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The COVID vaccine and pregnancy

If you're pregnant, trying to conceive, or breastfeeding, it's especially important to stay up to date with your COVID vaccine. Here's why.

Pregnant woman getting injection
Photo credit: iStock.com / Pamela Moore

Do you need a COVID vaccine during pregnancy?

Yes. Doctors and organizations including the Centers for Disease Control and PreventionOpens a new window (CDC), the American College of Obstetricians and GynecologistsOpens a new window (ACOG), and the Society for Maternal-Fetal MedicineOpens a new window (SMFM) recommend that pregnant women get the COVID-19 vaccine.

It's important for expecting moms to stay up to date with their COVID-19 vaccines, which means getting the latest shot when it's time. Your healthcare provider can help you with the timing.

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Here's why it's so important to get your 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, fetal growth restriction, and possibly stillbirth.

The risk of severe COVID symptoms applies to new moms, too – for at least 42 days postpartum.

"Data show that receiving an mRNA COVID-19 vaccine during pregnancy reduces the risk of severe illness and other health effects from COVID-19 for people who are pregnant," says the CDC.

COVID-19 antibodies can pass to your baby

If you're breastfeeding, it's also recommended that you get a COVID-19 vaccine. 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.

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 there are no reports of harm to women or their babies.

The vaccine doesn't cross over into your breast milk. It's composed of mRNA (cellular instructions to build a protein) within a little fat bubble, so the vaccine injected into your arm won't have a chance to travel through your bloodstream and into your milk.

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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.

You can get vaccinated in any trimester, but the sooner the better for best protection throughout pregnancy. And it's fine to get your COVID vaccine at the same time as other vaccines you'll get during pregnancy, including the flu and Tdap vaccines.

Is the COVID vaccine safe during pregnancy?

Yes, all available evidence shows that the COVID vaccine is safe during pregnancy. According to ACOG, "There is no evidence of adverse maternal or fetal effects from vaccinating pregnant individuals with the COVID-19 vaccine, and a growing body of data demonstrates the safety of such use."

A recent reviewOpens a new window published in Vaccine looked at 71 studies of more than 17 million pregnant women and found no safety concerns surrounding the COVID-19 vaccine.

Other large studies from around the world 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.

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The CDC is continuously monitoring the safety of vaccines by closely following tens of thousands of pregnant and breastfeeding women using systems like the Vaccine Adverse Event Reporting SystemOpens a new window (VAERS). These monitoring programs have rarely shown severe reactions after COVID-19 vaccination.

Which COVID vaccine will I get during pregnancy?

The COVID-19 vaccines currently recommended for use in pregnancy in the United States are:

  • Pfizer-BioNTech
  • Moderna

These are messenger RNA (mRNA) vaccines. They introduce lab-created mRNA – not a live virus – to the body to teach cells how to make a protein that triggers an immune response. This immune response produces antibodies to fight the virus. Once the protein is made, the body's cells break down the mRNA and remove it from the body. The mRNA vaccines are formulated for everyone ages 6 months and older.

No COVID-19 vaccines interact with or affect the body's DNA. And none of the introduced substances stick around. "After the body produces an immune response," explains the CDC, "it discards all of the vaccine ingredients, just as it would discard any substance that cells no longer need. This process is a part of normal body functioning."

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Newer COVID vaccines contain protection against the newest variants of COVID.

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 such as:

  • 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 women 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.

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However, some people have experienced serious side effects. These are extremely unlikely to happen, and keep in mind that the risks associated with getting COVID-19 far outweigh any potential risks of getting vaccinated.

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.

While this reaction was extremely rare, the Johnson & Johnson vaccine is no longer used in the United States.

Heart inflammation

There have been some reports of inflammation of the heart – called myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the outer lining of the heart) – 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.

Allergic reactions

About 5 people out of every million who get a COVID-19 vaccine experience a serious allergic reaction called anaphylaxis. In most cases, these reactions can be treated immediately with medications, and people fully recover – and recover quickly.

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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. Ask your healthcare provider about alternatives.
  • 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 don't 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 trying to conceive, pregnant, or breastfeeding, be sure to stay up to date with your COVID shots 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.

Learn more:

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Sources

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

ACOG. 2023. COVID-19 vaccination considerations for obstetric-gynecologic care. American College of Obstetricians and Gynecologists. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-careOpens a new window [Accessed September 2023]

ACOG. 2022. COVID-19 vaccines and pregnancy: Conversation guide. American College of Obstetricians and Gynecologists. https://www.acog.org/covid-19/covid-19-vaccines-and-pregnancy-conversation-guide-for-cliniciansOpens a new window [Accessed September 2023]

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CDC. 2023. Janssen (Johnson & Johnson) COVID-19 vaccine. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/info-by-product/janssen/index.htmlOpens a new window [Accessed September 2023]

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Karen Miles
Karen Miles is a writer and an expert on pregnancy and parenting who has contributed to BabyCenter for more than 20 years. She's passionate about bringing up-to-date, useful information to parents so they can make good decisions for their families. Her favorite gig of all is being "Mama Karen" to four grown children and "Nana" to nine grandkids.
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