COVID-19 vaccines have been available to patients and the public for a few months, and questions regarding the administration of the available COVID-19 vaccines to pregnant and lactating women have arisen. Andrew Satin, M.D., director of gynecology and obstetrics, and Jeanne Sheffield, M.D., director of maternal-fetal medicine, provide information on this topic.
Is the COVID-19 vaccine available to pregnant women?
Yes, COVID-19 vaccines currently authorized by the Food and Drug Administration (FDA) should not be withheld from pregnant individuals who choose to receive the vaccine. It is suggested that women talk with their doctor to discuss all factors about the vaccine and their pregnancy.
- Symptomatic pregnant individuals who contract COVID-19 are at more risk of severe illness, complications and death than non-pregnant women. Many pregnant women have medical conditions that put them at increased risk.
- Pandemic level in the community is a factor.
- No study to date has specifically evaluated the coronavirus vaccine in pregnant and lactating women, but there have been a few pregnant women who were inadvertently included in the vaccine trials. Preliminary developmental and reproductive toxicity studies do not indicate any adverse effects on reproduction or fetal development.
- Thus, there are not any known safety concerns, but more data will be available in the weeks and months ahead from additional studies.
Johns Hopkins Medicine agrees with and supports the recommendations of the Advisory Committee on Immunization Practices, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), even while acknowledging the unanswered questions about the vaccines for pregnant women. Below is the most current knowledge concerning pregnancy and breastfeeding.
Routine testing and pregnancy
Routine testing for pregnancy before COVID-19 vaccination is not recommended. Women who are trying to become pregnant do not need to avoid pregnancy after receiving an mRNA COVID-19 vaccine.
Pregnant and Breastfeeding Women COVID-19 Vaccine Guidelines
mRNA vaccines do not contain the live virus that causes COVID-19 and, therefore, cannot give someone COVID-19. Additionally, mRNA vaccines do not interact with a person’s DNA because the mRNA does not enter the nucleus of the cell. Cells break down the mRNA quickly. Based on how mRNA vaccines are designed to work, experts believe they are unlikely to pose a specific risk for people who are pregnant. However, the actual risks of mRNA vaccines to the pregnant person and her fetus are still under review because these vaccines have not been studied in pregnant women.
The FDA’s emergency use authorization for the Pfizer-BioNTech COVID-19 mRNA vaccine states: “If you are pregnant or breastfeeding, discuss your options with your healthcare provider.”
- Limited data are currently available from animal developmental and reproductive toxicity studies. No safety concerns were demonstrated in rats that received Moderna COVID-19 vaccine before or during pregnancy; studies of the Pfizer-BioNTech vaccine are ongoing.
- Researchers have studies planned in people who are pregnant.
- Both vaccine manufacturers are monitoring people in the clinical trials who became pregnant.
- ACOG and SMFM recommend that both COVID-19 vaccines authorized by the U.S. FDA should not be withheld from pregnant individuals who choose to receive the vaccine.
- A conversation between the patient and her clinical team may assist with decisions regarding the use of vaccines.
- The World Health Organization (WHO) states they do not have any reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women. Pregnant women at high risk of exposure to SARS-CoV-2 (for example, health workers) or who have comorbidities (health conditions that may contribute to death) that add to their risk of severe disease, may be vaccinated in consultation with their health care provider.