Vaccinations manage to be simultaneously one of the most technical clauses in the contract and one of the most sensitive topics in conversation – which is exactly why it's the kind of thing to settle early, calmly, and with full information. In this post I stick to the practical side: what's standard during pregnancy in the U.S., what happens with the newborn at the hospital, and the differences from Israel worth knowing.
Start with the pregnancy. Standard U.S. practice (similar to Israel) includes a whooping cough (Tdap) vaccine during pregnancy – designed to pass antibodies to the baby for its first months, before it can be vaccinated itself – and a flu shot in season. In recent years a new player joined: an RSV vaccine given during pregnancy, protecting the newborn from the virus that is the leading cause of infant hospitalizations in winter. Your surrogate's stance on pregnancy vaccinations appears in her profile – and if this topic matters to you either way, it's a matching criterion, not an argument to have in month eight.
Now the newborn, and here's the difference that most surprises Israelis: in the U.S. it's standard to give the first hepatitis B dose at the hospital within the first day of life (Israel does this too – a similarity, actually), but U.S. hospitals also routinely give a vitamin K shot and antibiotic eye ointment. These are default procedures the hospital staff performs – so your position on them needs to appear in the birth plan, as I wrote in that post: the team follows what's written, not what you thought in your heart.
What about the rest of the schedule? Here the flight enters the picture: a baby born in the U.S. who flies home after a few weeks "switches" midway between two similar-but-not-identical vaccine schedules. The right move is to leave the U.S. with an organized immunization record (ask for a printed and scanned copy!), and bring it to your well-baby clinic (Tipat Halav) in the first week home – they'll complete and sync the Israeli schedule. Don't postpone that visit; it's also your baby's official entry into the Israeli health system.
One final, important point: everything above describes common practice – it is not personal medical advice. The vaccination conversation – for the pregnancy and the baby – belongs to you and the doctors: the OB in the U.S. and your pediatrician in Israel. What I do wholeheartedly recommend: have it early.
My tip: prepare a one-page document in English with your position on all newborn procedures – vaccines, vitamin K, eye ointment, circumcision if relevant – and attach it to the birth plan. On the day itself you'll be busy trembling with excitement; let the paper speak for you.
