COVID-19 Vaccine and Pregnancy

Pregnancy woman receiving vaccine

Over the next few months, pregnant and breastfeeding women across the nation will have access to the much-anticipated COVID-19 vaccine. Dr. David Jude, chair of the Department of Obstetrics & Gynecology, addresses many of the questions these women may have when deciding whether the vaccine is right for them.


Do pregnant women have an increased risk of developing severe disease due to COVID-19?

Recent data indicate that pregnant women who contract COVID-19 have a higher risk of having severe disease compared to women who are not pregnant including:

  • 3 times increased risk of ICU admission
  • Mechanical ventilation (used to help a patient breathe)
  • 1.7 times increased risk of death among pregnant patients with symptomatic COVID-19 infection compared to symptomatic non-pregnant patients

Risk of poor outcomes are increased in women with underlying health conditions including obesity, diabetes, heart disease, chronic lung disease and smoking.

For these reasons, the Society for Maternal–Fetal Medicine (SMFM) and the American College of Obstetricians and Gynecologists (ACOG) strongly recommend that pregnant and breastfeeding women have access to the COVID-19 vaccines.

Are the COVID-19 vaccines safe to use during pregnancy?

Clinical trials of both the Pfizer-BioNTech and Moderna vaccines did not include women who are pregnant or lactating.  At this current time we do not have data on vaccine safety or efficacy when it is administered during pregnancy.  Neither of these vaccines contain a live virus and fetal risk is thought to be low.  Preclinical studies with the Pfizer vaccine have been reassuring.

What should I consider when deciding on vaccination while I am pregnant?

People who are pregnant and considering COVID-19 vaccination should balance the low but unknown fetal risk with the increased risk of severe disease during pregnancy.  Patients should also weigh their individual risk for both acquiring COVID-19 infection as well as their individual risk of developing severe disease.  Prevalence of the disease in the community is also another factor to consider in deciding whether or not to receive the vaccine.

So, if you are pregnant and have comorbidities like being overweight, have high blood pressure, smoke or any other underlying condition that makes severe disease more likely, or if you have a job or other factor that increases your risk of exposure, or if you live in an area with high prevalence of COVID-19 infections, you should strongly consider receiving the vaccine.

What are the side effects of the COVID-19 vaccine?

Expected side effects are a normal part of the body’s reaction to the vaccine and developing antibodies that protect against the disease.  Most side effects experienced include injection site reactions and flu like symptoms like fatigue, chills, muscle and joint pain, and headaches.  Side effects are more common after the second injection.

Should I get vaccinated if I have already had an infection due to COVID-19?

Prior infection due to COVID-19 does not automatically confer immunity.  Women who have had COVID-19 infections previously should consider being vaccinated.

Should I get the vaccine if I am breastfeeding?

Both SMFM and ACOG recommend COVID-19 vaccines be offered to breastfeeding women.  Stopping or avoiding starting breastfeeding is not necessary in order to receive the vaccine.

Should I get the vaccine if I am considering becoming pregnant soon?

ACOG strongly encourages COVID-19 vaccination for non-pregnant women who are otherwise eligible for the vaccine.  It is not necessary to delay pregnancy after completing COVID-19 vaccination.  If a person becomes pregnant after the first dose of the vaccine series, the second dose should be administered as indicated.  Pregnancy testing is not recommended prior to receiving a COVID-19 vaccine.

 

Patients are encouraged to discuss any questions with their ob-gyn or primary care provider. For more information, call Marshall OB/GYN at 304-691-1400.

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David Jude, MD

Dr. Jude is a board-certified OB/GYN and professor and chair of the department of obstetrics & gynecology at the Marshall University Joan C. Edwards School of Medicine.