This article was medically reviewed by Carolyn Swenson, MD, assistant professor of obstetrics and gynecology and a member of the Medical Prevention Committee.
Since the advent of COVID-19 vaccines, there has been confusion as to whether or not they are safe for pregnant women. The reason: early clinical trials of the vaccine did not include pregnant or lactating women, making it impossible to know for sure if they are safe to be immunized.
Reminder: Pregnant people have an increased risk of severe disease due to COVID-19, along with an increased risk of other side effects, such as premature birth, according to the Centers for Disease Control and Prevention (CDC).
In a recent press briefing, Anthony Fauci, MD, the nation’s leading infectious disease expert, said clinical trials are underway for pregnant women (and children), so we should have more definitive answers soon. And in the meantime, about 20,000 pregnant women have received the COVID-19 vaccine “without red flags,” said Dr. Fauci.
These revelations are promising, but if you are pregnant (or a loved one is), you may be wondering if it is a good idea for pregnant women to be vaccinated. Here’s what you need to know.
How does COVID-19 vaccine work again?
Both Pfizer-BioNTech and Moderna vaccines use a newer technology called messenger RNA or mRNA, which is genetic material for the virus, according to the CDC. (Note: it is not the virus itself – just the genetic coding of the virus. The vaccine will be not makes you sick with COVID-19.)
The mRNA tells the body how to make a spike protein, which the new coronavirus uses to attach to human cells. When your body starts pumping peak proteins, your system sees them as foreign and creates unique coronavirus antibodies. Eventually, your body removes both protein and mRNA, but the antibodies remain around, giving you protection against COVID-19 in case you become infected in the future.
What do public health organizations say about COVID-19 when you are pregnant or breastfeeding?
Here things get confusing. Both the American College of Obstetricians and Gynecologists (ACOG) and the CDC have largely said that pregnant and lactating women should be able to receive the COVID-19 vaccine if they wish. However, both organizations do not actually recommend that pregnant women be vaccinated.
Meanwhile, the World Health Organization (WHO) initially counseled women against receiving the vaccine. But in late January, the organization revised its recommendation, saying: “Based on what we know about this type of vaccine, we have no specific reason to believe that there will be specific risks that would outweigh the benefits of vaccination for pregnant women. . ”
Before receiving the vaccine, ACOG recommends that pregnant women discuss the following with their doctor:
- the level of activity of the virus in the community
- the potential effectiveness of the vaccine they have
- the risk and potential severity of the maternal disease, including the effects of the disease on the fetus and the newborn
- vaccine safety for the pregnant patient and the fetus
However, ACOG also states that a conversation with your doctor “should not be necessary” as it may cause “unnecessary barriers” to vaccination.
So is it safe for pregnant and lactating women to receive the COVID-19 vaccine?
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“In the absence of any data obtained from pregnant and lactating women, it is difficult to openly recommend an intervention,” says Emily S Miller, MD, MPH, assistant professor in the department of obstetrics and gynecology at Northwestern Medicine.
But based on what has been studied so far, “there is no reason to believe that pregnant women or their fetus would be at risk of receiving the COVID-19 vaccine,” said William Schaffner, MD, an infectious disease specialist and professor at Vanderbilt School. University of Medicine. And, he points out, studies on pregnant animals have found no cause for concern.
“Everything we know about the vaccine would indicate that it should be safe,” says Dr. Schaffner. “The RNA in the vaccine is not close to human DNA – either the mother’s or the fetus’s.”
The statements of public health organizations (such as the WHO) have been cautious, but “everything we have seen from women who became pregnant during clinical trials or were already pregnant and received the vaccine is reassuring,” says infectious disease expert Amesh A. Adalja, MD, principal investigator at the Johns Hopkins Center for Health Security.
Public health officials and organizations, including ACOG, “do their best with what they have to work with,” said Michael Cackovic, MD, a maternal and child fetal physician at The Ohio State Wexner Medical Center. “They say, ‘We don’t have the data to make that recommendation,’ and that’s fine.”
At the same time, Dr. Cackovic points out that this type of vaccine is considered safer for pregnant women than other types of vaccines. The COVID-19 mRNA vaccine does not contain a living virus, and these types of vaccines are considered more compatible during pregnancy because they act by inducing an immune response by the host, he explains.
In addition, the fact that pregnant women are at high risk for severe complications due to COVID-19 makes the vaccine at least worth considering, says Joanne Stone, MD, director of the Maternal Fetal Medicine Division for the Mount Sinai Health System. from New York. “It seems that the benefits outweigh the risks, although a conversation with a healthcare professional can help make an individual decision,” she explains. “And it’s important for women to be informed about the lack of vaccine safety data for pregnant women.”
Conclusion: Pregnant women should discuss the COVID-19 vaccine with their doctor.
Now that pregnant women are now included in vaccination studies, Dr. Cackovic says that “ongoing conversations with your doctor should include recently published information about the safety, efficacy and availability of the vaccine during pregnancy.”
Dr. Adalja agrees. “I think this is a decision between a doctor and a patient,” he says. “But in most cases, pregnant women should be immunized.”
This item is correct from the time of pressing. However, as the COVID-19 pandemic evolves rapidly and the understanding of the new coronavirus scientific community develops, some information may have changed since the last update. Although we aim to keep all stories up to date, please visit the online resources provided by CDC, WHICH, and yours local public health department to be informed about the latest news. Always talk to your doctor for professional medical advice.
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