COVID-19 vaccines and pregnancy: what you should know
Should you get a COVID-19 vaccine if you’re pregnant, breastfeeding or planning to become pregnant?
In short, the answer is yes. Recently, the Centers for Disease Control and Prevention(CDC), American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal-Fetal Medicine updated their guidance to recommend that pregnant, postpartum and lactating people should receive a COVID-19 vaccination. Currently, everyone 12 and older is eligible.
We spoke with Loren Molina, MD, medical director of MultiCare Tacoma General Hospital’s Birth Center, to better understand this change in guidance. Dr. Molina is a board-certified OB/GYN specializing in maternal-fetal medicine, focusing on patients with high-risk pregnancies.
New data sheds light
One reason leading health care organizations have amended vaccine guidance for pregnant and lactating people is the emergence of new safety data from two voluntary CDC registries.
As of August 2021, there have been over 148,000 pregnancies reported in the CDC’s v-safe After Vaccination Health Checker. This registry collects health information from people who received a COVID-19 vaccine and no safety concerns have been raised in those who are pregnant.
The second registry, called the v-safe COVID-19 Vaccine Pregnancy Registry, directly enrolls those who are pregnant to track their outcomes after vaccination. Researchers then compare the experiences and outcomes of participants to the general pregnant population.
As of August 2021, there were over 5,000 people enrolled in the registry, and there have been no indications that the COVID-19 vaccines lead to increased pregnancy complications, such as miscarriage, preterm birth, fetal growth restriction or stillbirth, or adverse outcomes for newborns.
“It’s common practice that pregnant women are not included in initial drug or vaccine trials,” says Dr. Molina. “Therefore, observational data is our next best source of safety information. This observational data suggests the COVID-19 vaccines pose no increased pregnancy risks for people who are pregnant or their babies.”
And that’s not all — there may be even more positive news for newborns. Initial research findings indicate that vaccine-generated antibodies (proteins that fight viruses) are present in umbilical cord blood and breastmilk after maternal vaccination.
The danger of the delta variant
Another reason the COVID-19 vaccine guidelines are shifting is the rise of the delta variant, a highly contagious form of the virus that causes COVID-19.
“In the beginning of the pandemic, many pregnant women with COVID-19 experienced mild symptoms or none at all,” says Dr. Molina. “However, there are now higher numbers of critically ill, unvaccinated pregnant patients with COVID-19 who are being admitted to hospitals and intensive care units worldwide.”
According to the CDC, pregnant people with COVID-19 face an increased risk of severe illness as well as preterm birth (delivering a baby earlier than 37 weeks).
“These changing circumstances have created a real sense of urgency,” says Dr. Molina. “We are encouraging all our patients who are pregnant or breastfeeding to get vaccinated.”
In general, those who are pregnant or lactating can expect to experience the same vaccine side effects as the overall population — and these are not considered harmful.
What hasn’t changed
While the global spread of the delta variant along with new information about safety have prompted an update in COVID-19 vaccine guidance, there are some recommendations that remain the same.
People who are planning to become pregnant in the future, should still get vaccinated. Dr. Molina cited a statement from the American College of Obstetricians and Gynecologists that dispels the notion that COVID-19 vaccines cause infertility. According to ACOG, “unfounded claims linking COVID-19 vaccines to infertility have been scientifically disproven.”
Any of the currently authorized COVID-19 vaccines can be administered to pregnant, recently pregnant or lactating people, as well as those planning to get pregnant. The Johnson & Johnson single dose vaccine has been associated with a rare occurrence of blood clots in women under 50, but still remains available to all women. The two-shot mRNA vaccines (Pfizer and Moderna) are also available and do not carry this clotting risk.
Aside from getting vaccinated, the best way to protect yourself and your loved ones from COVID-19 is to continue following community guidelines regarding masking and physical distancing.
“It’s important to stay informed because we are learning more all the time,” says Dr. Molina. “Patients should reach out to their providers if they have questions or concerns about the vaccine.”
For more information about pregnancy and COVID-19, visit the Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists.
