Pros and Cons of Covid Vaccine While Pregnant

If you’re pregnant or thinking about getting pregnant, there’s a lot you need to think about: how big your baby bump will be at work, how much maternity leave your company gives, whether to go au naturale or go screaming into the epidural. And now there’s something else on the list: whether or not to get the COVID-19 vaccine. While there isn’t a ton of data and we don’t have much experience with this new vaccine yet, here’s what we do know—and what you should talk over with your doctor if you’re expecting (or might be soon):

Pregnancy is a particularly risky time for COVID-19

Pregnancy is a particularly risky time for COVID-19. The risk of complications is higher, and the risks to the baby are higher as well.

  • Complications in pregnancy include miscarriage, stillbirth and birth defects.
  • There are several ways you can contract COVID-19 while pregnant:

Vaccine information and data is limited, but it’s reassuring

The vaccine is safe for pregnant women as well as breastfeeding women. It is also safe for infants, children, adults, and older adults who have chronic diseases such as asthma or diabetes.

There are possible risks during pregnancy

  • Risk of miscarriage: There are no specific studies on the risks of miscarriage in pregnant women who receive a co-vac. However, according to research, there is no increased risk for spontaneous abortion or stillbirth when pregnant women receive seasonal flu vaccines.
  • Risk of stillbirth: There are no specific studies on the risks of stillbirth in pregnant women who receive a co-vac. However, according to research, there is no increased risk for stillbirth when pregnant women receive seasonal flu vaccines.
  • Risk of birth defects: The benefits and risks associated with getting a co-vac during pregnancy have not been studied enough to determine whether it causes birth defects or not. However, since both vaccines contain live viruses (measles and mumps) that have been weakened but not removed from the vaccine, there may be some risk involved with these two vaccines if they were given while you were pregnant if you weren’t immunized before becoming pregnant because these live viruses could cause an infection with your newborn baby after birth if they were given while you were pregnant

There are advantages to vaccination during pregnancy

The most important thing to know about the flu vaccine is that it’s safe. Pregnant women can get the flu vaccine and not worry about their baby being harmed in any way. In fact, the American College of Obstetricians and Gynecologists recommends that all pregnant women receive a flu shot every year during any trimester (first, second or third) as soon as it’s available. The CDC recommends that everyone over 6 months old get a yearly flu shot; this includes men, women who are planning to become pregnant within 2 weeks after getting vaccinated and people with weakened immune systems (like cancer patients).

The influenza virus can be dangerous for babies under 6 months old because those babies haven’t yet developed antibodies against the virus—and they’ve never been exposed to it before! That means they won’t have immunity from previous exposure like older kids do. Getting vaccinated protects your entire family from catching this viral infection including yourself and your newborn baby!

the decision to vaccinate is up to you.

If you are pregnant, the decision to vaccinate is up to you. Talk to your doctor about the risks and benefits of the vaccine. Read the information on this topic provided by our medical experts at [link] and [link].

The decision whether or not to get vaccinated while pregnant is a personal one. Do your research and consult with your healthcare provider before making any changes in your medical care during pregnancy or after delivery.

Conclusion

So the bottom line is: The decision to vaccinate is up to you. Do what feels right for your body and your baby. If you’re still on the fence, talk with your doctor about why they think it’s a good idea or ask them any questions you have. And remember, there are resources available that can help guide you through this decision, like the WHO website or Tdap vaccine information statements (VIS) published by the CDC.

Study shows that vaccination doesn’t increase risk of preterm births.

pregnant woman receiving vaccination against COVID-19

Pregnant women are, first and foremost, concerned with the health of their unborn child, and some have had reservations about getting the COVID-19 vaccine—only about a third of pregnant women are fully vaccinated.

But a new study of more than 46,000 pregnant women shows that COVID-19 vaccination does not increase the risk of delivering a premature baby or of having a baby born smaller than expected—both of which are linked to higher chances of infant death and disability. 

The study, which adds to existing evidence that COVID-19 vaccination during pregnancy is safe, was published on Jan. 4, 2022, by the Centers for Disease Control and Prevention (CDC); Heather Lipkind, MD, a Yale Medicine obstetrician-gynecologist and high-risk pregnancy specialist, was its lead author. 

One of the first studies to examine the health of babies born to women vaccinated during pregnancy, it comes at a crucial time, when the Omicron variant is surging. 

Vaccination is key, Dr. Lipkind says, because pregnant women with COVID-19 are at increased risk for severe illness and complications during pregnancy, including preterm birth

“Women have been reluctant to receive the vaccine due to limited information about vaccine safety,” Dr. Lipkind says. “However, now, given the increasing rates of Omicron, protection provided by the vaccine is more important than ever. Because Omicron is so contagious, the typical measures we were taking before aren’t necessarily working. And if you are pregnant, it may now be harder to keep yourself from getting sick with COVID.” 

Women with symptomatic COVID-19 during pregnancy are twice as likely to need admission to the hospital intensive care unit and invasive ventilation compared to nonpregnant women with symptomatic infections. And they are 70% more likely to die than nonpregnant women with COVID-19. 

Additionally, earlier studies have shown that women vaccinated during pregnancy do not face a higher risk of miscarriage compared to unvaccinated women. 

Details from the study on pregnant women and COVID vaccines

This latest study examined 46,079 pregnancies that resulted in a live birth. It included 10,064 pregnant women who received one or more doses of a COVID-19 vaccine between Dec. 15, 2020, and July 22, 2021. Most of the women received Pfizer-BioNTech or Moderna vaccines, and the majority were vaccinated during their second or third trimester. 

A total of 6.6% of babies from the study were born prematurely (before 37 weeks) and 8.2% were born small for their gestational age (referred to as SGA), weighing less than 5 pounds and 8 ounces. There was no difference in the rate of these occurrences between mothers who had been vaccinated while pregnant and those who were not, and the rates were consistent with what is expected in the population. 

Dr. Lipkind and her team plan to do follow-up research on infants born to women who have been vaccinated. 

Why vaccination in pregnancy is important

Given that women infected with the coronavirus appear to be at higher risk of preterm birth, vaccination is key to avoiding the various developmental issues that can accompany a baby born too soon.

“Delivering early is associated with an increased risk of developmental delay for the baby,” Dr. Lipkind says. “We also don’t know the long-term effects of COVID on babies if a mother passes the virus to her child.”

Meanwhile, one study on mRNA vaccines has shown that pregnant vaccinated women pass protective antibodies to their babies. 

COVID Vaccine and Trying To Get Pregnant

  • COVID-19 vaccination is recommended for people who are trying to get pregnant now or might become pregnant in the future, as well as their partners.
  • People who are trying to get pregnant now or might become pregnant in the future should stay up to date with their COVID-19 vaccines, including getting a COVID-19 booster shot when it’s time to get one.
  • There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems (problems trying to get pregnant) in women or men.
  • COVID-19 can make you very sick during pregnancy. Additionally, if you have COVID-19 during pregnancy, you are at increased risk of complications that can affect your pregnancy and developing baby.

Babies Born After COVID Vaccine

Across the US, COVID-19 vaccines are widely available for all adults and children ages 5 and older, including people who are pregnant. During pregnancy, vaccinations are a safe and routine part of prenatal care.

The more easily spread Delta variant of COVID-19 drove up rates of illness, hospitalizations, and deaths in the US. Most COVID-19 infections, severe illness, and deaths are occurring among unvaccinated people. Research shows that pregnant people have a higher risk of severe illness if they get COVID-19. And new evidence gathered from tens of thousands of pregnant people demonstrates that COVID-19 vaccines are safe and effective in pregnancy.

If you are pregnant, the US Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM) recommend getting an approved COVID-19 vaccine. They also recommend a booster shot if you received the Pfizer/BioNTech or Moderna vaccine at least six months ago, or the Johnson & Johnson vaccine at least two months ago. If you are not yet vaccinated, be sure to take basic measures to protect against the virus, such as frequent handwashing, mask-wearing in public places, and limiting possible exposures.

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Here are answers to some questions you may have about getting a COVID-19 vaccine if you’re pregnant — or considering pregnancy, soon or in the future. Keep in mind that information will continue to evolve. Your obstetric provider or medical team can advise you more fully about benefits and risks, based on your personal health risks, exposures to the virus that causes COVID-19, and preferences.

For information on breastfeeding and COVID-19, see this blog post.

What do we know about how COVID-19 affects people who are pregnant?

COVID-19 is potentially dangerous for all people. And while the actual risk of severe illness and death among pregnant individuals is 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 it is possible for the virus to spread from mother to baby during pregnancy, this is rare. Most often it is linked to having COVID infection two weeks before birth.

Which vaccines are authorized?

  • The Pfizer/BioNTech vaccine is authorized for ages 5 and older.
  • Moderna or Johnson & Johnson vaccines are authorized for ages 18 and older through emergency use authorization from the FDA.

All three vaccines help the immune system block the virus that causes COVID-19. This can be done in different ways:

  • Two-dose Pfizer/BioNTech vaccine: this vaccine uses mRNA.
  • Two-dose Moderna vaccine: this vaccine uses mRNA.
  • One-dose Johnson & Johnson vaccine: this vaccine uses a harmless, modified form of the common cold virus in humans called an adenovirus.

Do COVID-19 vaccines effectively protect pregnant people?

Broad studies show these vaccines are extremely effective in reducing risk for severe illness, hospitalizations, and deaths from COVID-19. They also help reduce risk for moderate illness. So, while some people who are fully vaccinated may still get COVID-19, they usually are protected against serious illness and death.

Whether a vaccinated person is pregnant or not pregnant, research shows the immune response is similar. Immune response from the vaccine is better than the response achieved through a natural infection with the virus.

Booster shots further increase the effectiveness of the vaccines. Ask your doctor if you need a booster shot.

You can read more about the different vaccines on the Harvard Health Coronavirus Resource Center.

Are the vaccines safe for people who are pregnant?

Evidence on the safety and effectiveness of COVID-19 vaccines during pregnancy is growing, according to the CDC. A new report on early data from safety monitoring systems that gather information on people who were pregnant when vaccinated and their babies finds no concerns about safety. Another report based on people enrolled in the v-safe COVID-19 Pregnancy Registry who received COVID-19 vaccines before 20 weeks of pregnancy notes no increased risk for miscarriage.

The CDC continues to follow people vaccinated during different trimesters of pregnancy to better understand effects on pregnancy and babies.

Important points about mRNA vaccines

  • 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.
  • mRNA vaccines do not contain any virus particles.
  • mRNA particles used in the vaccine are eliminated by our bodies within hours or days, so these particles are unlikely to reach or cross the placenta.
  • The immunity that a pregnant person generates from COVID-19 vaccination can cross the placenta, and may help keep the baby safe after birth.

Important points about the Johnson & Johnson vaccine

  • The modified adenovirus used in the vaccine can’t replicate or cause illness. The body quickly clears it from the injection site, so it’s unlikely to reach or cross the placenta.
  • In animal tests, this vaccine did not affect fertility or cause problems with pregnancy.
  • Vaccines similar to this one — called adenovirus vector vaccines — have been studied in humans for HIV, Ebola, and Zika virus. Trials that enrolled pregnant people reported no harmful pregnancy outcomes.
  • We know that other kinds of vaccines generally are safe for use in pregnancy — in fact, many are recommended. The immunity that a pregnant person generates from vaccination can cross the placenta, and may help keep the baby safe after birth.

What are the common vaccine side effects?

Common side effects include pain at the injection site, muscle aches, and tiredness. Fever for a day or two after vaccination is also possible, occurring in about

  • 1% to 3% of people after the first dose of mRNA vaccine
  • 15% to 17% after the second dose of mRNA vaccine
  • 9% after the Johnson & Johnson single-dose vaccine.

Fevers are generally low. Acetaminophen (Tylenol) is safe to take to bring down a fever during pregnancy. Rarely, high, prolonged fevers in pregnancy may lead to birth defects.

What are the rare vaccine side effects?

Blood clots with low platelets (thrombosis with thrombocytopenia syndrome, or TTS) has occurred in nine out of one million people who received the Johnson & Johnson vaccine. No cases have been reported in people who were pregnant, even though most cases of this rare condition occur in people of reproductive age. Warning signs include severe headache, changes in vision, abdominal pain, nausea and vomiting, back pain, shortness of breath, leg pain or swelling, easy bruising, or bleeding within six to 14 days of the vaccination. Call your doctor or seek medical help if you experience these symptoms.

Heart inflammation (myocarditis and pericarditis) may occur after the Pfizer/BioNTech and Moderna vaccines. This rare side effect has mostly affected male teens and young adults, usually after a second dose. No cases have been reported in people who were pregnant.

For more information about common and rare COVID vaccine side effects, see this CDC resource page.

If you’re thinking of becoming pregnant soon or in the future

Many people who are considering a pregnancy soon or in the future wonder if the COVID-19 vaccines affect fertility. However, there’s no evidence that they do, according to ACOG and SMFM. While human vaccine trials did not specifically study fertility, no signs of infertility were noted in animal studies, or reported among people of reproductive age who have been vaccinated worldwide.

Getting vaccinated prior to pregnancy is a great way to ensure that you — and your pregnancy — are protected.

How can you stay informed?

Check trusted health websites, such as sites included in this post, and talk 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.

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