COVID-19 Vaccine and Pregnancy
Apr 06, 2022 Cedars-Sinai Staff
If you or your partner is pregnant or wants to become pregnant, you might have questions about COVID-19 vaccination.
The number of pregnant people getting the shots is increasing but still lags compared with other adults: 42% of pregnant people ages 18 to 49 were fully vaccinated against the virus that causes COVID-19 before or during pregnancy, according to Jan. 8, 2022, figures from the Centers for Disease Control and Prevention (CDC).
Vaccination provides more reliable, robust protection than a natural infection.
Reproductive health experts emphasize that the benefits of vaccination outweigh any possible drawbacks: The main risk for pregnant people is COVID-19, not vaccines.
Are COVID-19 vaccines safe for pregnant women?
Mounting data paint a clear picture: The approved mRNA vaccines (Pfizer-BioNTech and Moderna) pose very little risk for pregnant people—no different than for people who are not pregnant—and vaccination does not cause adverse effects in fetuses, the CDC says.
One study of more than 40,000 pregnant women found no link to preterm birth or smaller infant size at delivery. Continued monitoring and research have also shown no risk of miscarriage among pregnant women who were vaccinated just before or up to 20 weeks into pregnancy and identified no safety concerns for moms or babies when immunized late in pregnancy.
The CDC is still tracking the effects of COVID-19 vaccination during all pregnancy trimesters.
Based on how mRNA vaccines work in the body and break down quickly, health experts believe they are unlikely to cause any long-term health effects for infants.
Can a pregnant woman contract the virus if she takes the COVID-19 vaccine?
It's important to know that the approved vaccines do NOT contain the live virus that causes COVID-19, SARS-CoV-2. That includes the two mRNA vaccines and the Johnson & Johnson (Janssen) vaccine, which uses a modified version of a different virus.
Pregnant women cannot get COVID-19 by taking any of these shots.
Are pregnant women at an increased risk of severe illness from COVID-19?
Yes. Be aware that your health and your baby's health are more compromised if you contract SARS-CoV-2, the virus that causes COVID-19.
Getting COVID-19 during pregnancy or after a recent pregnancy raises the likelihood that the patient will be admitted to an Intensive Care Unit, require mechanical ventilation or respiratory support through an artificial lung device (extracorporeal membrane oxygenation), and even die, according to the Journal of the American Medical Association (JAMA).
More than 148,000 pregnant women contracted SARS-CoV-2 between Jan. 22, 2020, and Nov. 29, 2021, CDC figures cited by JAMA show. More than 20% of those with available hospitalization data were admitted to the hospital with COVID-19 or pregnancy complications.
COVID-19 is more dangerous for older women and those with a high body mass index or other pre-existing conditions, such as high blood pressure and diabetes.
COVID-19 also can affect fetal development, increasing risk of outcomes such as preterm delivery, fetal death or stillbirth. The CDC reported 1.26% of U.S. pregnant women with COVID-19 delivered stillborn between the beginning of the pandemic and September 2021, versus 0.64% of pregnant women who didn't have COVID-19.
Should pregnant women get the COVID-19 vaccine? Which vaccines should they take and when?
The CDC recommends vaccination for pregnant women with either the Pfizer or Moderna mRNA vaccines. The current schedule includes an initial two-dose primary series, followed by a booster dose at least five months after the last primary dose.
Although it's not preferred, the Johnson & Johnson shot can be an option for some women. Women who experienced a severe reaction to an earlier mRNA dose or who are severely allergic to an ingredient in the mRNA vaccines might benefit from switching to the Johnson & Johnson vaccine. Women who get this vaccine should take a booster dose at least two months after their last primary dose.
But pregnant and recently pregnant women under age 50 should consider the rare risk of thrombosis with thrombocytopenia syndrome—a blood-clotting condition linked to the Johnson & Johnson vaccine.
Health officials encourage vaccination for pregnant women at any time in their pregnancy, as well as for those trying to become pregnant or who might become pregnant in the future.
I'm pregnant and already had COVID-19. Should I still get vaccinated?
Vaccination provides more reliable, robust protection than a natural infection. Getting vaccinated after having COVID-19 adds extra immunity: Unvaccinated women were at a two times higher risk of becoming reinfected with the virus that causes COVID-19 than those who were fully vaccinated after having the virus, according to the CDC.
What if I am breastfeeding or lactating?
The CDC also recommends COVID-19 vaccination for breastfeeding women.
In fact, getting the Pfizer or Moderna vaccines may have some benefits for the baby. Studies have found antibodies against the virus that causes COVID-19 in the umbilical cord blood and breast milk of vaccinated mothers, which may extend some protection to their infants: Most (57%) babies born to women who were vaccinated during pregnancy had antibodies against the virus that causes COVID-19, in a recent study cited by the CDC.