COVID vaccine recommendations for pregnant women
The CDC, the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM), among many other medical organizations, all recommend that pregnant women receive the COVID-19 vaccine.
These organizations also recommend getting a booster shot two months after your last original vaccine series or booster dose. The current booster is a bivalent vaccine, meaning it contains components of both the original SARS-CoV-2 virus and the most recent Omicron variants, BA.4 and BA.5. This booster will help protect against the most common Omicron variants circulating in the U.S. right now.
If you're breastfeeding, it's also recommended that you get a COVID-19 vaccine and booster. Research on the safety and effectiveness of the vaccines in breastfeeding women is ongoing, but current findings show the vaccines protect against severe illness, and pose no harm to you or your baby.
Vaccine components won't cross over into your breast milk. As the vaccine is composed of mRNA (cellular instructions to build a protein) within a little fat bubble, the vaccine injected into your arm won't have a chance to travel through your bloodstream and into your milk.
On the flip side, research shows that antibodies produced by the vaccine do make it into your breast milk and are passed on to your baby, potentially protecting your child from COVID-19. Several other vaccines, such as the flu vaccine, are proven to have this effect.
Benefits of the COVID vaccine during pregnancy
The vaccine lowers the risk of severe COVID
Although the majority of pregnant women who get COVID-19 have healthy pregnancies and babies, they're at higher risk for severe illness and ICU admission, intubation, and death, as well as pregnancy-specific complications such as preterm birth and fetal growth restriction.
Pregnant women who get COVID-19 are three times more likely to require admission to the hospital and to the ICU than women of similar age who aren't pregnant. The risk of death from COVID-19 is 1.7-fold higher for pregnant women than for non-pregnant women.
COVID-19 antibodies can pass to your baby
Studies indicate that COVID vaccines are safe and effective in pregnant and breastfeeding women, and if you're nursing, you're likely to produce antibodies that can pass protection to your baby. Studies also show getting vaccinated during pregnancy can lower your baby's risk of getting COVID.
Studies show the vaccine is safe
The CDC is continuously monitoring the safety of vaccines by closely following tens of thousands of pregnant and breastfeeding women using systems like the v-safe program. These monitoring programs have shown no safety concerns for pregnant women who've received a COVID-19 vaccine, or their babies.
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Other large studies from around the world, including those from the United States, Canada and Europe, show that getting the COVID vaccine during pregnancy didn't lead to an increased risk of pregnancy complications such as miscarriage, preterm birth, stillbirth, placental infections, or blood loss after birth.
Important: Though there have been widespread rumors on social media, there's no evidence, or even a plausible basis for speculation, that getting a COVID-19 vaccine affects fertility or causes miscarriage. And there's no need to put off getting a vaccine because you're trying to get pregnant.
COVID vaccine side effects
Serious side effects from the COVID-19 vaccines are extremely rare, and some people experience no side effects at all. But it's common to have mild vaccine side effects. These include:
- Swelling, redness or pain at the injection site
- Fever
- Headache
- Fatigue
- Muscle pain
- Chills
- Nausea
You're very unlikely to develop any long-term side effects from the COVID-19 vaccines. According to the CDC, vaccine monitoring historically shows that if side effects do happen, it's within 6 weeks of receiving a vaccine dose. Before authorizing the vaccines, the FDA required drugmakers to monitor clinical trial participants for at least 8 weeks after they received the final dose.
Are there any risks associated with the COVID vaccine?
The currently authorized vaccines have proven safe and effective for adults, children 6 months and older, pregnant women, breastfeeding moms, and those hoping to become pregnant. Millions of people across the United States and the world have received the vaccines safely. The vaccines went through a rigorous clinical trial process before being approved, and the CDC continues to monitor their safety.
However, some people have experienced serious side effects. These are extremely unlikely to happen, but worth knowing about.
Blood clots
Even though the risk of blood clots is rare, there have been reports of thrombosis with thrombocytopenia syndrome (TTS), or blood clots with low platelet levels in the blood, associated with the Johnson & Johnson vaccine.
This reaction is extremely uncommon (TTS has occurred in 4 cases per one million Johnson & Johnson doses given), and the CDC still recommends the Johnson & Johnson vaccine for those 18 and older who aren't able to get Moderna or Pfizer, or who otherwise wouldn't get the COVID vaccine.
According to the American Heart Association, the risk of getting a blood clotting disorder from a COVID infection is 8 to 10 times higher than the risk associated with getting the vaccine. Also. the CDC emphasizes that the Moderna and Pfizer vaccines don't carry the risk of blood clots.
Even though this side effect is rare, if you received the vaccine within the past three weeks and develop severe headache, abdominal pain, leg pain, or shortness of breath, seek medical care right away.
Heart inflammation
There have been some reports of inflammation of the heart – called myocarditis and pericarditis – following vaccination with the Pfizer and Moderna vaccines, specifically in teens and young adults. These cases occurred primarily in boys ages 16 and older, within a few days of receiving the second vaccine dose. Most patients recovered quickly after getting treatment and rest.
The risks associated with getting COVID-19, such as long-term health issues, hospitalization, and even death, far outweigh any potential risks of experiencing this rare reaction to the vaccine, says the CDC. However, seek medical care if your child experiences chest pains, shortness of breath, or has a fast or fluttering heartbeat within a week after receiving a COVID-19 vaccine.
Allergic reactions
Between 2 and 5 people out of every million who get a COVID-19 vaccine experience a serious allergic reaction. In most cases, these reactions can be treated immediately with medications, and people fully recover – and recover quickly.
However, because some people are more at risk of a severe vaccine reaction than others, the CDC recommends the following:
- If you've had an immediate allergic reaction to any other kind of vaccine or injectable therapy in the past (even if it wasn't severe), ask your doctor whether you should get a COVID-19 vaccine.
- If you have an allergic reaction to your first shot of a COVID-19 vaccine, ask your doctor if you should get a different type of vaccine.
- If you're allergic to polyethylene glycol (PEG), don't get the Pfizer or Moderna vaccines. If you're allergic to polysorbate, don't get the Johnson and Johnson vaccine
- You can get the vaccine if you have a history of severe allergic reactions unrelated to vaccines (such as allergies to pets, food, and latex).
Symptoms of allergic reaction include hives, pale skin, swelling in the face or mouth, and wheezing or trouble breathing. They do not include vaccine side effects such as fever, chills, or fatigue, which tend to occur within a few days after vaccination.
The bottom line? If you're pregnant, breastfeeding, or trying to become pregnant, be sure to stay up to date with your COVID shots and boosters to protect both you and your baby. Talk to your provider if you have any questions or concerns. They can walk you through your options and offer guidance on getting your shots.
Read more about pregnancy and COVID, and COVID-19 in babies, toddlers, and young children.
