Now that COVID-19 vaccines are rolling out, pregnant and breastfeeding people have many questions around risks and benefits. At first, many of those receiving vaccines in US will be healthcare workers, although the circles for vaccine eligibility are widening.
The Centers for Disease Control and Prevention (CDC), the American College of Obstetrics and Gynecology (ACOG), and the Society for Maternal-Fetal Medicine agree that the new mRNA COVID-19 vaccines should be offered to pregnant and breastfeeding individuals who are eligible for vaccination.
Here are answers to some basic questions you may have about getting a COVID-19 vaccine if you’re pregnant or breastfeeding — or are considering a pregnancy. Keep in mind that information is evolving rapidly. Your obstetric provider or medical team can advise you more fully, based on your personal health risks, exposures to the virus that causes COVID-19, and preferences.
COVID-19 is potentially dangerous for all people. Although the actual risk of severe illness and death among pregnant individuals is very low, it is higher when compared to nonpregnant individuals from the same age group. Those who are pregnant are at higher risk for being hospitalized in an intensive care unit and requiring a high level of care, including breathing support on a machine, and are at higher risk for dying if this happens.
If you’re pregnant, you may also wonder about risks to the fetus if you get COVID-19. Research suggests that having COVID-19 might increase risk for premature birth, particularly for those with severe illness. So far, studies have not identified any birth defects associated with COVID-19. And while transmission of the virus from mother to baby during pregnancy is possible, it appears to be a rare event. You can read more about pregnancy and COVID-19 here.
The mRNA vaccine trials did not deliberately include pregnant or breastfeeding individuals, so our direct knowledge is currently limited. Some vaccine trial participants inadvertently became pregnant; 18 of these people received the vaccine. Further information may be available in coming months.
When studied during animal tests, the mRNA vaccines did not affect fertility or cause any problems with pregnancy. In humans, we know that other kinds of vaccines generally are safe for use in pregnancy — in fact, many are recommended.
It’s also important to know that
What about vaccine side effects? One possible short-term side effect of the mRNA vaccine trials (occurring within one to two days of vaccination) is fever. About 1% to 3% of people have experienced fever after the first dose of mRNA vaccine, and about 15% to 17% after the second dose. These fevers are generally low and can be managed with acetaminophen, which is safe to take during pregnancy. Rarely, high, prolonged fevers in pregnancy may lead to birth defects.
For more information about common COVID vaccine side effects, click here.
Eligibility for COVID vaccines varies from state to state. Healthcare workers with direct patient contact are typically in the first phase for vaccines, followed by other people at high risk for getting COVID, such as first responders, essential workers, nursing home residents, people over age 75, and people with certain health conditions.
Assuming the mRNA vaccine is available to you during your pregnancy, you have several options to discuss with your health care provider.
If you are considering deferring the vaccine, ask whether vaccination will be available to you at a later date. The answer may vary depending on supplies of the COVID vaccines and vaccination programs where you live.
Experts believe it is most likely safe to get an mRNA COVID-19 vaccine if you’re breastfeeding. Although breastfeeding people were not included in the vaccine trials, the mechanism of mRNA vaccines and experience from other vaccines suggest this is true.
It is important to know:
If you are considering pregnancy soon, accepting the COVID-19 vaccine as soon as it is available to you is a great way to ensure that you — and your pregnancy — are protected.
COVID-19 vaccination is not believed to affect future fertility.
COVID-19 vaccination for people who are pregnant or breastfeeding has potential benefits, and raises some as yet unanswered questions. It helps to become as informed as you can when making your decision, but realize that information may be changing rapidly. We will be learning more about COVID vaccine safety during pregnancy and while breastfeeding from animal studies now underway, and from human studies that are enrolling participants.
Meanwhile, you can stay informed by checking trusted health websites, such as those listed above, and talking with your healthcare providers. Together you can balance the latest data on risks of COVID-19 in pregnancy, the safety of available vaccines, your individual risk factors and exposures, and most importantly, your values and preferences.
The post Wondering about COVID-19 vaccines if you’re pregnant or breastfeeding? appeared first on Harvard Health Blog.