COVID-19 Vaccine During Pregnancy: Everything Parents Should Know
Many pregnant people are particularly conscious about what they put in their body, which begs an important question during the pandemic: Should I get the COVID-19 vaccine? According to the Centers for Disease Control and Prevention (CDC), the answer is a resounding yes.
In August, the organization updated their guidance to say that everyone 12 years and older should get vaccinated—"including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future." The CDC previously said that vaccination was a personal choice during pregnancy.
On September 29, the CDC again stressed the importance of vaccination during pregnancy in a health advisory. It said more than 125,000 COVID-19 cases were reported in pregnant people as of September 27, including 22,000 hospitalizations and 161 deaths. Twenty-two deaths happened in August 2021 alone.
Research has repeatedly shown that pregnant people are at an increased risk for severe illness and death from COVID-19 compared with non-pregnant folks of reproductive age. One review of several studies indicated that pregnant people were 62 percent more likely to be admitted to the ICU and 88 percent more likely to require the use of a ventilator. And the CDC health advisory says that expectant parents have a 70 percent increased risk of death from COVID-19.
"This is most likely a result of cardiovascular and respiratory changes that occur in pregnancy, which put pregnant people at higher risk of severe disease," says Marta Perez, M.D., a Parents advisor and assistant professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis.
Also, growing evidence suggests that vaccines are safe and effective during pregnancy, and they haven't been associated with an increased risk of miscarriage. On the other hand, studies have linked COVID-19 infection to preterm birth and other complications. "There is an increased risk for adverse pregnancy and neonatal outcomes, including preterm birth and admission of their neonate(s) to an intensive care unit (ICU). Other adverse pregnancy outcomes, such as stillbirth, have been reported," says the CDC.
Despite this information, only 31 percent of pregnant people were fully vaccinated "before or during their pregnancy" as of September 18, says the CDC. There are also vaccination coverage disparities based on race and ethnicity; for example, non-Hispanic Black pregnant people have a vaccine rate of only 15.6 percent.
Given the evolving information around the vaccines and virus (including the highly contagious Delta variant), it's natural that expectant folks still have questions. Parents asked health experts to share the most up-to-date information on how the vaccine might affect those who are pregnant or who intend to be soon.
Can Pregnant People Get the COVID-19 Vaccine?
Yes, pregnant people can receive the COVID-19 vaccine. Currently, three options (Pfizer, Moderna, and Johnson & Johnson) have been granted authorization from the Food and Drug Administration (FDA), and anyone 12 and older is eligible to get vaccinated. All available vaccines have been shown to reduce the risk of severe illness, hospitalization, and death—even against the Delta variant that's currently devastating the country.
Besides the CDC, several other medical organizations strongly support COVID-19 vaccination during pregnancy, including the American College of Obstetricians and Gynecologists (ACOG), American Academy of Family Physicians, American Academy of Pediatrics (AAP), American College of Nurse-Midwives, and more. "As the leading organizations representing experts in maternal care and public health professionals that advocate and educate about vaccination, we strongly urge all pregnant individuals—along with recently pregnant, planning to become pregnant, lactating and other eligible individuals—to be vaccinated against COVID-19," according to a joint statement from these organizations.
Is the Vaccine Safe for Pregnant People and Babies?
Research is currently being conducted on pregnant and lactating individuals because they weren't originally included in any clinical trials. "Usually trials with [pregnant women] start later, after deemed safe in other groups," explains Purvi Parikh, M.D., an allergist and immunologist with the Allergy and Asthma Network and co-investigator on the vaccine trials.
That said, "we have very little concern that the COVID-19 vaccines could harm a pregnant person or their developing fetus," says Geeta Swamy, M.D., a member of The American College of Obstetricians and Gynecologists' Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group. Doctors indicate that this is true regardless of trimester.
After injection, the vaccine doesn't move much beyond the muscle cells and immune cells in lymph nodes, and it doesn't alter DNA, so it cannot cause genetic changes. In addition, "the vaccine doesn't contain live virus, so there's no risk of infecting the mom or baby with COVID," says Judette Louis, M.D., department chair of obstetrics and gynecology at the University of South Florida in Tampa.
There's also increasing evidence about the safety and effectiveness of COVID-19 vaccines for expecting parents. Take a study published in The New England Journal of Medicine, which researched 35,000 pregnant people who got vaccinated with Pfizer or Moderna. It found no problems in pregnant people—even those in the third trimester. Participants only experienced typical COVID-19 vaccine side effects, such as pain at the injection site, headache, chills, and fever. What's more, no neonatal deaths were reported in the study, and adverse reactions (like preterm birth and small size) seemed unrelated to the vaccine.
The CDC also cites research from it's v-safe COVID-19 Vaccine Pregnancy Registry. According to the organization, v-safe is "a new smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines." Data reported from 2,456 pregnant people— published on August 9—concluded that the mRNA vaccines aren't associated with an increased risk of miscarriage.
Can Newborns Get the COVID-19 Vaccine?
As of now, the vaccines are approved only for people 12 and older. While pediatric trials are currently underway, vaccines for babies will probably be the last to be approved. Thankfully, COVID-19 infections in newborns are very uncommon, and severe illness appears to be rare.
The best way to protect your newborn against COVID-19 is getting vaccinated. The CDC says vaccination allows your body to build antibodies to the coronavirus—and these antibodies have been found in umbilical cord blood. "This means COVID-19 vaccination during pregnancy might help protect babies against COVID-19," according to the organization. "More data are needed to determine how these antibodies, similar to those produced with other vaccines, may provide protection to the baby."
Along those lines, "some types of antibodies cross into breast milk," says Dr. Perez, who got her own COVID-19 vaccine two weeks postpartum while nursing.
I Got the COVID-19 Vaccine—Now What?
No vaccine has an efficacy of 100 percent, and pregnant people should try limiting exposure as much as possible. "Make sure you are in the best health possible so that if you do get sick, your body and immune system is able to fight it," says Dr. Parikh. "This includes appropriate doctors visits, vitamins, getting other vaccines like the flu shot, and proper sleep and nutrition."
Another COVID-19 prevention method is creating a "bubble of protection" around expectant parents, suggests Lorene Temming, M.D., Medical Director of Labor and Delivery, maternal-fetal medicine specialist, and Director of the Medical Student Clerkship program at Atrium Health. This means that partners, family members, and other close contacts should be vaccinated, so if they're ever exposed to the coronavirus, they have a smaller chance of transmitting it to the expectant parent.
The Bottom Line
Several organizations—including CDC and ACOG—strongly recommend that pregnant people get vaccinated. Talk to your health care provider about any questions or uncertainties.