This article has been medically reviewed by Carolyn Swenson, MD, an assistant professor of obstetrics and gynecology and a member of the Prevention Medical Review Board.
Since the advent of the COVID-19 vaccines, there has been confusion as to whether or not they are safe for pregnant women. The reason: Early clinical trials of the vaccine did not include pregnant or breastfeeding women, making it impossible to know for sure if it is safe for them to be immunized.
As a reminder, according to the Centers for Disease Control and Prevention (CDC), pregnant people are at an increased risk of serious illness from COVID-19, along with an increased risk of other adverse outcomes, such as premature birth.
At a recent press conference, Anthony Fauci, MD, the country’s foremost infectious disease expert, said clinical trials for pregnant women (and children) are underway, so we should have more definitive answers soon. And in the meantime, about 20,000 pregnant women have received the COVID-19 vaccine “with no red flags,” said Dr. Fauci.
These revelations are promising, but if you’re pregnant (or a loved one) you may still be wondering if it’s a good idea for pregnant women to get vaccinated. Here’s What You Should Know.
How does the COVID-19 vaccine work again?
Both the Pfizer BioNTech and Moderna vaccines use a newer technology called messenger RNA or mRNA, which is genetic material from the virus, according to the CDC. (Note: It’s not the virus itself – just the genetic coding of the virus. The vaccine is not making you sick with COVID-19.)
The mRNA tells your body how to make a spike protein, which the new coronavirus uses to attach to human cells. When your body starts pumping out spike proteins, your system sees them as foreign and makes antibodies unique to the coronavirus. Your body eventually eliminates both the protein and the mRNA, but the antibodies linger and protect you from COVID-19 should you become infected in the future.
What are public health organizations saying about getting the COVID-19 vaccine if you are pregnant or breastfeeding?
This is where things get confusing. Both the American College of Obstetricians and Gynecologists (ACOG) and the CDC have largely said that pregnant and breastfeeding women should be able to get the COVID-19 vaccine, if they want to. However, both organizations stop actually recommending that pregnant women get vaccinated.
Meanwhile, the World Health Organization (WHO) initially advised women against get the vaccine. But in late January, the organization revised its recommendation, stating, “Based on what we know about this type of vaccine, we have no specific reason to believe that there will be specific risks outweighing the benefits of vaccination for pregnant women. . “
Before receiving the vaccine, the ACOG recommends that pregnant women talk to their doctor about the following:
- the activity level of the virus in the community
- the potential efficacy of the vaccine available to them
- the risk and potential severity of maternal disease, including the effects of the disease on the fetus and newborn
- the safety of the vaccine for the pregnant patient and the fetus
However, the ACOG also states that a discussion with your doctor “should not be required,” as this may create “unnecessary barriers” to vaccination.
So, is it safe for pregnant and breastfeeding women to get the COVID-19 vaccine?
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“In the absence of data obtained in pregnant and lactating individuals, it is difficult to openly recommend an intervention,” said Emily S. Miller, MD, MPH, assistant professor in the division of obstetrics and gynecology at Northwestern Medicine.
But, based on what has been researched so far, “there is no reason to believe that pregnant women or their fetus are at risk of receiving the COVID-19 vaccine,” said William Schaffner, MD, an infectious disease specialist. and professor at Vanderbilt. University School of Medicine. And he points out that studies in pregnant animals have found no cause for concern.
“Everything we know about the vaccine would indicate that it should be safe,” says Dr. Schaffner. “The RNA in the vaccine is nowhere close to human DNA – neither from the mother nor from the fetus.”
Statements from public health organizations (such as the WHO) have been cautious, but “everything we’ve seen from women who became or were already pregnant during clinical trials and received the vaccine is reassuring,” said infectious disease expert Amesh A. Adalja. MD, senior scholar at the Johns Hopkins Center for Health Security.
Public health officials and organizations, including the ACOG, “are doing what they can with what they need to work with,” explains Michael Cackovic, MD, a physician for fetal mothers at Wexner Medical Center in Ohio State. “They say, ‘We don’t have the data to make that recommendation,’ and that’s right.”
At the same time, Dr. Cackovic points out that this type of vaccine is considered safer for pregnant women than other types of vaccines. “The COVID-19 mRNA vaccine does not contain live virus, and these types of vaccines are considered more compatible during pregnancy because they work by eliciting an immune response in the host,” he explains.
Plus, the fact that pregnant women are at high risk for serious complications from COVID-19 makes the vaccine at least worth considering, says Joanne Stone, MD, division director of maternal fetal medicine for the Mount Sinai Health System in New York. “It seems that the benefits outweigh the risks, although talking to a health care provider can help make an individual decision,” she explains. “And it is important that women are informed about the lack of data on the safety of vaccines in pregnant women.”
Bottom Line: Pregnant women should talk to their doctors about the COVID-19 vaccine.
With pregnant women now being included in vaccine trials, Dr. Cackovic says, “ongoing discussions with your doctor should include newly published information about the safety, efficacy and availability of the vaccine during pregnancy.”
Dr. Adalja agrees. “I think this is a decision between a doctor and a patient,” he says. “But in most cases, pregnant women need to be immunized.”
This item is correct as of press time. However, as the COVID-19 pandemic evolves rapidly and the scientific community’s understanding of the novel coronavirus evolves, some of the information may have changed since it was last updated. While we strive to keep all of our stories up to date, you can check the online resources of the CDC WHO, and your local public health department to keep up to date with the latest news. Always talk to your doctor for professional medical advice.
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