Should pregnant women receive the COVID-19 vaccine?

As the COVID-19 vaccine pandemic continues, multiple vaccine candidates have emerged.

The U.S. Food and Drug Administration (FDA) has issued an emergency use authorization (EUA) to vaccines developed by Pfizer/BioNTech and Moderna. Other vaccine candidates may seek approval in the future.

The first doses of vaccine will go to frontline health care workers and residents of long-term care facilities. Other high-risk groups will be eligible for the vaccine afterward.

One high-risk group for COVID-19 is pregnant women. A report from the American College of Obstetricians and Gynecologists (ACOG) says COVID-19 vaccines should not be withheld from pregnant women and lactating women when they meet the other criteria for receiving the vaccine.

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COVID-19 Risk in Pregnant Women

According to the Centers for Disease Control and Prevention (CDC), pregnant women with symptoms are at greater risk for severe illness from COVID-19 than people who are not pregnantThe CDC also says symptomatic pregnant women with COVID-19 are at greater risk for adverse pregnancy outcomes like preterm birth.

Pregnant women with other health conditions like obesity and diabetes may be at even greater risk, according to a CDC report. Black and Hispanic women who are pregnant also appear to have a higher risk of COVID-19 infection and death, the report says. Asian and Native Hawaiian/Pacific Island women who are pregnant have a higher risk of ICU admission.

For those reasons, all pregnant women should take precautions against COVID-19, the CDC says.

Is the COVID-19 Vaccine Safe for Pregnant Women?

The Pfizer/BioNTech vaccine has a reported 95% efficacy rate, while the Moderna vaccine has a reported 94% efficacy rate. According to the FDA, side effects for both vaccines tend to be mild and include:

  • Injection site reactions
  • Fatigue
  • Headache
  • Muscle pain
  • Chills
  • Joint pain
  • Fever

Neither vaccine was tested directly in pregnant women, but studies are planned. The ACOG says there are no signals yet identified that would show the vaccines are unsafe for pregnant or lactating women. Pregnant and lactating women have received vaccines for other diseases for many years, the ACOG says.

Should Pregnant Women Get the COVID-19 Vaccine?

The first doses of new COVID-19 vaccines began distribution in the United States in December 2020.

The Advisory Committee on Immunization Practices (ACIP) recommended the first phase of doses go to frontline health care workers and residents of long-term care facilities. According to the ACIP’s recommendations, people in those categories should be age 16 and older to receive the Pfizer vaccine and age 18 or older to receive the Moderna vaccine.

CDC guidance is expected soon for other populations who are part of a group that is scheduled to receive a vaccine.

According to the ACOG report, it is expected that pregnant and lactating women who are members of a group scheduled to receive the vaccine — a pregnant health care worker, for example — can get the vaccine if they choose.

The ACOG recommends pregnant and lactating women should not be withheld from vaccine distribution. They should be free to get a vaccine if they choose. They may want to discuss the vaccine with their health care provider to help them make their decision, the ACOG report says.

When Will Pregnant Women Get the COVID-19 Vaccine?

The ACIP recommended health care workers and residents of long-term care facilities should receive the first doses of vaccine. This is considered Phase 1A.

As manufacture and distribution of the vaccine or vaccines continue, people in other high-risk groups likely will receive them. Those groups include essential workers, people over 65 years old, and people with underlying medical conditions.

Because it likely will take months for full vaccine distribution to take place, it is unknown when the general public will be eligible to receive the vaccine.

Other COVID-19 vaccine candidates are in development and may also receive approval for use. As vaccine distribution continues, scientists will continue to monitor their safety and efficacy and more data will become available.

UPMC has begun distributing the Pfizer vaccine to frontline health care workers. We will continue to distribute the vaccine to recommended groups as we receive it.

For more information, visit UPMC.com/COVID19.

Sources

Laura E. Riley, MD, Richard Beigi, MD, Denise J. Jamieson, MD, Brenna L. Hughes, MD, Geeta Swamy, MD, Linda O'Neal Eckert, MD, Cynthia Gyamfi-Bannerman, MD, Mark Turrentine, MD, American College of Obstetricians and Gynecologists, Vaccinating Pregnant and Lactating Patients Against COVID-19. Link

    Centers for Disease Control and Prevention, COVID-19 and Pregnancy. Link

    Centers for Disease Control and Prevention, Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. Link

    Centers for Disease Control and Prevention, The Advisory Committee on Immunization Practices' Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine — United States, December 2020. Link

    Centers for Disease Control and Prevention, Phased Allocation of COVID-19 Vaccines. Link

    Food and Drug Administration, Vaccines and Related Biological Products Advisory Committee Meeting, December 10, 2020. Link

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