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Updated November 2021

Three COVID-19 vaccines — developed by Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen (J&J) — are being distributed in the United States. Millions of Americans have received vaccines, and Americans 5 and older are eligible.

The vaccine is safe and effective against COVID-19. It especially can help prevent severe illnesses and deaths from COVID-19.

One high-risk group for COVID-19 is pregnant women. Because pregnant women are more at risk of COVID-19 complications, the Centers for Disease Control and Prevention (CDC) recommends pregnant and breastfeeding women get vaccinated.

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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 pregnant. Severe illness includes hospitalization, possible mechanical ventilation, and death. A November 2021 study released by the CDC reported pregnant women with COVID–19 were at higher risk of maternal death.

The CDC also says symptomatic pregnant women with COVID-19 are at greater risk for adverse pregnancy outcomes like preterm birth.

A November 2021 study released by the CDC reported that pregnant women with COVID-19 had a higher risk of stillbirth.

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.

Pregnant women are “at a clearly higher risk for severe outcomes should they get COVID-19,” says Richard Beigi, MD, president, UPMC Magee-Womens Hospital. “The good news is that this is a largely preventable problem.”

Is the COVID-19 Vaccine Safe for Pregnant Women?

The Pfizer, Moderna, and J&J vaccines are all safe and highly effective in preventing COVID-19. All three are especially effective in preventing severe outcomes, including hospitalization and death.

According to the FDA, side effects for the vaccines tend to be mild and include:

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

Clinical studies before the U.S. Food and Drug Administration (FDA) first authorized the vaccines didn’t include pregnant women. However, reported data show no safety concerns for pregnant women since vaccine distribution began.

“Among the tens of thousands of women who have been closely studied after they chose to get the COVID-19 vaccines, the data is clear: these vaccines are safe,” Dr. Beigi says. “This large group of moms-to-be who received the COVID vaccine over around a year ago have given birth to thousands of healthy babies, without any evidence of negative effects on their pregnancies.”

In April 2021, the New England Journal of Medicine published a preliminary study on the Pfizer and Moderna vaccines’ safety for pregnant women. According to the study, there were no signs that the vaccines were unsafe for pregnant women or their unborn babies.

The study showed pregnant women experienced injection site pain more frequently than women who were not pregnant. Pregnant women reported headaches, myalgia, chills, and fever at a lower rate than women who were not pregnant.

According to the CDC, multiple studies report that the vaccines have not shown safety concerns for pregnant women. The benefits of COVID-19 vaccination outweigh any known or potential risks of vaccination during pregnancy, the CDC says. The vaccines can prevent severe illness and may even provide some protection to your baby.

The American College of Obstetricians and Gynecologists (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.

Scientists continue to monitor the vaccines’ effects in everyone, including pregnant women, as they are being distributed.

On April 23, 2021, the Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) released a statement lifting a nationwide pause in use of the Johnson & Johnson/Janssen COVID-19 vaccine. Federal health officials investigated cases of a rare, serious blood clot reported in some people after they received the J&J vaccine.

After their investigation, the CDC and FDA determined the risk of blood clots from this vaccine is very low and the known benefits in preventing COVID-19 are very high for all, outweighing the risks. The vaccine is safe and effective in preventing COVID-19.

According to ACOG, pregnant women can receive any of the three available vaccines. However, they should be made aware of the potential risk of blood clots with the J&J vaccine. They can choose to receive the Pfizer or Moderna vaccine instead if they wish.

Should Pregnant Women Get the COVID-19 Vaccine?

Pregnant women are much more at risk from COVID-19 complications than they are from the vaccine. Because of that, getting the vaccine is an important step to prevent COVID-19. Vaccines can help prevent infection but are especially effective in preventing severe cases of COVID-19.

The spread of the Delta variant (B.1.617.2) throughout the United States also makes vaccination crucial. The vaccines are effective against the Delta variant.

The CDC recommends that all Americans 5 and older get the COVID-19 vaccine. That includes women who are:

  • Pregnant.
  • Breastfeeding.
  • Trying to become pregnant.
  • May become pregnant in the future.

ACOG and the Society for Maternal-Fetal Medicine (SMFM) both recommend vaccination for pregnant women.

“Because of the risk to anyone pregnant and the demonstrated safety record that we now have, the CDC and UPMC recommend these vaccines for all pregnant patients,” Dr. Beigi says.

Does the COVID-19 Vaccine Affect Fertility?

There is no evidence that the authorized COVID-19 vaccines can cause problems with fertility, the CDC says.

“Tens of thousands of women have received the COVID vaccine before getting pregnant and have not had any struggles related to infertility whatsoever,” Dr. Beigi says. “The often-mentioned but completely unsubstantiated concerns about COVID-19 vaccines causing either miscarriages or other problems with their pregnancy, or causing problems even getting pregnant, is a complete myth, plain and simple.

“What is not a myth is the harm that COVID-19 can have on pregnant women and their unborn babies.”

If you are trying to become pregnant now or in the future, you can get the vaccine if you are eligible.

The vaccines carry some common side effects. They include pain and swelling where you get the shot, fever, chills, fatigue, and headache. Side effects are generally mild and subside within a few days.

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.

For more information, visit UPMC.com/COVID19.

Editor's Note: This article was originally published on .

Sources
Tom T. Shimabukuro, MD, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. New England Journal of Medicine. Food and Drug Administration. FDA and CDC Lift Recommended Pause on Johnson & Johnson (Janssen) COVID-19 Vaccine Use Following Thorough Safety Review. American College of Obstetricians and Gynecologists. ACOG Statement on the Johnson & Johnson COVID-19 Vaccine.

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Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 700 doctors’ offices and outpatient centers, with locations in central and western Pennsylvania, Maryland, New York, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals.