COVID-19 Vaccine in Pregnancy Q&A

If you’re pregnant, planning to conceive, or currently breastfeeding your newborn, you want to do everything you can to keep yourself and your baby healthy — and that includes staying safe from COVID-19.

These leading women’s health experts recently were invited by UPMC Magee-Womens Hospital to share their latest insights on the COVID-19 vaccine and pregnancy:

Here’s what they had to say about vaccine safety, pregnancy risk factors, concerns about fertility, and being pregnant during a pandemic.

Is it safe to get the COVID vaccine when pregnant?

Dr. Richard Beigi: The good news is the vaccine is very safe. It’s been studied in thousands of pregnant women, so we feel very good about recommending it. And pregnant women actually are less likely to have some of the side effects.

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When we talk about the COVID vaccine, we are primarily concerned with preventing disease in the mother. Some women ask if there’s a better time to get vaccinated or boosted during pregnancy. For now, the most important thing is to get vaccinated as early during your pregnancy as you can. We’ve learned how safe these vaccines are and how effective they are in preventing the disease in pregnant women.

We also want to remind everyone of the importance of getting the flu vaccine. We’ve known for centuries that influenza can worsen diseases during pregnancy, just like we now know with COVID. The clear message is that pregnant people should get their COVID vaccine, as well as their flu shot.

Dr. Anne-Marie Rick: When a pregnant person receives the COVID vaccine, the antibodies produced in the mother cross the placenta and into the baby. That provides added protection for the baby before and after birth. That protection is important because the baby doesn’t have the opportunity to get vaccinated after being born. Those antibodies actually pass into the mother’s milk. If she is breastfeeding, they potentially help protect the baby.

Why are pregnant women at a higher risk for severe illness from COVID?

Dr. Hyagriv Simhan: Normal changes happen to a woman’s immune system, heart, and lungs during pregnancy. We’ve known for many years that pregnant women are at higher risk for serious medical complications, including kidney infections, influenza, and pneumonia because of these changes. COVID-19 is another illness that puts pregnant individuals at a substantially higher risk.

What affects the mother affects the baby. The good news at this time is that the COVID-19 infection is unlikely to pass to the fetus in utero.

If a woman does acquire COVID in pregnancy, has symptoms, or has been exposed to the virus, she should contact her doctor and get tested immediately.

It’s important to know if a pregnant woman has a COVID-19 infection as quickly as possible so we can offer treatments to reduce the risk that she gets very sick or needs to be hospitalized. The same treatments that prevent severe illness or death in a mother also help the baby.

We also recommend getting an ultrasound about a month after a woman recovers from COVID. We want to make sure that the placenta is working well, and the baby is growing normally.

How do you counsel pregnant women about the benefits of the vaccine and how to stay safe during COVID?

Dr. Sharee Livingston: Many people are nervous about the vaccine. When we talk about getting vaccinated, we need to think about it from multiple perspectives: communities, families, and patients.

Counseling them about COVID requires empathy and education. That’s why it’s important to understand where the patient is coming from. If they haven’t yet had their shots, I delve into why: Are they afraid of something? Is it an access issue?

I share all the positive things we know about the COVID vaccine — that it’s highly recommended, it’s safe, and it’s effective. We’ve been following 140,000 pregnant patients who received the vaccine last fall, and those pregnancies are going really well.

But it’s just as important to share information that might be unsettling. If you’re pregnant and you get COVID, you are more likely to end up in the intensive care unit on life support or a ventilator. And death is also a possibility. These scenarios are all things we work toward preventing.

For our breastfeeding and chestfeeding people, it’s important to emphasize that getting the COVID vaccine while lactating is extremely important — and it’s extremely safe.

What risks does having COVID while pregnant pose to the babies?

Dr. Rick: Fortunately, we know that the risk of COVID infection for babies when they’re in the womb is low. Less than 3% of moms who are infected pass the virus to the baby. The risk of an infant getting COVID is actually greater after the baby is born, although it is an overall low risk.

We encourage moms recovering from COVID to wear a mask when changing a diaper or feeding the baby (bottle or breastfeeding) — and to wash their hands before and after touching the baby.

The CDC recommends that all infants exposed to COVID get tested around 24 hours after birth. If the baby tests positive, we monitor them very closely to make sure they don’t become dehydrated or need further care in the hospital.

The biggest impact is that moms can be in their 10-day COVID isolation period around the time of giving birth. That means the family may have both mom and baby sick or in isolation for several weeks, which can be a huge challenge.

Does the COVID vaccine affect fertility in women or men?

Dr. Gabriella Gosman: The vaccine does not harm fertility or cause miscarriage. For those trying to get pregnant, getting the vaccine now is super important for all the reasons that Dr. Simhan noted about pregnant people being at higher risk. It’s really important for people to feel confident in the safety of the vaccine — whether they plan to get pregnant now or in the future.

For anyone planning to conceive a child in the future, getting vaccinated now is an important step in keeping yourself and your family healthy — as well as your friends and loved ones.

What concerns do you hear from pregnant patients about the COVID vaccine, and how can they be addressed?

Dr. Rickquel Tripp: Pregnant women who come into our Emergency Department with COVID symptoms are already stressed about their baby and themselves. Many are not vaccinated, and I counsel them to consider getting the vaccine.

When an unvaccinated person has a positive PCR test, I ask them to tell me why they chose not to get vaccinated. The reasons I hear — especially from Black mothers — include common myths about the vaccine. That’s why I’ve made it my mission to be a COVID “myth buster.”

I go through every question or myth that they have about COVID and explain why it is or isn’t true or valid. I want my patients to know there are consequences to not getting a vaccine.

But the big thing I really talk up to mothers is that you’re actually looking out for two people — yourself and that person inside you. Protecting yourself from COVID protects your baby, even after being born.

Does a woman getting the COVID-19 vaccine before becoming pregnant still pass the antibodies on to babies conceived later?

Dr. Livingston: Pregnant people are more likely to be hospitalized and admitted to the ICU if they get sick with COVID-19. Therefore, it is better to receive the COVID-19 vaccine to protect you and your baby from becoming sick from COVID-19. Antibodies cross the placenta and confer protection to the fetus while in utero and after birth.

According to the CDC, decades of data show the safety and efficacy of most vaccines received during pregnancy.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.