As COVID-19 vaccines are becoming increasingly available across the country and eligibility guidelines are quickly expanding, Motherfigure takes a look at what the vaccine means for women who are pregnant or breastfeeding.
Over the past year, we have learned that pregnant women are at an increased risk for developing severe illness from COVID-19, resulting in intensive care admission, mechanical ventilation, and sometimes even death. What’s more, pregnant women with COVID-19 may also have an increased risk for adverse pregnancy outcomes like preterm birth.
Given the severe consequences of developing COVID-19, the question of whether to get vaccinated is a very serious and personal decision for pregnant and lactating women. Before signing up for your shot, here’s what you need to know.
What does the vaccination research say for pregnant women?
Currently, there is limited clinical data on the safety of COVID-19 vaccines for pregnant women, but scientists understand how these vaccines operate in the body and believe that they are unlikely to pose a risk for people who are pregnant.
The Pfizer-BioNTech and Moderna vaccines are mRNA vaccines, which means they don’t contain the live coronavirus and cannot give someone COVID-19. The mRNA technology is relatively new, and it works by teaching our cells to make a protein that triggers an immune response in the body, which then produces antibodies to protect the body from the virus.
Johnson & Johnson’s Janssen vaccine (J&J/Janssen) is a viral vector vaccine that functions as a delivery shuttle—it uses a modified version of a different virus (called the vector) to deliver instructions to our cells. This technology has been used to develop vaccines for other diseases such as ebola. Clinical trials of women in all trimesters of pregnancy who received other vaccines using the same viral vector found no adverse pregnancy-related outcomes.
In addition, animal studies involving the Moderna, Pfizer, and J&J vaccines have shown no safety concerns before or during pregnancy.
Clinical trials to study the COVID-19 vaccines’ safety and efficacy in pregnant people are in progress or planned, but in the meantime, the Centers for Disease Control and Prevention (CDC) and the Federal Drug Administration (FDA) are closely monitoring cases involving vaccination during pregnancy. Vaccine manufacturers are also monitoring people in clinical trials who were vaccinated and became pregnant.
How about vaccination research on women who are breastfeeding?
Unfortunately, clinical trials for COVID-19 vaccines in the United States have not included women who are breastfeeding. Since vaccine studies have excluded lactating people, there is almost no data available on the safety of COVID-19 vaccines in women who are breastfeeding, the effects of vaccination on the breastfed infants, or the effects on milk production or excretion.
Despite the lack of available evidence, however, experts say that the vaccines should be safe for lactating women. The authorized COVID-19 vaccines are non-replicating vaccines, which means they do not reproduce inside the body’s cells and therefore are unlikely to pose a risk to breastfeeding mothers or their infants.
Any good news?
The latest data on how vaccines may affect new and expecting mothers has encouraging results. A recent study, published in March 2021, found that pregnant and lactating people who received the COVID-19 vaccine developed strong, protective antibodies that were transferred to their babies via the placenta and breast milk.
In this study, 131 women were monitored—84 of the participants were pregnant, 31 were lactating, and the rest made up the control group. After getting vaccinated, analysis of the participants’ umbilical cord blood and breast milk showed COVID-19 antibodies, suggesting that some amount of immunity could be passed on in utero and after birth.
While the study is based on a very small sample set, the preliminary results are a positive sign for pregnant and lactating women.
Getting vaccinated is a personal choice
Ultimately, it’s up to you to decide whether you want to get vaccinated. Any of the currently authorized COVID-19 vaccines are available to people who are pregnant or breastfeeding. The CDC recommends speaking with your healthcare provider to determine whether getting vaccinated is right for you.
When considering vaccination, here are some important questions you should consider:
- How likely are you to be exposed to the virus that causes COVID-19?
- What are the risks of COVID-19 to you and the potential risks to your fetus or infant?
- What are the benefits of vaccination to you and your fetus or infant?
- What is known about the vaccine?
- Do you have any history of severe allergic reactions (anaphylaxis) to other vaccines or injectable therapies?
So you’ve decided to get vaccinated, what else should you know?
Vaccination side effects are a normal sign that your body is building up its protection against the coronavirus. After getting vaccinated, you may experience pain, redness, or swelling on the arm where you got the shot. Throughout the rest of your body, you may experience fever, tiredness, headache, muscle pain, chills, or nausea. In some cases, people have experienced allergic reactions after receiving the vaccine.
If you received the Pfizer-BioNTech or Moderna vaccine, side effects after your second shot may be more intense than what you felt after the first dose. These side effects may hamper your ability to perform daily activities but should disappear within a few days.
It’s important to note that pregnant people have not reported any different side effects from the vaccines when compared to non-pregnant people.
The CDC recommends talking to your doctor about taking over-the-counter medicine—such as ibuprofen, acetaminophen, aspirin, or antihistamines—to mitigate any pain and discomfort you may experience after getting vaccinated. To help lessen pain where you got the shot, you can apply a clean, cool, wet washcloth to the area or exercise your arm muscles. Also, remember to drink lots of fluids and dress lightly to reduce discomfort from fever.
While most cases of discomfort from pain or fever are normal and will eventually go away, you should contact your doctor or health provider if:
- The redness or tenderness where you got the shot gets worse after 24 hours
- Your side effects are worrying you or do not seem to be going away after a few days