Should Pregnant People Get the COVID Vaccine?
The COVID-19 vaccines for pregnant people were approved in 2021—but many people remain uncertain about getting vaccinated. Coronavirus protocols have changed so much and so quickly since 2020, that it’s understandable to still have questions. To help address all your concerns and dispel any misinformation, we turned to ob-gyns and medical authorities. Keep reading for everything you need to know about getting the COVID-19 vaccine in pregnancy.
In this article:
What are the risks of COVID-19 in pregnancy?
What COVID-19 vaccines are currently available for pregnant people?
How does the COVID-19 vaccine work for pregnant people?
Why weren’t pregnant people included in trials?
Should pregnant people get the COVID-19 vaccine?
Are there any side effects or risks to getting the covid vaccine?
Does the COVID-19 vaccine affect fertility?
Who should not get the COVID-19 vaccine during pregnancy?
According to the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists (ACOG), while overall risks for COVID-19 are low, pregnant people are more likely to get severely sick and need hospitalization or die. Plus, a COVID infection during pregnancy could result in increased risk of complications like preterm labor and stillbirth.
The CDC notes that pregnant and breastfeeding people can currently get one of three available COVID vaccines from Pfizer-BioNTech, Moderna or Novavax. As of September 2023, all three vaccines have been updated to provide stronger protection against the COVID variants currently circulating, the US Food and Drug Administration (FDA) says. You might recall a fourth COVID-19 vaccine from Janssen (Johnson & Johnson). However, per the CDC, it’s no longer available in the US, as all government stock expired in May 2023.
It’s a common misconception that the COVID-19 vaccines use a live virus, says Daniel Roshan, MD, FACOG, FACS, director for ROSH Maternal-Fetal Medicine. Instead, the current Pfizer-BioNTech and Moderna COVID-19 vaccines use mRNA technology, which teaches the body to create an immune response. The mRNA works by replicating part of the COVID-19 virus’ DNA. It then “mimics the virus in the body and, without causing illness, works by triggering an immune response in the body to create immunity, at least partially, to COVID-19,” Roshan explains. He adds that mRNA technology has been studied for years in vaccines for influenza, Zika, rabies and to target cancer cells by oncologists. “We know how this COVID-19 vaccine and the mRNA works because it’s been studied for decades for possible use in other vaccines,” he says.
The Novavax vaccine uses protein subunits. Essentially, the vaccine uses harmless copies of the COVID-19 spike proteins to trigger an immune response. However, like the others, it doesn’t contain the live COVID-19 virus and can’t give you COVID, the CDC explains. You can learn more about each COVID-19 vaccine (including Johnson & Johnson’s Janssen), their ingredients, functionality and vaccination recommendations at the CDC’s website.
Pregnant and lactating people are usually never included in clinical trials for vaccines or medicines due to ethical reasons, Roshan says. Once the vaccine or medication receives FDA approval, “governing bodies for obstetrical and maternal-fetal medicine societies conduct their own research and extrapolate what’s known about the vaccine or drug and the possible impact on pregnancy and/or breastfeeding,” he adds. From this research, those governing bodies make recommendations about the use of the vaccine or drug during pregnancy and while breastfeeding. For the COVID-19 vaccine, all medical authorities, including the CDC, ACOG, Society for Maternal-Fetal Medicine and American Academy of Pediatrics (AAP) have issued strong recommendations in favor of the COVID-19 vaccine for pregnant and breastfeeding people.
According to the AAP, the COVID-19 vaccine doesn’t affect fertility; it points to a 2022 study that was conducted with over 2,000 women between 21 and 45 years old, as well as their partners. The study found that vaccination didn’t affect the fertility or conception chances of either partner. Another 2022 study from RMA of NY shows that vaccination against COVID-19 didn’t impact fertility, IVF outcomes, egg quality, the development of an embryo and pregnancy outcomes. Devora Aharon, co-author of the study and an ob-gyn and a reproductive endocrinologist with RMA of NY, encourages individuals undergoing fertility treatments go consider getting the COVID-19 vaccine. “The decision to receive the vaccine should be made in consultation with a healthcare provider, taking into account individual health circumstances and any specific risks or concerns,” she says.
“The vaccine is much safer than becoming infected with COVID-19 during pregnancy, as we know the many issues infection during pregnancy can cause,” Roshan says. Aharon agrees, noting that getting the vaccine can help reduce the risk of hospitalization, severe illness and other complications due to a COVID-19 infection during pregnancy.
Moreover, getting the vaccine doesn’t just protect you—it protects baby too. According to the CDC and previous studies, getting the vaccine will enable you to pass protective antibodies to baby in-utero and through your breast milk. This offers baby some protection until they’re able to get their own COVID-19 vaccine at 6 months old. In fact, a recent study found that getting the COVID-19 vaccine during pregnancy helped prevent COVID hospitalizations in newborns and babies younger than 6 months.
While the vaccine is strongly recommended by medical experts, be sure to check in with your doctor. “It’s essential to discuss any concerns or specific medical conditions with a healthcare provider before making a decision about receiving the COVID-19 vaccine during pregnancy,” Aharon says.
Yes, you should still get the vaccine, as immunity levels may vary depending on how long it’s been since you’ve had COVID, how severe your illness was and your age, the ACOG says. For people that have already received one (or more) doses of the previous COVID-19 vaccine, the CDC recommends getting one booster dose (or more depending on your previous dosage) of any of the the three updated vaccines. (None are preferred over another, the org says.)
Like with other vaccines, you may experience some side effects afterwards—and they’ll be the same experienced by those of the general population. According to the CDC, you may experience some of the usual side effects following vaccination, including:
- Pain, redness and swelling at the injection site
- Muscle aches
All of these side effects should be mild and only last 24 to 48 hours.
While the CDC strongly recommends pregnant and breastfeeding people get any of the updated COVID-19 vaccines, there are some instances where the vaccine may be deferred or may not be recommended at all. According to Aharon and the CDC, these include:
- Allergies to any COVID-19 vaccine ingredients
- A prior severe allergic reaction following COVID-19 vaccination
- A history of MIS-C or MIS-A
- If you have a mild illness at the time of vaccination
“Additionally, individuals with certain medical conditions or those undergoing specific treatments might need to consult with a healthcare provider to assess the risks and benefits of vaccination based on their individual circumstances,” Aharon says.
The choice to get vaccinated will be different for everyone based on their individual circumstances. Ultimately, it’s up to you. Remember, as you do your own research to inform your decision, check in with your doctor for personalized advice.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Devora Aharon, MD, is a reproductive endocrinologist, infertility specialist and board certified ob-gyn with RMA of New York. She earned her medical degree from and completed her residency at the Icahn School of Medicine at Mount Sinai in New York City.
Daniel F. Roshan, MD, FACOG, FACS, is the director at ROSH Maternal & Fetal Medicine in Manhattan. He specializes in maternal-fetal medicine, high-risk pregnancies, recurrent pregnancy losses, preterm labor, managing chronic diseases during pregnancy and more. He’s also an active member of the American College of Obstetricians and Gynecologists (ACOG) and the American College of Surgeons (ACS).
Centers for Disease Control and Prevention, New CDC Data: COVID-19 Vaccination Safe for Pregnant People, August 2021
Centers for Disease Control and Prevention, Pregnant and Recently Pregnant People, October 2022
American College of Obstetricians and Gynecologists, Why Should I Get the COVID-19 Vaccine While I'm Pregnant?, August 2021
Centers for Disease Control and Prevention, COVID-19 Vaccines for People Who Are Moderately or Severely Immunocompromised, October 2023
US Food and Drug Administration, FDA Takes Action on Updated mRNA COVID-19 Vaccines to Better Protect Against Currently Circulating Variants, September 2023
Centers for Disease Control and Prevention, Janssen (Johnson & Johnson) COVID-19 Vaccine, May 2023
Centers for Disease Control and Prevention, Stay Up to Date with COVID-19 Vaccines, October 2023
Centers for Disease Control and Prevention, How Protein Subunit COVID-19 Vaccines Work,
Centers for Disease Control and Prevention, Overview of COVID-19 Vaccines, October 2023
Society for Maternal-Fetal Medicine, Society for Maternal-Fetal Medicine, 2023
American Academy of Pediatrics, COVID-19 Vaccines During Pregnancy & Breastfeeding: Parent FAQs, October 2023
Centers for Disease Control and Prevention, COVID-19 Vaccines While Pregnant or Breastfeeding, September 2023
Centers for Disease Control and Prevention, Effectiveness of Maternal mRNA COVID-19 Vaccination During Pregnancy Against COVID-19–Associated Hospitalizations in Infants Aged <6 Months During SARS-CoV-2 Omicron Predominance — 20 States, March 9, 2022–May 31, 2023, September 2023
Centers for Disease Control and Prevention, Getting Your COVID-19 Vaccine, September 2023
American Journal of Epidemiology, A Prospective Cohort Study of COVID-19 Vaccination, SARS-CoV-2 Infection, and Fertility, July 2022
American College of Obstetricians and Gynecologists, COVID-19 Vaccines: Answers From Ob-Gyns, September 2023
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