COVID-19 vaccination in pregnancy, lactation, and planning pregnancy

Vaccines, including influenza and pertussis, have been safely given to pregnant and lactating people for decades. There are principles we have learned from these other vaccines that are useful for evaluating the safety of COVID-19 vaccines in pregnancy. 

The COVID 19 clinical trials meet the same high standards for safety and efficacy as those for any other vaccine.

The COVID-19 mRNA vaccines do not have live or killed viruses. This means they cannot cause a person to become sick with COVID-19 or test positive for the virus. The mRNA is degraded quickly by normal cellular processes. It does not integrate or change the genetic material in the body’s cells.

The vaccine works by teaching your immune system how to recognize and fight the virus that causes COVID-19. The vaccine can cause fever, muscle pain, chills, fatigue, headache, or soreness in the arm where the vaccine is given, which is normal and a sign the body is building immunity.

If you are lactating

While there are no studies about lactating persons getting the COVID-19 vaccine to at this time, many other vaccines have been studied in those who are lactating and have been found safe.

The American College of Obstetricians and Gynecologists (ACOG) and the Society of Maternal Fetal Medicine (SMFM) suggest lactating individuals get the vaccine. This means if you are lactating, you can and should get the COVID-19 vaccine. You can still breastfeed after receiving the vaccine.

If you are planning for pregnancy

The American College of Obstetricians and Gynecologists (ACOG) and Society of Maternal Fetal Medicine (SMFM) also strongly recommend non-pregnant people actively trying or thinking about getting pregnant get the COVID-19 vaccine. People undergoing fertility treatment should be vaccinated as well.

If a person gets pregnant after the first dose, the second dose should be given as scheduled. Since the vaccine is not a live virus, you can still try to get pregnant after the first and second doses.

If you are pregnant

We know deciding to get a COVID-19 vaccine during pregnancy can feel like an overwhelming decision.

Pregnant and lactating persons were not part of the clinical trials, so we do not know if there are side effects specific to pregnancy or how well the vaccine works in pregnant people. Some people have chosen to get the vaccine while pregnant, and we are starting to gather informal data from those women. Though the information is not as complete as what we would gather during a formal clinical trial, there have been no indications that the vaccines have had any adverse effects on the pregnancy. Formal studies have been started but getting data will take time.

We do know that the COVID-19 vaccines do not have any ingredients that are known to be harmful in pregnancy or to the baby. Those who are pregnant are more likely to die from the virus, and preterm birth may be more common in those with severe COVID-19 disease. The mRNA vaccines prevent about 95% of COVID-19 infections. Think about your risk for getting COVID-19 and your risk for getting very ill from COVID-19.

You may want to talk with your obstetrical provider at your next visit. Choosing to be vaccinated is a personal choice. We support your decision to be vaccinated in pregnancy or to wait. Your care will not change either way.

The following are considerations on whether to get the vaccine. You can also talk with your obstetrical provider about the vaccine.

You should consider getting the vaccine if you are at higher risk of getting very sick from COVID-19, such as:

  • You have contact with people outside your home who do not wear masks
  • You are 35 years old or older
  • You work in health care
  • You are a smoker, overweight, or obese
  • You have other health conditions, such as:
    • Diabetes
    • High blood pressure
    • Heart disease

It might make sense to wait and learn more about the vaccine in pregnancy if you are not at higher risk for COVID-19 and:

  • Your community does not have high or increasing COVID-19 cases
  • You and the people you live with can physically distance from others during your pregnancy
  • You always wear a mask outside your home
  • You are more worried about the unknown risks than about getting COVID-19
  • You have had a severe allergic reaction to a vaccine in the past

How the COVID-19 mRNA vaccine works

From the U.S. Centers for Disease Control and Prevention

All the COVID-19 vaccines that are currently authorized or being tested deliver harmless “decoys” that look like the coronavirus “spike” protein. This is the protein that the virus uses to break into cells, a critical early step in the infection process. The vaccines create an immune response so if the actual COVID-19 spike protein shows up, the immune system is primed to recognize and target the spike protein and prevent the virus from infecting cells. 

At the end, our bodies have learned how to protect against future infection. People who are vaccinated are protected without having to risk getting very sick with COVID-19.

To learn more, read:

Last reviewed: 
February 2021

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