COVID-19 Q&A: Pregnancy, Breastfeeding and the COVID-19 Vaccine

Posted March 16, 2021

Pregnancy is considered a high-risk health category during COVID-19, making pregnant individuals eligible for the vaccine before the general public. You may have questions or concerns about the safety of the vaccine while pregnant or breastfeeding and we are here to help.

University of Vermont Medical Center experts Marjorie Meyer, MD, division chief of maternal fetal medicine and Kristen Pierce, MD, infectious disease physician, discuss pregnancy, breastfeeding and the COVID-19 vaccine.

Can you get COVID-19 from the vaccine?

No, you cannot get COVID-19 from any of the vaccines that are currently available or are close to being released under the emergency-use authorization. – Dr. Kristen Pierce

Are there groups of people for whom the COVID-19 vaccine would not be appropriate?

If someone has had a severe allergic reaction to any of the components of the current vaccines, it is recommended that they talk to their provider before getting the vaccine. – Dr. Kristen Pierce

What side effects can people expect from the vaccine?

Some people have no side effects, and others experience fever, fatigue, muscle aches, joint aches and pain at the injection site. Side effects seem to be more pronounced after the second vaccine, but they don’t last long.

I would ask people to think about the fact that since the vaccines have been introduced, we have seen a decrease in deaths, hospitalization and severe cases of COVID-19. It’s important to balance the benefits against a day or two of feeling pretty crummy.  – Dr. Kristen Pierce

Why are women who are pregnant considered high risk for COVID-19?

The American College of Obstetrics and Gynecologists specifically asked the Centers for Disease Control and Prevention (CDC) that pregnant women be included in the high-risk group, which underscores how important prevention of this disease is during pregnancy. Pregnant women have a higher chance of getting very ill, and those that get very ill are more likely to have a complication of the pregnancy, such as preterm birth; they also have a higher chance of hospitalization and are more likely to develop lung problems. – Dr. Marjorie Meyer

Do pregnant women typically get vaccines?

There are some vaccines that are given during pregnancy and others that aren’t. The pertussis vaccine, for example, is offered to pregnant women around 28 to 29 weeks gestation; as a result, incidents of whooping cough in young children have dropped by about 50 percent.

Vaccines are often used during pregnancy to try and help mom’s antibodies crossover to the placenta to reduce the risk of infection for the baby. However, we don’t yet know if that is the case with the COVID-19 vaccine. – Dr. Marjorie Meyer

Should pregnant women get the vaccine? If so, is there a certain time during pregnancy they should or should not get it?

All pregnant women should be offered the vaccine. The American College of Obstetrics and Gynecologists and the Society for Maternal Fetal Medicine both feel that pregnant women are more likely to derive benefit from the vaccine than any potential harm. As of March 2021, the vaccine has been administered to over 30,000 pregnant women without evidence of increased reaction or pregnancy complication.

Pregnant women were excluded from enrolling in the vaccine trials, but the American College of Obstetrics and Gynecologists and the Society of Maternal Fetal Medicine’s position is that the risk from COVID vaccination is only theoretical, whereas we know that COVID disease can harm a pregnancy.

If women are particularly concerned and feel that they can remain safe through the first trimester, we would support their decision to wait until they’re out of the first trimester. – Dr. Marjorie Meyer

Should a woman who is pregnant but already had COVID-19 get the vaccine?

Yes. If you’ve previously had COVID-19, you should still consider getting the COVID-19 vaccine. – Dr. Marjorie Meyer

If a pregnant woman gets the vaccine, how would she reduce her risk of side effects, such as fever?

Fever is not dangerous during pregnancy. It is important to stay hydrated and drink plenty of fluids. When you are pregnant your blood pressure can drop, so you’ll be a little more sensitive to dehydration.

If you do have symptoms, you can take Tylenol, but avoid using NSAIDs such as ibuprofen. Side effects should only last about 24 hours. – Dr. Marjorie Meyer

Should breastfeeding mothers get the vaccine? Is there any evidence that the antibodies could travel through breastmilk to benefit the baby?

The COVID-19 vaccine is not a live virus, so there is no need to “pump and dump” breastmilk. You can certainly get the vaccine and continue breastfeeding. As for antibody transfer, we don’t yet know if this is possible. – Dr. Marjorie Meyer

If you are thinking of becoming pregnant, should you wait until after receiving the vaccine?

Planning pregnancy is no reason to delay vaccination. Should you become pregnant between the first and second dose, the recommendation is to receive the second dose of vaccine as scheduled.  – Dr. Marjorie Meyer

If the vaccine isn’t approved for children, why would it be okay for someone who is pregnant to get it?

Pediatric COVID-19 vaccine trials have not been completed yet. My understanding is that children are lower on the priority list because they don’t get that sick from COVID-19.

When we are vaccinating the moms, we are not vaccinating to protect the fetus. The vaccination is really about the maternal health and impact of the disease on the mom. Any antibody the fetus would get would be because the mom makes it and transfers it to the fetus. – Dr. Marjorie Meyer

Are there any reasons why someone who is pregnant or breastfeeding should not receive the vaccine?

If someone has had a severe allergic reaction to any of the components of the current vaccines, it is recommended that they talk to their provider before getting the vaccine. Other than that, no. – Dr. Kristen Pierce