Should Pregnant or Breastfeeding Women Get The COVID-19 Vaccine? Yes!

December 22, 2020

Clinical Contributors to this Story

Thomas Bader, M.D. contributes to topics such as Medical Quality.

Updated: 8/12/2021

As the COVID-19 pandemic continues to evolve and new variants like Delta are circulating, the U.S. Centers for Disease Control and Prevention (CDC) has announced that it’s recommending people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future get the COVID-19 vaccine.

The move comes amid growing evidence that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.

We connected with our expert, Thomas Bader, M.D., OB/GYN and chief clinical officer at Hackensack Meridian Health, to talk about what those thinking of starting a family should know.

Virus Risk vs. Vaccine Risk

The main thing you should be aware of is that the virus itself poses a greater risk to pregnant or breastfeeding women than the vaccine. The new Delta variant of COVID-19 is more transmissible and can cause severe symptoms, especially in those that are not vaccinated.

A severe illness of COVID-19 can mean treatment that requires hospitalization, intensive care, need for a ventilator or special equipment to breathe, or even death. Additionally, pregnant people with COVID-19 are at increased risk of preterm birth and can be at increased risk of other adverse pregnancy outcomes, compared with pregnant women without COVID-19.

“Historically, vaccines have been given to pregnant and breastfeeding women and have been deemed appropriate and safe to do so,” says Dr. Bader. “The COVID-19 vaccines are similarly safe in pregnancy and they have gone through rigorous testing and trials to ensure their safety and efficacy – these are good vaccines.”

In a new analysis of current data from the V-safe pregnancy registry,scientists did not find an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy.

How do the vaccines work?

In the case of the vaccines using mRNA technology, the vaccine is injected into the muscle and teaches the cells how to make a harmless piece of the spike protein for the new coronavirus. The spike protein’s presence sits on the surface of the cells and triggers the body’s immune response so that it develops antibodies to protect us from getting infected with COVID-19.

The J&J vaccine is based on a viral vector platform which uses a gene code unique to SARS-CoV-2 that helps produce a spike protein and display it on the cell’s surface. Once on the surface of the cell, it causes the immune system to begin producing antibodies and activating T-cells to fight off what it thinks is an infection.

“The one major concern is that when your immune system is activated, you can develop a fever, which is something to be avoided when pregnant,” says Dr. Bader. “With that in mind, it is important that if a pregnant woman gets a fever from the vaccine, that the mom-to-be treat her fever with acetaminophen, unless otherwise directed by her physician.”

Does the vaccine provide any protection for the baby?

As of this writing, there have been limited studies as to the transfer of protective immunity to babies while in the womb. There has been some research which showed that an infant in Florida had tested positive for protective COVID-19 antibodies after birth from a vaccinated mother.

“While the results of these initial studies are certainly encouraging, we still need some more definitive research before we’re able to determine if there’s strong evidence of immunity in these babies,” says Dr. Bader.

Why is the CDC updating recommendations now?

At the time that the vaccines were first granted emergency use authorization in late 2020 and early 2021, data around the safety of the vaccine for pregnant and breastfeeding women was reassuring – but there still wasn’t enough real world evidence.

Since then the CDC has analyzed data from three monitoring systems in place to gather information and experiences about COVID-19 vaccination in pregnant women. These early data did not find any safety concerns for pregnant people who were vaccinated or their babies, according to the CDC. Importantly, the CDC now has pregnancy outcome data from pregnant women who received the vaccine during ALL phases of pregnancy – first, second and third trimester.

Another report looking at safety data from the v-safe pregnancy registry showed there was no increased risk for miscarriage after receiving an mRNA vaccine before 20 weeks of pregnancy.

Armed with this new information, regulators had the knowledge they needed to make the decision to amend the recommendation.

“This move by the CDC is a welcome change in their stance on vaccination for pregnant women,” says Dr. Bader. “Especially at a time when the Delta variant has become the predominant strain in the U.S. it’s important that all pregnant women get vaccinated to protect them and their babies.”

“In 2020, we could only dream of having vaccines against COVID-19 that were so safe and effective. And now we know that they are also safe in pregnancy.”

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The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.