COVID Vaccine and Pregnancy—What You Need to Know

The first batches of the Pfizer-BioNTech COVID vaccine are now rolling out across the U.S. following it being granted an emergency use authorization by health authorities earlier this month, but the coronavirus crisis is far from over.

As cases in the country continue to hit record numbers, there are many questions remaining for those who have the opportunity to be administered with a vaccine. For now, one of the gaps in the data is how it will affect pregnant and lactating patients.

Despite the lack of solid scientific evidence, U.S. health agencies have released some initial advice about the options available to pregnant people, addressing some of the big safety concerns with the still unapproved vaccine. Here's what we know so far.

There is limited scientific data— may be 'unlikely' to pose a risk

The Centers for Disease Control and Prevention (CDC) said on December 15 that studies have not included pregnant patients, but experts believe mRNA-based vaccines, like Pfizer's, are "unlikely" to pose a risk for pregnant people.

While it explains that mRNA vaccines don't contain the virus that causes COVID-19 and therefore can't give someone the disease, it does stress the "potential risks of mRNA vaccines to the pregnant person and her fetus are unknown" at this stage.

The agency said it will have "monitoring systems" in place to "capture information about vaccination during pregnancy and will closely monitor reports."

There is also no data on the safety of the Pfizer-BioNTech vaccine in lactating women or the effects it could have on the breastfed infant or production of milk. Despite this, it says mRNA vaccines are not believed to be a risk to the breastfeeding infant.

It's a personal choice to get a vaccine if pregnant

The CDC has said people who are pregnant and also part of a group recommended to receive the COVID vaccine—primarily healthcare personnel for now—can choose to be vaccinated, with the same advice given to those who are breastfeeding.

"A conversation between pregnant patients and their clinicians may help them decide whether to get vaccinated with a vaccine that has been authorized for use under Emergency Use Authorization (EUA). While a conversation with a clinician may be helpful, it is not required prior to vaccination," the CDC explains online.

Considerations to discuss with a healthcare provider will be known side effects of the vaccine, potential risks to their fetuses and the risks of COVID to themselves.

Pregnant people who choose to take the vaccine should continue to follow health guidelines, including social distancing and wearing of a face-covering.

The American College of Obstetricians and Gynecologists (ACOG) has said vaccines "should not be withheld from pregnant people who meet criteria for vaccination" but patients who decline a vaccine need to be "supported in their decision."

The CDC has also said that "routine testing for pregnancy before COVID-19 vaccination is not recommended." People who are trying to become pregnant do not need to avoid pregnancy after receiving an mRNA-based COVID-19 vaccine, the agency said.

The vaccines could have side effects to consider

Health experts warn the COVID vaccines have a range of known side effects, including headache, muscle pain, fever, nausea, tiredness and more. Officials say there is also a remote chance the Pfizer-BioNTech vaccine can cause a severe allergic reaction.

The CDC has advised: "Pregnant women who experience fever following vaccination may be counseled to take acetaminophen because fever has been associated with adverse pregnancy outcomes. Acetaminophen may be offered as an option for pregnant women experiencing other post-vaccination symptoms as well."

Data shows pregnant people with COVID have increased risk of severe illness, including an illness that would result in mechanical ventilation and death, the CDC notes.

The ACOG said even though safety data on the use of vaccines during pregnancy is not available, there were no red flags during studies that it would be an issue.

It continued: "In the interest of allowing pregnant individuals who would otherwise be considered a priority population for a vaccine approved for use under EUA make their own decisions regarding health, ACOG recommends that pregnant individuals should be free to make their own decision in conjunction with their clinical care team."

You can read the full CDC guidance here, and the full ACOG guidance here.

COVID-19 vaccine
Nurse Eunice Lee prepares to give an injection of the COVID-19 vaccine to a health care worker at Ronald Reagan UCLA Medical Center on December 16, 2020 in Westwood, California. Brian van der Brug-Pool/Getty