The COVID-19 Vaccine and Pregnancy: What You Need to Know
The first COVID-19 vaccines are available to patients and the public, and with that come many questions regarding administration of the available COVID-19 vaccines in pregnant and lactating women. Andrew Satin, M.D., director of gynecology and obstetrics, and Jeanne Sheffield, M.D., director of maternal-fetal medicine, provide information on this topic.
Is the COVID-19 vaccine available to pregnant women?
Yes, COVID-19 vaccines currently authorized by the Food and Drug Administration (FDA) should not be withheld from pregnant individuals who choose to receive the vaccine. We strongly recommend that women talk with their doctor to discuss all factors about the vaccine and their pregnancy.
- Symptomatic pregnant individuals who contract COVID-19 are at more risk of severe illness, complications and death than non-pregnant women. Many pregnant women have medical conditions that put them at further increased risk.
- Another factor to consider is the level of activity of the pandemic in your community.
- It is important to know that no study to date has specifically evaluated the coronavirus vaccine in pregnant and lactating women, though there have been a few pregnant women who were inadvertently enrolled in the vaccine trials. Preliminary developmental and reproductive toxicity studies do not indicate any adverse effects on reproduction or fetal development.
- Thus, there are not any known safety concerns, but more data will be available in the weeks and months ahead from additional studies.
While there are many unanswered questions about the vaccines for pregnant women, Johns Hopkins Medicine agrees with and supports the recommendations of the Advisory Committee on Immunization Practices, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). As national recommendations evolve, we will continue to update the following information:
COVID-19 Vaccine Guidelines for Pregnant and Breastfeeding Women
- The FDA’s emergency use authorization for the Pfizer-BioNTech COVID-19 mRNA vaccine states: “If you are pregnant or breastfeeding, discuss your options with your healthcare provider.”
- ACOG and SMFM recommend that both COVID-19 vaccines authorized by the U.S. FDA should not be withheld from pregnant individuals who choose to receive the vaccine.
- A conversation between the patient and her clinical team may assist with decisions regarding the use of vaccines.
- The World Health Organization (WHO) states they do not have any reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women. Pregnant women at high risk of exposure to SARS-CoV-2 (for example, health workers) or who have comorbidities (health conditions that may contribute to death) that add to their risk of severe disease, may be vaccinated in consultation with their health care provider.
- You can review their recommendations here:
- ACOG: Vaccinating Pregnant and Lactating Patients Against COVID-19
- SMFM: Experts in High-Risk Pregnancy Respond to the FDA’s Decision to Offer the Newly Approved COVID-19 Vaccine to Pregnant and Lactating People
- SMFM Statement: SARS-CoV-2 Vaccination in Pregnancy
- WHO: The Moderna COVID-19 Vaccine: What You Need to Know
- ACOG and SMFM Joint Statement on WHO Recommendations Regarding COVID-19 Vaccines and Pregnant Individuals
Can I get the COVID-19 vaccine if I am breastfeeding?
Based upon available data, it appears safe to get the COVID-19 vaccine if you are nursing a baby. Although the vaccines have not been studied in nursing mothers, lactating women should be offered the COVID-19 vaccine. The vaccines do not contain live virus, so being vaccinated does not pose a risk to the baby. If you are vaccinated for the coronavirus, there is no need to delay or discontinue breastfeeding.
Will the COVID-19 vaccine affect my fertility?
No, getting the COVID-19 vaccine will not affect your fertility. Women actively trying to conceive may be vaccinated with the current COVID-19 vaccines — there is no reason to delay pregnancy after completing the vaccine series.
Confusion around this issue arose when a false report surfaced on social media, saying that the spike protein on this coronavirus was the same as another spike protein called syncitin-1 that is involved in the growth and attachment of the placenta during pregnancy. The false report said that getting the COVID-19 vaccine would cause a woman’s body to fight this different spike protein and affect her fertility. The two spike proteins are completely different, and getting the COVID-19 vaccine will not affect the fertility of women who are seeking to become pregnant, including through in vitro fertilization methods. During the Pfizer vaccine tests, 23 women volunteers involved in the study became pregnant, and the only one in the trial who suffered a pregnancy loss had not received the actual vaccine, but a placebo.
Can I get COVID-19 from the coronavirus vaccine?
No, you cannot catch COVID-19 from the currently available vaccines. You may experience mild, temporary side effects, but this is an indication of the immune response to the vaccination, not COVID-19.
Can COVID-19 be severe in pregnant women?
Yes, the Centers for Disease Control and Prevention includes pregnant women as a high-risk group for severe COVID-19 illness. Therefore, getting vaccinated for the coronavirus is an important consideration for pregnant women.
- Recent data report an increased risk of intensive care unit admission, need for mechanical ventilation and ventilator support, and death in pregnant women with symptomatic COVID-19.
- Co-morbidities (health conditions that may contribute to death) as well as several racial and socioeconomic factors increase the risk of severe COVID-19.
- Lactating women are not considered at higher risk of developing severe illness compared with the non-pregnant population.
As always, be sure to talk to your obstetrician about care considerations that are specific to you.