Vaccines and food precautions in pregnancy, including cured ham

Key rules

• Whooping cough vaccine: The free whooping cough vaccine is given at weeks 27-36, ideally weeks 27-28.
• Cured meats: If you are not immune to toxoplasma, freeze raw cured meats at -20°C for at least 24-48 hours or cook them.
• Alcohol: Avoid alcohol completely during pregnancy.
• Maternal RSV vaccine: Availability depends on your region, so ask your regional health department.

Which vaccines are free in pregnancy

Three vaccines are recommended in every pregnancy, and all are free through the public health system. Your midwife or health centre will usually offer them at the right time.

• Whooping cough (Tdap): given at weeks 27-36, ideally weeks 27-28. It protects your baby in the first months of life, so do not let the window pass.
• Flu (inactivated): at any stage of pregnancy, during the flu season.
• COVID-19: recommended for pregnant women in the autumn campaign, because pregnancy puts you in a risk group.

Campaign dates and COVID-19 advice change each season and by region. Your health centre will tell you the current dates.

The RSV vaccine

RSV is a virus that can make newborns seriously ill. A maternal RSV vaccine exists and is authorised in the EU for weeks 24-36. Spain has mainly protected babies with nirsevimab, an antibody given to the infant, which has been funded since the 2023-24 season. The maternal vaccine is offered only in some regions. Ask your regional health department or midwife whether it is available where you live.

Cured ham, chorizo and salchichón

This is the Spain-specific precaution to know. Raw cured meats can carry toxoplasma, a parasite that can harm your baby. Whether this matters for you depends on your immunity.

• If you are immune to toxoplasma: you can eat them. Your first-trimester blood test shows this, so ask your midwife for the result.
• If you are not immune, or do not know: do not eat jamón, chorizo, salchichón or other raw cured meats unless you have frozen them first at -20°C for at least 24-48 hours, or longer for large pieces. Cooking them thoroughly also works.
• Cooked ham (jamón cocido) and cooked sausages: these are fine if they have been heated or properly processed.

Also avoid raw or undercooked meat, and wash fruit and vegetables well.

Other food precautions

• Alcohol: avoid it completely. It can cause fetal alcohol spectrum disorders. Limit caffeine, and do not smoke.
• Cheese and milk: avoid unpasteurised milk and cheeses made from it. Avoid mould-ripened and blue cheeses too, because of listeria.
• Smoked fish and pâté: avoid refrigerated smoked fish and pâtés, also because of listeria.
• Fish with high mercury: avoid swordfish (pez espada or emperador), shark, cazón and dogfish, bluefin tuna and pike. Limit tuna in general.
• Raw fish and eggs: eat fish that has been cooked or frozen, which guards against anisakis, a worm found in raw fish. Avoid raw or undercooked eggs.
• Produce: skip raw sprouts.

Your midwife can confirm anything you are unsure of. The checklist, warnings and questions below cover the same points in short form.

Timeline and deadlines

• Get the COVID-19 vaccine, recommended for pregnant women: during the autumn campaign

• Ask about the maternal RSV vaccine, if your region offers it: weeks 24-36

Check this season's flu and COVID-19 campaign dates with your regional health department or midwife.

Checklist

• Ask your midwife whether your first-trimester blood test showed you are immune to toxoplasma.

• Freeze raw cured ham, chorizo and salchichón at -20°C for at least 24-48 hours before eating them, or cook them thoroughly, if you are not immune.

• Wash fruit and vegetables well and skip raw sprouts.

• Choose pasteurised milk and cheeses, and check labels on soft and blue cheeses.

• Cut out alcohol completely and limit caffeine.

What to watch out for

• Raw cured meats if you are not immune to toxoplasma: Cured ham, chorizo, salchichón and other raw cured meats can carry toxoplasma if you are not immune. Check your immunity with your midwife. If you are not immune, freeze them at -20°C for at least 24-48 hours (longer for large pieces) or cook them thoroughly.

• Listeria in cheese, smoked fish and pâté: Unpasteurised milk, soft cheeses made from it, mould-ripened or blue cheeses, refrigerated smoked fish and pâtés can carry listeria. Choose pasteurised dairy and skip those fish and pâtés.

• Alcohol: Alcohol can cause fetal alcohol spectrum disorders, and no amount is considered safe. Avoid alcohol entirely and limit caffeine.

• High-mercury fish and raw fish: Swordfish (emperor), shark, dogfish (cazón), bluefin tuna and pike are high in mercury, and raw or undercooked fish and meat carry infection risks. Avoid those fish, limit tuna, and eat fish only frozen or cooked.

• Missing the whooping cough vaccine window: The free whooping cough vaccine is given at weeks 27-36, so waiting too long can mean missing it. Book it with your midwife around weeks 27-28.

Frequently asked questions

Can I eat cured ham if I am pregnant in Spain?

Yes, you can eat cured ham if your first-trimester blood test shows you are immune to toxoplasma. If you are not immune, avoid it unless it has been frozen at -20°C for at least 24-48 hours (longer for large pieces) or cooked thoroughly. The same goes for chorizo and salchichón.

Is cooked ham (jamón cocido) safe in pregnancy?

Yes, cooked ham and cooked sausages are fine if they are heated or properly processed. Raw cured meats are the ones that need freezing or cooking first.

Is the RSV vaccine for pregnant women free in Spain?

It depends on your region, so ask your regional health department or midwife.

Which fish should I avoid while pregnant in Spain?

Avoid swordfish (emperor), shark and dogfish (cazón), bluefin tuna and pike because of their high mercury, and limit other tuna. Eat fish only if it has been frozen or cooked, which also protects against anisakis, a fish parasite.

Which cheeses should I avoid in pregnancy?

Avoid cheeses made from unpasteurised milk, soft cheeses made from it, and mould-ripened or blue cheeses because of listeria. Also skip refrigerated smoked fish and pâtés.