Is The COVID-19 Vaccine Safe For Pregnant Women?

Jacqueline Slobin23 Mar 2021

Quick Digest

  • There are currently two mRNA COVID-19 vaccines that were granted FDA emergency use authorization.
  • While pregnant and breastfeeding women were not part of vaccine clinical trials, many experts believe that vaccines are safe for these groups and outweigh the risks of getting sick from COVID-19.
  • In some states, pregnant women may be eligible for vaccination due to the increased risk of COVID-19 complications.
  • Getting vaccinated is a personal choice. When making your decision, you may want to consult with your doctor to evaluate your personal risk of contracting COVID-19 based on your job, living situation, and underlying medical conditions.

We interviewed the following experts in women’s health to provide insights on safety data regarding the COVID-19 vaccine and pregnancy: 

Felice Gersh, M.D. is an award-winning OB/GYN specializing in all aspects of women’s health, and founder/director of the Integrative Medical Group of Irvine, in Irvine, CA. Her practice provides comprehensive healthcare for women, combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine.

Lorrie Harris-Sagaribay, MPH, is the Program Coordinator and an information specialist at MotherToBaby North Carolina, where she provides exposure counseling in English and Spanish by phone, email, and online chat. Lorrie serves as a member of the Emerging Issues Task Force, which is currently focused on responding to the COVID-19 pandemic. 

Kirstie Perrotta, MPH, is an information specialist at MotherToBaby California, where she provides counseling by phone and chat. Kirstie serves as a member of the Emerging Issues Task Force, which is currently focused on responding to the COVID-19 pandemic.

COVID-19 Infection and Pregnancy 

How does infection with COVID-19 affect pregnant women?

“Pregnancy is considered among the risk factors increasing more serious outcomes in women infected with the coronavirus,” says Dr. Gersh.

“This means that pregnant women who acquire this novel viral infection are at a higher risk for hospitalization, progressing to needing critical care and of requiring a ventilator, and dying. 

Fortunately, most pregnant women do fine with COVID, but they are considered to be in a high-risk group.”

“At this time, there are no reports of babies born with birth defects related to COVID-19," explains the MotherToBaby team. "However, if COVID-19 causes high fever in the first trimester, this can be a concern. 

Having severe symptoms or complications from any illness might increase the chance of pregnancy complications, such as preterm delivery (delivery before 37 weeks of pregnancy)."

COVID-19 Vaccines For Pregnant and Lactating Women

Do you believe that Pfizer and Moderna's mRNA COVID-19 vaccines are safe for pregnant women?

According to Dr. Gersh, “although there is nothing definitive on this topic, and pregnant women were not in the vaccine trials, I believe the mRNA vaccines are safe in pregnancy.

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The mRNA vaccines contain no viruses and cannot enter the cell nucleus to alter the DNA. They simply rely on the immune system to generate pieces of the spike protein to which the immune system creates antibodies. 

mRNA vaccines are actually quite brilliant discoveries. Vaccines should be made available to pregnant women, but as no published studies yet exist, they should never feel pressured to getting vaccinated and it is a personal decision.”

In addition, the MotherToBaby team explains that “although this is the first time this technology has been made available in vaccines, the science behind mRNA vaccines is not new. Researchers have been studying mRNA vaccines for decades.

Factors to consider when getting the COVID-19 vaccine if pregnant

“People who are pregnant and offered the COVID-19 vaccine can discuss the risks and benefits with their healthcare provider,” explains the MotherToBaby Team.

“They can consider their own level of risk for coming into contact with the virus, including the current spread of COVID-19 in their community, whether their job or other activities increase their chance of exposure, and how well they can continue to practice preventative measures such as social distancing.

It is also important to consider the possible risks associated with having COVID-19 during pregnancy, and how getting the vaccine may help reduce these risks.”

Do you believe that Pfizer and Moderna's mRNA COVID-19 vaccines are safe for breastfeeding women?

According to Dr. Gersh, there is no current data on COVID-19 vaccinations and breastfeeding women. 

She explains that "although no published data exists, there is no mechanism known with the mRNA vaccines to expect them to harm the baby via breast milk. Still, there is no data on this and that must be discussed.”

In addition, MotherToBaby Team explains that “based on what is known about the way the vaccines work, experts do not believe that the components of the vaccine would enter the breast milk or pose a risk to a breastfeeding infant. 

Studies have shown that other kinds of vaccines that are routinely given in the United States are not harmful during breastfeeding. (Only smallpox and yellow fever vaccines, which are not routinely given in the U.S., are not recommended for most people while breastfeeding.)”

Will there be more data on how mRNA vaccines may affect pregnant women soon?

The MotherToBaby Team says more information on mRNA vaccines and pregnant women will be coming soon; "Like all new vaccines and medications, it takes time to collect and analyze enough data to be able to assess safety in pregnancy. However, efforts are currently underway to learn more. A new phase of clinical trials that includes people who are pregnant is expected to begin sometime early this year. 

In addition, pregnancy registries such as the one being conducted by MotherToBaby will provide additional data. 

MotherToBaby is currently enrolling women who have received the COVID-19 vaccine within 30 days since their last menstrual period or any time during pregnancy. People can learn more about participating in this research here.”

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Have any pregnant women in the U.S. or other countries had complications from the COVID-19 vaccines?

Both Dr. Gersh and the MotherToBaby Team have not heard of any serious complications during pregnancy caused by the COVID-19 vaccine. 

MotherToBaby Team notes that "common side effects after vaccination include pain and swelling at the injection site, fever, chills, tiredness, and headache. These effects are expected as the body learns how to build an immune response and create antibodies. 

Fever is a possible side effect of getting the COVID-19 vaccine. Having a fever of at least 101 degrees for more than 24 hours can increase the chance of neural tube defects (problems with the development of the brain and spinal cord) in the baby.

If a pregnant person develops a fever after getting the vaccine, they should try to reduce the fever as soon as possible. Acetaminophen is usually recommended to treat fever in pregnancy, but people can check with their healthcare providers about the best way to lower their fever.”

COVID-19 Vaccines And Future Pregnancy

Do you believe that Pfizer and Moderna's mRNA COVID-19 vaccines are safe for women who are trying to get pregnant in the near future?

Dr. Gersh explains the truth behind the infertility rumors, “the rumors that the vaccines can affect fertility are pure nonsense and must be countered with science.

Moreover, an actual infection with COVID would be more likely to lead to such an outcome than the vaccine and there is no evidence that having a COVID infection renders women infertile. If it were available, I’d encourage women wanting to become pregnant to be vaccinated with one of the mRNA vaccines.”

Likewise, the MotherToBaby team notes that “there is no recommended wait time to become pregnant after getting the vaccine. If someone gets the first vaccine in the series and then becomes pregnant, it is recommended that they still get the second vaccine as scheduled.

Because pregnant people who have COVID-19 are at increased risk of severe illness, those who are pregnant and planning pregnancy should take all possible precautions to prevent infection with the virus. This includes getting a COVID-19 vaccine when it becomes available to them.”

What’s the Bottom Line? 

While there is no data from clinical trials on how the COVID-19 vaccines may affect pregnant women, getting the COVID-19 vaccine while pregnant can prevent infection and serious illness from the virus. 

Additionally, the American College of Obstetrics and Gynecology recommends that all breastfeeding mothers get the COVID-19 vaccine. 

If you are unsure about getting vaccinated, you should talk to your OB/GYN about your medical history and risks of contracting COVID-19. Data and information regarding COVID-19 and pregnancy is constantly changing, so staying up to date on medical advice can help guide your decision.