines are not recommended during pregnancy.

Updated COVID-19 Vaccines in Pregnancy

CDC and the U.S. Department of Health and Human Services continue to recommend updated COVID-19 vaccination for pregnant people, consistent with age-based guidance for the general population. Multiple observational studies have shown that COVID-19 infection during pregnancy increases the risk of severe illness, intensive care admission, and pregnancy complications such as preterm birth.

Safety monitoring systems, including those run by CDC and FDA, have not identified safety concerns specific to pregnancy with mRNA COVID-19 vaccines. Most of the available data are observational rather than randomized trials in pregnant individuals, which is common in pregnancy research. That means researchers continue to monitor for rare effects over time.

What About Side Effects and Safety?

Common side effects from these vaccines during pregnancy are similar to those in non-pregnant adults: soreness at the injection site, fatigue, low-grade fever, or body aches. Severe reactions are rare.

Federal agencies, including CDC and FDA, use multiple surveillance systems to monitor vaccine safety in pregnancy. These include systems that track reported side effects and link vaccination data with health outcomes. While no medical intervention is without risk, current evidence supports the safety of recommended vaccines in pregnancy.

Who May Need Extra Counseling?

Some pregnant people may want additional discussion with a clinician, including those who:

Have a history of severe allergic reactions to vaccines.
Are carrying multiples (twins or more).
Have high-risk medical conditions such as asthma, diabetes, heart disease, or immune compromise.
Have limited access to prenatal or pediatric care and need help coordinating vaccination timing.

Insurance coverage is an important access issue. Most recommended vaccines during pregnancy are covered without cost-sharing under federal preventive services requirements when given by in-network providers. Medicaid coverage policies may vary by state but generally include recommended maternal vaccines.

Oral Health in Pregnancy: An Overlooked Piece

Pregnancy can increase the risk of gum inflammation (pregnancy gingivitis) due to hormonal changes. CDC and major dental associations recommend continuing routine dental care during pregnancy. Untreated dental infections can affect overall health and comfort, and preventive dental visits are considered safe during pregnancy. Good oral hygiene is part of whole-person prenatal care.

When to Seek Care

Pregnant people should seek medical care urgently if they develop:

Difficulty breathing or shortness of breath.
Persistent high fever.
Chest pain.
Signs of dehydration.
Reduced fetal movement later in pregnancy.

Even mild respiratory symptoms during pregnancy are worth mentioning to a prenatal care provider, especially during peak virus season.

What This Means for Readers

For most pregnant people in the United States, current federal guidance for the 2025–2026 respiratory season supports vaccination against RSV (late pregnancy), influenza, and COVID-19. These recommendations are based on clinical trials, long-term safety monitoring, and national surveillance data.

If you are pregnant—or planning to be—talk with your prenatal care clinician about timing. Protection during pregnancy is not only about your health. It is also one of the first ways to protect your newborn in those early, high-risk months.

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.

Sources

Centers for Disease Control and Prevention (CDC) – Maternal RSV Vaccination Guidance
U.S. Food and Drug Administration (FDA) – RSV Vaccine Approval Information
New England Journal of Medicine – Maternal RSV Vaccine Randomized Trial
CDC – Influenza Vaccination During Pregnancy
CDC – COVID-19 Vaccination Guidance for Pregnant and Breastfeeding People