Pregnancy and the COVID-19 Vaccine
The Centers for Disease Control and Prevention has now recommended the COVID-19 vaccination for all pregnant and breastfeeding women. We know you might have questions regarding the COVID-19 vaccine and whether it is the right choice for you while you are pregnant or trying to get pregnant. At Women’s Health Connecticut, we believe it is a shared decision between you are your provider. For most people, getting the COVID vaccine as soon as possible is the safest choice. Your provider will be able to evaluate your risk of exposure and risk tolerance for the vaccine and give you their best recommendations. The information below covers the Pfizer and Moderna COVID-19 vaccines. These are also called “mRNA” vaccines.
* Information provided by Shared Decision Making: COVID Vaccination in Pregnancy working group at the University of Massachusetts Medical School – Baystate Health.
Risks of contracting COVID-19 while pregnant
- COVID is more dangerous for pregnant women.
- COVID patients who are pregnant are 5 times more likely to end up in the intensive care unit (ICU) or on a ventilator than COVID patients who are not pregnant. [i]
- Preterm birth may be more common for pregnant women with severe COVID.[ii]
- Pregnant women are more likely to die of COVID than non-pregnant women with COVID.[iii]
What are the benefits of getting an mRNA COVID Vaccine?
- The mRNA COVID vaccines prevent about 95% of COVID infections.
- According to the CDC, recent data has shown that breastfeeding people who have received mRNA COVID-19 vaccines have antibodies in their breastmilk, which could help protect their babies.
- Getting a vaccine will prevent you from getting COVID and may help keep you from giving COVID to people around you.
- The mRNA COVID vaccines cannot give you COVID.
- These vaccines have no live virus.[iv]
- These vaccines do NOT contain ingredients that are known to be harmful to pregnant women or to the fetus.
- Many vaccines are routinely given in pregnancy and are safe (for example: tetanus, diphtheria, and flu).
What are the risks of getting an mRNA COVID vaccine?
- Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing.
- None of the studies on any of the mRNA vaccines have found any safety concerns for pregnant women receiving the vaccine or their babies.
- No evidence has been found of a correlation between the COVID-19 vaccine and the increase of miscarriages.
- Some women became pregnant during the vaccine studies. Eighteen of these women were in the vaccine group, and two months later none had miscarried. There were seventeen women in the placebo group who became pregnant, and two months later two of them had had miscarriages. (In general, 10-20% of pregnancies end in miscarriage).
- There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men.
- People getting the vaccine will probably have some side effects that are caused by their immune system’s normal response to the vaccine.
The most common side effects were:[v]
- injection site reactions like sore arm
- muscle pain
- joint pain
Of 100 people who get the vaccine, 1 will get a high fever (over 102°F). A persistent high fever during the first trimester might increase the risk of fetal abnormalities or miscarriage. The CDC recommends using Tylenol (acetaminophen) during pregnancy if you have a high fever. Another option is to delay your COVID vaccine until after the first trimester.
What do the experts recommend?
The CDC recommends the COVID-19 primary series vaccines for all people 6 months and older, including people who are pregnant, breastfeeding, trying to get pregnant, or might become pregnant in the future. They also recommend that everyone age 5 years and older should get a COVID-19 booster shot, if eligible.
What about breastfeeding?
The Society for Maternal-Fetal Medicine and the Academy of Breastfeeding Medicine reports that there is no reason to believe that the vaccine affects the safety of breastmilk.[ix] The vaccine does not contain the virus, so there is no risk of infecting your baby. Because mRNA is fragile, it is very unlikely that any part of the vaccine gets into breastmilk. The mRNA vaccine doesn't last long enough to get into breast milk. When we have an infection or get a vaccine, our bodies make antibodies to fight the infection. Antibodies can pass into the breastmilk and then to the baby - and may help prevent infections.
Want more information?
Do you have more questions? Call your WHC provider to talk about your own personal decision. For additional information regarding receiving the COVID-19 Vaccine while pregnant, view Baystate’s full COVID-19 vaccine decision aid, here.
[i] DeBolt CA, et al. Pregnant women with severe or critical COVID-19 have increased composite morbidity compared to non-pregnant matched controls. Am J Obstet 2020 Nov doi: 10.1016/j.ajog.2020.11.022
[ii] Adhikari EH, et al. Pregnancy outcomes among women with and without severe acute respiratory syndrome coronavirus 2 infection. JAMA Network Open 2020 Nov 3(11):e2029256
[iii] DiMascio D, WAPM working group on COVID-19. Maternal and Perinatal Outcomes of Pregnancy Women with SARScoV-2 infection. Ultrasound Obstet Gynecol. 2020 Sept. doi: 10.1002/uog.23107
[iv] Abbasi J. COVID-19 and mRNA Vaccines—First Large Test for a New Approach. JAMA. 2020;324(12):1125–1127. doi:10.1001/jama.2020.16866