COVID & Pregnancy: Vaccinations & Latest Research Findings [Updated Dec 2021]

Updated 17 December 2021

Welcome to our dedicated post on the latest research findings and recommendations related to COVID-19 and pregnancy. We'll keep updating this post as new information comes out, so give this page a bookmark!

When it comes to vaccine recommendations, if you’re pregnant or breastfeeding, you and your baby are more likely to suffer severe complications from COVID-19. Taking this into consideration, you should talk with your healthcare provider and weigh the risks and benefits of getting vaccinated.

Key Takeaways

1. On the 16th December, pregnant women were added to the UK's priority COVID vaccine list by the vaccines advisory group, the JVCI.

2. The CDC and ACOG recommend women who are pregnant and breastfeeding get vaccinated against COVID, including a booster dose (third dose) after initial vaccine(s).

3. Growing research suggests the vaccine does not increase the risk of adverse pregnancy outcomes, including miscarriage.

FAQs on the COVID-19 vaccine while pregnant and breastfeeding

What are the known risks for people who are pregnant or breastfeeding?

Those who were pregnant and breastfeeding were excluded from initial clinical trials of the vaccine due to FDA protocol, but research is on the way! Researchers at Pfizer-BioNTech announced on February 18th, 2021 that they are testing the safety and efficacy of their vaccine in a large-scale clinical trial of about 4,000 pregnant women over 18 years old in their 2nd and 3rd trimesters of pregnancy. They’ll also be monitoring the babies for 6 months after birth to ensure it’s safe for our newborns (if you’re interested in participating, we have more information at the end of this post!).

There were no signs of safety concerns in studies of animals that received the Moderna, Pfizer-BioNTech, or Johnson & Johnson/Janssen vaccine before or during pregnancy. Scroll down to find new research studies on the safety and efficacy of the vaccines.

Are vaccines safe during pregnancy and breastfeeding?

Vaccines are widely considered to be safe, and since the 1960s, people have been encouraged to get vaccinated during pregnancy against many diseases, including respiratory ones similar to COVID, like flu or whooping cough.

The CDC continually updates the vaccination rates for pregnant people and currently, around 31% of pregnant people in the US have received one or more doses of the vaccine prior to and during pregnancy. More than 189,000 people who identified as pregnant when receiving the vaccine registered with the CDC’s v-safe program to monitor the effects with follow up health check-ins. So far, evidence suggest the vaccines do not pose a risk for pregnant or breastfeeding people and their babies.

Will the COVID vaccine harm my fertility?

If you’re trying to conceive or want to become pregnant in the future, there’s currently no evidence suggesting that any vaccine — including COVID vaccines — cause fertility problems. We have an entire post dedicated to understanding more about the COVID vaccine and female fertility and you can find it here!

Will my period change after getting the vaccine? Is this a bad thing?

Reports of women’s monthly cycles changing after receiving a COVID vaccine have been reported, but so far, women who experience these changes seem to find them short-lived. However, research is limited on how COVID vaccines may impact your period and studying this relationship directly can be difficult. To read more about the current research on the vaccine’s effects on your monthly cycle, check out this post from NPR!

Should I wait to get pregnant after getting a COVID vaccine?

Research currently shows COVID vaccines do not cause fertility problems or any concerns for people trying to get pregnant. It’s recommended by organizations like the CDC that people who may become pregnant in the future or those who are trying to conceive get vaccinated. This also extends to their partners.

Will I get COVID-19 from the vaccine?

The COVID vaccines do not contain a live virus, meaning the vaccine itself can’t give you coronavirus.

How do I know if I should get the COVID vaccine? 

As you’re making your decision it's important to know where the information you hear or see is coming from (Baby2Body is science-backed and uses evidence-based research!), so you can fully understand the risks and benefits, and decide what’s best for you.

What we know from research is that pregnant women with COVID are more likely to suffer from adverse health outcomes and pregnancy complications, such as preterm birth and being put on a ventilator. We’ve listed the recommendations from major health organizations below, but ultimately, the choice to be vaccinated is yours and you should speak to your healthcare provider to discuss what’s best for you.

Will I need a booster dose?

As new strains of COVID like the Delta variant continue developing, booster doses may help increase protection. One study from Israel showed a reduced protection from COVID around six months after vaccination, although, the data has not yet been peer-reviewed (a very important step in validating the quality of research!) and Pfizer has yet to release studies.

On September 24, the CDC released interim recommendations for Pfizer-BioNTech’s booster COVID vaccine recommending groups of people who “should” get a booster dose or “may” receive a booster dose based on their personal benefits and risks. One group of people who “may” receive a booster dose are people with underlying medical conditions. The CDC states people who are pregnant or recently pregnant (for at least 42 days after pregnancy) should be considered in the same group as people with underlying medical conditions, meaning they may receive a coronavirus vaccine booster dose.

The FDA and CDC are currently working on providing further booster vaccine guidance for those who received primary vaccine doses that were not the Pfizer-BioNTech coronavirus vaccine, such as Moderna and Johnson & Johnson/Janssen vaccines.

As of December 16 2021, pregnant women have been added to the UK's priority Covid vaccine list by the vaccines advisory group, the JVCI. UK experts have said that pregnant women are at heightened risk from Covid and "should get vaccinated to protect themselves and their child", this includes receiving the first and second dose of the vaccine, as well as the booster.

New research you should know about

We’ll keep updating this regularly as new research is released, but here are highlights from important studies on the safety and efficacy of the COVID-19 vaccines for pregnancy and breastfeeding.

Pregnancy outcomes after COVID vaccine during pregnancy

Women who received at least 1 dose of the COVID vaccine during pregnancy were not more likely to experience adverse pregnancy outcomes when compared to similar unvaccinated pregnant women.

Published on 9 August 2021 in American Journal of Obstetrics and Gynecology

A quick summary: Researchers matched and compared 133 women who had at least one vaccine dose before birth with 399 women who did not have any vaccine during pregnancy. Of women who received a vaccine, almost all were were given a mRNA vaccine. Adverse pregnancy outcomes happened at a similar rate for women who received at least one dose of the COVID-19 vaccine during pregnancy as unvaccinated pregnant women. This included the risk of preterm birth, miscarriage, stillbirth, low-birth weight baby, or congenital abnormalities.

Transmission of COVID antibodies in breast milk

After 26 pregnant people received the Pfizer vaccine, breast milk shows COVID antibodies were transferred after the first dose, and then accelerated antibody production after the second dose.

Published on 27 June 2021 in Journal of Human Lactation

A quick summary: Researchers analyzed 366 breast milk samples of women before COVID vaccination and then 3, 5, 7, 9, 11, 13, and 15 days after both vaccine doses to better understand antibody transmission. Samples showed an increased antibody production after receiving the first dose, and again after the second dose. After the second dose, antibodies increased at a much faster rate than the first. In the end, the Pfizer vaccine showed to have a positive impact on COVID antibodies found in breast milk.

COVID vaccine effect on placenta

Placentas from vaccinated women showed no higher risk of injury or abnormality than unvaccinated women.

Published on 11 May 2021 in Obstetrics & Gynecology

A quick summary: Researchers examined placentas from 84 women who had received either the Pfizer or Moderna vaccine during pregnancy and 116 women who had not received the vaccine during pregnancy. Placentas from women who received a vaccine during pregnancy showed no signs of an increased risk of placenta abnormality or injury from the vaccine. Many women in the study were vaccinated in their 3rd trimester so although there are limitations and more research needs to be done, these findings help support growing evidence of the safety of the COVID vaccine during pregnancy.

COVID vaccine safety during pregnancy

Early findings from a large study on the safety of mRNA vaccines during pregnancy found no obvious signs of safety risks.

Published on 21 April 2021 in New England Journal of Medicine

A quick summary: Researchers studied data from over 35,000 women who identified as pregnant through the v-safe registry and the Vaccine Adverse Event Reporting System (VAERS) and found no obvious signs of safety risk with mRNA vaccines. Pain at the injection site was more common among pregnant women than nonpregnant women, while fever, chills headache, and myalgia were less common. This is preliminary data and researchers will need additional follow-up data to determine the impact of mRNA vaccines on pregnancy, and maternal and infant outcomes.

COVID vaccine side effects during pregnancy and breastfeeding

A study of 131 women found both the Pfizer-BioNTech and Moderna mRNA vaccines to be safe and effective during pregnancy and breastfeeding. Mild side effects experienced were similar to other reports from non-pregnant/breastfeeding adults.

Published on 25 March 2021 in American Journal of Obstetrics and Gynecology

A quick summary: The study included 3 groups of women: 84 pregnant, 31 breastfeeding, and 16 not pregnant. Researchers found antibody levels in pregnant and breastfeeding women to be similar to non-pregnant women, and detected antibodies in the umbilical cord and breastmilk. Findings suggest pregnant and breastfeeding women receiving one of these vaccines can produce similar vaccine-immune responses as non-pregnant women, and possibly transfer some of those protective antibodies to baby.

Note: The majority of women were White, not Hispanic or Latino, and had the 1st vaccine dose in the 2nd or 3rd trimester (average around 23 weeks). More research is needed to confirm these findings, as well as additional data for other racial and ethnic populations.

Ongoing research studies

Before participating in any research, be aware of the safety and scientific validity of the study. Know the potential risks and benefits of clinical studies and talk to your health care provider before deciding to participate. We’ve listed a few studies below, but check out these COVID-19 Maternal & Infant Health Registries to learn more about studies you may be able eligible to participate in.

If you live in the US:

• Pfizer-BioNTech vaccine study. Pfizer-BioNTech is currently conducting a large-scale clinical trial on the safety and efficacy of their vaccine in about 4,000 pregnant women over 18 years old in their 2nd and 3rd trimesters of pregnancy. The study will have a placebo control group and will track safety information for 7 to 10 months, as well as the safety and antibody transfer in infants for up to 6 months after birth. If you’re interested in learning more or being involved, you can find out more information here.

• COVID-19 Vaccines International Pregnancy Exposure Registry (C-VIPER). Harvard School of Public Health is conducting an observational study to collect safety information from 5,000 women who receive a COVID vaccine during pregnancy. This will include women who have received at least 1 dose of a vaccine, or pregnant women unexposed to a vaccine before enrolling. If you’re interested in learning more or being involved, you can find out more information here. 

If you live in the UK:

• Evaluating Clinical Parameters of COVID-19 in Pregnancy (COpregVID). The Chelsea and Westminster House NHS Foundation Trust is conducting a retrospective case review using existing clinical data from participating centres and will include patients who were diagnosed with COVID-19 at the start of the pandemic as well as new and current cases. Data will be taken from NHS electronic and paper notes, which will contain patient identifiable information, but measures will be taken to ensure confidentiality and data will be anonymized for research teams. If you’re interested in learning more or being involved, you can find out more information here.

Online surveys available for multiple countries:

• Risk Factors for Anxiety and Depression Among Pregnant Women During the COVID-19 Pandemic. This observational study is being conducted across 17 countries and enrolling 8,500 women to take their survey. This survey will measure the impact the pandemic has on mental health, as countries have different approaches to fighting COVID and everyday lives of pregnant women are affected in unique ways. If you’re interested in learning more or being involved, you can find out more information here.

Recommendations from major health organizations around the world

We know vaccines are generally safe, but more research is needed before recommendations can become more unified. This is why it’s universally recommended that women should talk to their healthcare providers about the benefits and risks of vaccinations for their unique case.

World Health Organization (WHO)

• Pregnancy: WHO recommends pregnant women consider getting the vaccine based on the risks versus benefits of your personal situation (such as a higher risk of contracting COVID due to a job or underlying conditions that increase the risk of severe outcomes). There’s no evidence suggesting COVID vaccines would cause adverse outcomes during pregnancy, but due to limited data, it’s recommended you speak with your provider before vaccination. It’s not recommended to delay or terminate pregnancy because of vaccination.

• Breastfeeding: WHO recommends that the vaccine can be offered to those breastfeeding, and does not recommend stopping breastfeeding after vaccination.

Centers for Disease Control (CDC)

• Pregnancy & Breastfeeding: It’s recommended women who are pregnant, breastfeeding, and trying to conceive now or in the future receive full COVID vaccination and a booster dose. Clinical data is limited on the safety of vaccines in lactating people or the effects of vaccination on a breastfed baby or on a mother's milk production or excretion. However, the way these vaccines work in the body is thought to not pose a risk to lactating people or their breastfeeding babies.

• If you’re pregnant or breastfeeding, here are a few things to consider: 

  • Your likelihood of exposure

  • Risks of COVID to you and your baby

  • Type of immunity the vaccine builds, known side effects, and the limited, but growing research available of safety during pregnancy

  • How the vaccine may transfer antibodies to the baby during pregnancy (following recent reports of passing antibodies mostly during the 3rd trimester)

• Regarding the Johnson & Johnson/Janssen vaccine, women under 50 should know about the rare risk of blood clots with low platelets after getting the vaccine, and that there are other COVID-19 vaccines available without this known risk. If you have already received the vaccine, here's what you should know.

American College of Obstetricians and Gynecologists (ACOG)

• Pregnancy & Breastfeeding: ACOG recommends that all people, including those who are pregnant, lactating, or who may consider pregnancy in the future, receive the COVID vaccine and a booster dose.

Royal College of Obstetrics and Gynecologists (RCOG) & Royal College of Midwives (RCM) 

• Pregnancy & Breastfeeding: The Joint Committee on Vaccination and Immunisation (JCVI) recommends COVID-19 vaccines for women who are pregnant, breastfeeding, and trying to conceive now or in the future. As of December 14th, all adults in the UK, including pregnant women, are urged to book a booster dose 3 months after their initial vaccine.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)

• Pregnancy: In a joint statement by RANZCOG and the Australian Technical Advisory Group on Immunisation (ATAGI), it’s recommended that pregnant women be offered the Pfizer (Cominarty) or Moderna vaccines routinely during pregnancy. You can receive the vaccine if you plan to become pregnant in the future. ATAGI recommends adults get a booster dose of these vaccines 5 months after receiving initial doses.
  

• Breastfeeding: Although research is limited, there are no safety concerns for receiving the vaccine while breastfeeding so it’s not recommended to stop before or after vaccination. Pfizer and Moderna are the recommended vaccines for breastfeeding women.

India Ministry of Health and Family Welfare

• Pregnancy & Breastfeeding: Pregnant women have the choice to receive the vaccine with the consideration that they should know the risks and benefits of getting vaccinated and getting a COVID infection.

Vaccine information for you

If you live in the US: See individual state vaccination data here and find out where you can go to get the vaccine here.

If you live in the UK: You can find information about eligibility and how to book an appointment on the NHS website. 

If you live in Australia: If you’d like to check your vaccine eligibility and find out when you can receive it, use this helpful tool here.

If you live in India: If you’d like to learn more about coronavirus in general, the Ministry of Health and Family Welfare answers Frequently Asked Questions here. You can also find more information about coronavirus cases and hot spots here.

Don’t see your country? To find out more vaccination rollout information for your country, you can read more here.

What questions do you have about COVID-19 and what it means for pregnancy and breastfeeding? Let us know in the questions below and we will do our best to get you the trusted information you need at this time.

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