COVID-19 Vaccine and Pregnancy
The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine agree that the new mRNA COVID-19 vaccines should be offered to pregnant and breastfeeding individuals who are eligible for vaccination.
Here are answers to some basic questions you may have about getting a COVID-19 vaccine if you’re pregnant. Keep in mind that information is evolving rapidly.
What do we know about how COVID-19 affects people who are pregnant?
COVID-19 is potentially dangerous for all people. Although the actual risk of severe illness and death among pregnant individuals is very low, it is higher when compared to nonpregnant individuals from the same age group. Those who are pregnant are at higher risk for being hospitalized in an intensive care unit and requiring a high level of care, including breathing support on a machine, and are at higher risk for dying if this happens.
What do we know about how COVID-19 affects the fetus?
Remember that researchers are learning more about COVID-19 all the time. Some researchers are looking specifically at COVID-19 and its possible effects on a fetus. Here’s what they know now:
- Researchers have found a few cases of COVID-19 that may have passed to a fetus during pregnancy, but this seems to be rare.
- Researchers have studied COVID-19 infection, preterm birth, and stillbirth. Some studies suggest there may be an increased risk of preterm birth and stillbirth for women with COVID-19. Other studies have not found this to be true. But information is still limited. Researchers are continuing to study these outcomes to better understand the effects of COVID-19 before birth.
After birth, a newborn can get the virus if they are exposed to it.
What do we know about the safety of newly available mRNA COVID-19 vaccines in people who are pregnant?
The mRNA vaccine trials did not deliberately include pregnant or breastfeeding individuals, so our direct knowledge is currently limited. Some vaccine trial participants inadvertently became pregnant; 18 of these people received the vaccine. Further information may be available in coming months.
When studied during animal tests, the mRNA vaccines did not affect fertility or cause any problems with pregnancy. In humans, we know that other kinds of vaccines generally are safe for use in pregnancy — in fact, many are recommended.
It’s also important to know that:
- The mRNA vaccines do not contain any virus particles.
- Within hours or days our bodies eliminate mRNA particles used in the vaccine, so these particles are unlikely to reach or cross the placenta.
- The immunity that a pregnant individual generates from vaccination can cross the placenta, and may help to keep the baby safe after birth.
Vaccine Side Effects:
One possible short-term side effect of the mRNA vaccine trials (occurring within one to two days of vaccination) is fever. About 1% to 3% of people have experienced fever after the first dose of mRNA vaccine, and about 15% to 17% after the second dose. These fevers are generally low and can be managed with acetaminophen, which is safe to take during pregnancy. Rarely, high, prolonged fevers in pregnancy may lead to birth defects.
Assuming the mRNA vaccine is available to you during your pregnancy, you have several options to discuss with your health care provider.
- Get vaccinated as soon as the vaccine is available to you. You might decide to do this if you have additional risk factors for severe complications from COVID-19 (such as high blood pressure or obesity), and/or multiple potential exposures to COVID-19 from your work, your family, or your community.
- Wait until after you give birth to get the vaccine. You might choose to do this if pregnancy is your only risk factor for severe disease, and you are able to control your exposures by limiting interactions with people outside of your household and using protective measures (mask-wearing, handwashing, and physical distancing).
- Consider ways to modify your exposures to COVID-19 and possibly defer getting the vaccine. Most people have some risk factors and some uncontrolled exposures. If this describes you, you still have options. You may decide to modify your exposures if possible and defer vaccination until the second trimester, when the natural risk of miscarriage is lower. Or you may choose to delay vaccination until after the baby is born.
- Wait for a traditional vaccine similar to the flu shot or Tdap vaccines. These vaccines are in development but are not yet approved in the US. Experts know much more about using these types of vaccines in people who are pregnant. However, depending on your exposures to COVID-19 and your risk for getting seriously ill if you get infected, it may be wisest to have an mRNA vaccine.
COVID-19 Vaccine and Breastfeeding
Experts believe it is most likely safe to get an mRNA COVID-19 vaccine if you’re breastfeeding. Although breastfeeding people were not included in the vaccine trials, the mechanism of mRNA vaccines and experience from other vaccines suggest this is true.
It is important to know:
- There is no virus in the mRNA vaccines. You cannot get COVID, or give your baby COVID, by being vaccinated. The components of the vaccine are not known to harm breastfed infants.
- When you receive the vaccine, the small mRNA vaccine particles are used up by your muscle cells at the injection site and thus are unlikely to get into breast milk. Any small mRNA particles that reach the breast milk would likely be digested.
- When a person gets vaccinated while breastfeeding, their immune system develops antibodies that protect against COVID-19. These antibodies can be passed through breast milk to the baby. Newborns of vaccinated mothers who breastfeed can benefit from these antibodies against COVID-19.
COVID-19 Vaccine and Fertility
If you are considering pregnancy soon, accepting the COVID-19 vaccine as soon as it is available to you is a great way to ensure that you — and your pregnancy — are protected.
COVID-19 vaccination is not believed to affect future fertility.