5 Crucial Things to Know About COVID-19 Vaccines and Pregnancy

5 Crucial Things to Know About COVID-19 Vaccines and Pregnancy

by Sue Jones
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Pregnancy can be a tremendously difficult time even under the best of circumstances. For many people, it’s full of frequent worry and unending questions—Can I eat this? Is this medicine safe for me to take? The COVID-19 pandemic has unsurprisingly compounded these concerns. So, what are the best ways to keep yourself safe from this virus if you’re pregnant—and protect the growing life within you at the same time? Below are the most important takeaways we have right now about pregnancy, COVID-19, and the COVID-19 vaccines.

1. COVID-19 can be extremely dangerous for pregnant people.

Pregnancy is a time of physiologic internal conflict. Because half of the fetus’s genetic information is foreign, the body’s immune system response adapts throughout the pregnancy to protect the fetus from attack. This flux in the immune response can result in an increased vulnerability to infections, including to respiratory viruses such as influenza and SARS-CoV-2, the virus that causes COVID-19.

We’ve seen this play out over the last year, and the statistics are dire. Those who contract COVID-19 during pregnancy are more likely to develop severe disease than nonpregnant people. “Compared with those who aren’t pregnant, current data shows that pregnant people infected by the COVID-19 virus are three times more likely to require ICU care; are two to three times more likely to require advanced life support and a breathing tube; face an increased risk of death; and face an increased risk of stillbirth and preterm birth,” Cynthia Gyamfi-Bannerman, M.D., a maternal-fetal medicine subspecialist in San Diego who serves on the Society for Maternal and Fetal Medicine’s (SMFM) COVID-19 Task Force, tells SELF.

Dr. Gyamfi-Bannerman also notes this danger is more pronounced in older pregnant people, those with pre-existing health conditions, and Black or Latinx individuals, who have a greater risk of severe disease and death than white people do if infected with COVID-19.

2. Vaccination against COVID-19 during pregnancy can help drastically reduce these risks.

“Vaccination is the best way to reduce the risks of COVID-19 infection and related complications for both mothers and babies,” explains Dr. Gyamfi-Bannerman. She notes that vaccines offer some protection against viral variants, including the delta variant. And even if someone contracts COVID-19 after vaccination, which we know is possible, they “are likely to have a much milder infection than those who are unvaccinated,” Dr. Gyamfi-Bannerman says. The vast majority of those who are currently hospitalized with or dying from COVID-19 are unvaccinated.

Dr. Gyamfi-Bannerman continues: “This is why vaccines have been endorsed by leading maternal health organizations, and the Centers for Disease Control and Prevention strongly recommend COVID-19 vaccination for everyone 12 years of age or older, including those who are pregnant, breastfeeding, trying to become pregnant, or may become pregnant in the future.”

Though pregnant people weren’t purposely included in the vaccine clinical trials, some individuals became pregnant during the trials. Additionally, we have data on vaccines in pregnancy from more than 148,500 pregnancies reported via the CDC’s V-safe post-vaccination health monitoring system, where vaccinated people can report how they feel in the days and weeks following their doses. Overall, vaccine side effects were similar in pregnant and nonpregnant populations, and no unexpected pregnancy or fetal outcomes have been identified as a result of COVID-19 vaccination, Linda Eckert, M.D., a physician and member of the American College of Obstetricians and Gynecologist’s (ACOG) Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group, explains.

The CDC, vaccine manufacturers, and independent scientists are conducting additional studies in this realm. As of mid-July 2021, over 5,000 pregnant people were enrolled in the V-safe pregnancy registry, which will follow vaccinated individuals throughout their pregnancies and beyond. This will include self-reported data as well as reviewing medical records to obtain detailed information on pregnancy outcomes.

Dr. Gyamfi-Bannerman also addresses one of the false yet lingering rumors about COVID-19 vaccination: that it may affect fertility. “There is no evidence that links COVID-19 vaccination to increased rates of miscarriage,” she says. “Furthermore, there is no possibility of vaccination altering the body’s DNA or other genetic material.”

And while pregnant people can’t receive some vaccines during pregnancy because they contain live virus, this is not the case for any of the current FDA-authorized or approved COVID-19 vaccines in the United States. It is impossible to get COVID-19 from receiving the vaccine.

3. There’s no one trimester that’s better than the others for COVID-19 vaccination.

Both experts agreed: The best time to get vaccinated against COVID-19 while pregnant is as soon as possible. “Based on available data, there is no trimester that is considered to be safer than another for vaccination,” says Dr. Eckert.

Dr. Gyamfi-Bannerman agrees that COVID-19 vaccination is safe and effective at any point during pregnancy. “Of 2,400 pregnant people vaccinated in the first trimester, there has been no increased risk of pregnancy loss, growth problems, or birth defects compared with pregnant people who were not vaccinated,” she says. “No problems have been reported in those vaccinated later in pregnancy.”

4. Vaccination while pregnant can also help protect your newborn after birth.

“Even after pregnancy, COVID-19 vaccination can protect infants through antibodies,” Dr. Gyamfi-Bannerman says. We know that vaccination during pregnancy can protect infants from other infectious diseases, such as pertussis and influenza, during the early months when they are most vulnerable to infection but unable to be vaccinated. Fortunately, we’re seeing something similar with COVID-19 vaccination.

Dr. Eckert points to a prospective cohort study finding that people who are vaccinated while pregnant are likely to pass anti-COVID-19 antibodies to their babies. “In numerous studies of vaccinated moms, antibodies were found in the umbilical cord blood of babies and in the mother’s breast milk,” she explains. Studies are ongoing to examine how long SARS-CoV-2 antibodies will persist in infants and how well they might protect against COVID-19 infection and serious disease.

5. Bottom line: Anyone who is eligible should get vaccinated.

Although we cannot ignore that access issues continue to be an issue for some, overall it remains relatively easy to receive a COVID-19 vaccine in this country. “In the United States, anyone over age 12 is eligible to receive the COVID-19 vaccine for free regardless of immigration status or insurance coverage,” Dr. Gyamfi-Bannerman says. “Patients may be asked for their social security number, but it is NOT required to get vaccinated. If you are pregnant or planning to become pregnant and have any questions about COVID-19 vaccination, speak with your health care provider or visit the CDC’s website.” You can find locations to receive the vaccine on Vaccines.Gov.

Especially with the highly transmissible delta variant circulating, the unvaccinated are at increased risk of developing a serious outcome if infected. “Pregnant individuals who have decided to wait until after delivery to be vaccinated may be inadvertently exposing themselves to an increased risk of severe illness or death,” Dr. Eckert says. “Those who have recently delivered and were not vaccinated during pregnancy are strongly encouraged to get vaccinated as soon as possible.”


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