Pregnancy and the COVID-19 Vaccine

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 WHC provider. For most people, getting the COVID vaccine as soon as possible is the safest choice. However, these vaccines have not been tested in pregnant and breastfeeding women yet. 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.
  • 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?

  • These COVID vaccines have not yet been tested in pregnant people.
  • We do not know if the vaccines work as well in pregnant people as they did in non-pregnant people.
  • We do not know whether there are unique downsides in pregnancy, like different side effects or an increased risk of miscarriage or fetal abnormalities.
  • The Moderna vaccine was tested in female rats to look at its effects on pregnancy. No significant negative effects were found on female fertility or fetal development.
  • 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).
  • Because these studies are still ongoing, we don’t know how the rest of the pregnancy went for these women.  
  • 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
      • fatigue 
      • headache 
      • muscle pain
      • chills 
      • joint pain 
      • fever 

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 says that the mRNA vaccines for COVID-19 are recommended for adults. However, because there are no studies of pregnant women yet, there are no clear recommendations for pregnant women. This is standard for a new drug and is not due to any particular concern with this vaccine.[vi]
  • The Society for Maternal-Fetal Medicine strongly recommends that pregnant individuals have access to COVID vaccines. They recommend that each person talk to their doctor or midwife about their own personal choice.[vii]
  • The American College of Obstetricians and Gynecologists recommends that the COVID vaccine should not be withheld from pregnant individuals.[viii]

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.  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.

COVID-19 Resources

Citations

[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

[v] https://www.fda.gov/media/144245/download

[vi] https://www.cdc.gov/vaccines/acip/recs/grade/covid-19-pfizer-biontech-etr.html

[vii] https://www.smfm.org/publications/339-society-for-maternal-fetalmedicine-smfm-statement-sars-cov-2-vaccination-in-pregnancy

[viii] https://www.acog.org/en/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-Pregnant-andLactating-Patients-Against-COVID-19 (Accessed December 14, 2020)

[ix] https://abm.memberclicks.net/abm-statement-considerations-for-covid-19-vaccination-in-lactation