Across the US, COVID-19 vaccines are widely available for all adults and children ages 12 and older, including people who are pregnant. During pregnancy, vaccinations are a safe and routine part of prenatal care.
Right now, the more easily spread Delta variant of COVID-19 is driving up rates of illness, hospitalizations, and deaths in the US. Most of these COVID-19 infections, severe illness, and deaths are occurring among unvaccinated people. Research shows that pregnant people have a higher risk of severe illness if they get COVID-19. And new evidence gathered from tens of thousands of pregnant people demonstrates that COVID-19 vaccines are safe and effective in pregnancy. If you are pregnant, the US Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM) recommend getting a COVID-19 vaccine.
Here are answers to some basic questions you may have about getting a COVID-19 vaccine if you’re pregnant — or considering pregnancy, soon or in the future. Keep in mind that information will continue to evolve. Your obstetric provider or medical team can advise you more fully about benefits and risks, based on your personal health risks, exposures to the virus that causes COVID-19, and preferences.
For information on breastfeeding and COVID-19, see this blog post.
What do we know about how COVID-19 affects people who are pregnant?
COVID-19 is potentially dangerous for all people. And while 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.
If you’re pregnant, you may also wonder about risks to the fetus if you get COVID-19. Research suggests that having COVID-19 might increase risk for premature birth, particularly for those with severe illness. So far, studies have not identified any birth defects associated with COVID-19. And while transmission of the virus from mother to baby during pregnancy is possible, it appears to be a rare event.
Which vaccines are approved or authorized?
The Pfizer/BioNTech COVID-19 vaccine is fully approved by the Food and Drug Administration (FDA) for people ages 16 and older (children 12 to 15 can receive this vaccine through emergency use authorization). The Moderna and Johnson & Johnson COVID-19 vaccines have emergency use authorization from the FDA.
All of these vaccines deliver instructions to the body that help the immune system block the virus that causes COVID-19. This can be done in different ways:
- Two-dose Pfizer/BioNTech vaccine: this vaccine uses mRNA.
- Two-dose Moderna vaccine: this vaccine uses mRNA.
- One-dose Johnson & Johnson vaccine: this vaccine uses a harmless, modified form of the common cold virus in humans called an adenovirus.
Studies show all three vaccines are extremely effective in reducing risk for severe illness, hospitalizations, and deaths from COVID-19. They also help reduce risk for moderate illness. So, while some people who are fully vaccinated may still get COVID-19, they are protected against serious illness and death. Booster shots may be considered to further increase the effectiveness of the vaccines for some people. Ask your doctor about this.
You can read more about the different vaccines on the Harvard Health Coronavirus Resource Center.
What do we know about the safety of COVID-19 vaccines in people who are pregnant?
Evidence on the safety and effectiveness of COVID-19 vaccines during pregnancy is growing, according to the CDC. A new report on early data from safety monitoring systems that gather information on people who were pregnant when vaccinated and their babies finds no concerns about safety. Another report based on people enrolled in the v-safe COVID-19 Pregnancy Registry who received COVID-19 vaccines before 20 weeks of pregnancy notes no increased risk for miscarriage.
The CDC continues to follow people vaccinated during different trimesters of pregnancy to better understand effects on pregnancy and babies.
Important points about mRNA vaccines:
- 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.
- mRNA vaccines do not contain any virus particles.
- mRNA particles used in the vaccine are eliminated by our bodies within hours or days, so these particles are unlikely to reach or cross the placenta.
- The immunity that a pregnant person generates from COVID-19 vaccination can cross the placenta, and may help keep the baby safe after birth.
Important points about the Johnson & Johnson vaccine:
- The modified adenovirus used in the vaccine can’t replicate or cause illness. The body quickly clears it from the injection site, so it’s unlikely to reach or cross the placenta.
- In animal tests, this vaccine did not affect fertility or cause problems with pregnancy.
- Vaccines similar to this one — called adenovirus vector vaccines — have been studied in humans for HIV, Ebola, and Zika virus. Trials that enrolled pregnant people reported no harmful pregnancy outcomes.
- We know that other kinds of vaccines generally are safe for use in pregnancy — in fact, many are recommended. The immunity that a pregnant person generates from vaccination can cross the placenta, and may help keep the baby safe after birth.
What about vaccine side effects?
One possible side effect of the COVID-19 vaccines is fever for a day or two after vaccination. This occurred in about
- 1% to 3% of people after the first dose of mRNA vaccine
- 15% to 17% after the second dose of mRNA vaccine
- 9% after the Johnson & Johnson single-dose vaccine.
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.
For more information about common COVID vaccine side effects, see this CDC resource page.
What to consider about COVID-19 vaccines if you’re pregnant
Your decision to be vaccinated during pregnancy should be based on your risk for exposure to the virus and how sick you might get if you do get the virus. Given the latest available data about COVID-19 risk in pregnancy and the safety of the vaccines, the CDC, ACOG, and SMFM strongly recommend getting vaccinated now.
If you wish to wait until after you give birth, it is important to control your exposures by limiting interactions with people outside of your household and using protective measures (mask wearing, handwashing, and physical distancing).
What to consider if you’re thinking of becoming pregnant soon or in the future
Many people who are considering a pregnancy soon or in the future wonder if the COVID-19 vaccines affect fertility. However, there’s no evidence that they do, according to ACOG and SMFM. While human vaccine trials did not specifically study fertility, no signs of infertility were noted in animal studies, or reported in the tens of thousands of people of reproductive age who have been vaccinated worldwide.
Getting vaccinated prior to pregnancy is a great way to ensure that you — and your pregnancy — are protected.
The bottom line
COVID-19 vaccination is recommended for people who are pregnant. It helps to become as informed as you can when making your decision. We will continue to learn more about COVID vaccine safety during pregnancy from ongoing studies. Right now, we know that COVID-19 puts people who are pregnant at higher risk for serious illness and hospitalization. New evidence shows that the vaccines are safe and effective during pregnancy, which is why the CDC, ACOG, and SMFM recommend them.
You can stay informed by checking trusted health websites, such as those listed above, and by talking with your healthcare providers. Together you can balance the latest data on risks of COVID-19 in pregnancy, the safety of available vaccines, your individual risk factors and exposures, and most importantly, your values and preferences.
ACOG and SMFM Recommend COVID-19 Vaccination for Pregnant Individuals. American College of Obstetricians and Gynecologists.
Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients. American College of Obstetricians and Gynecologists.
New CDC Data: COVID-19 Vaccination Safe for Pregnant People. Centers for Disease Control and Prevention.
COVID-19 Vaccines While Pregnant or Breastfeeding. Centers for Disease Control and Prevention.
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