The COVID vaccines have always been an option for anyone who is pregnant or thinking about getting pregnant, as well as those who are breastfeeding. But at first, data was lacking, and pregnant people were kind of on their own to make a decision whether to get the shot or not. Now, multiple studies make it clear the benefits of getting a vaccine in pregnancy outweigh the risks.
The CDC has now released a collection of data on people who got the vaccine before or during pregnancy, or who were breastfeeding. It all points in the same direction: the vaccines are safe, and not getting a COVID vaccine is the riskier choice.
COVID vaccines caused no increased risk of miscarriage
Miscarriages were no more common in people who got the vaccine than in the general population, according to one of the newly-released studies. The researchers followed 2,500 people who received either the Pfizer or Moderna vaccines before pregnancy or in the first 20 weeks. Thirteen percent had a miscarriage; the CDC reports that typically, 11-16% of pregnancies end in miscarriage.
No concerns from pregnancy data monitoring
The CDC follows pregnancy outcomes from multiple data sources, and they have noted that so far, they “did not find any safety concerns for pregnant people who were vaccinated late in pregnancy or for their babies.” (The previously mentioned study, on miscarriage, looked at people vaccinated early in pregnancy.)
That study included over 35,000 people and found that rates of pregnancy loss, premature birth, and small birth weight are comparable to those found in pre-COVID studies. In other words, there was no direct control group for this or the miscarriage study (withholding a vaccine for the sake of the study would be considered unethical) but the data supports the idea that vaccinated people are equally as likely as unvaccinated people to have a healthy pregnancy.
Vaccination may protect your baby even after birth
Another important study is this one, which looked at the effectiveness of the vaccine in pregnant people. (Remember, people were excluded from the original vaccine trials if they were pregnant.) Not only was the vaccine effective, as you would expect, but babies retained some antibodies against the COVID virus after birth.
This type of immunity is known from other vaccines, and it’s the reason why a pertussis shot (TDaP) is recommended during each pregnancy, even if you as the pregnant person are up to date on your shots—your baby hangs on to some of those antibodies for a few months.
While there is still not much information on the vaccine and breastfeeding specifically, there is some evidence that antibodies against COVID can be present in breast milk. The vaccine is considered safe for lactating people and their babies.
COVID is more of a risk than the shot
It’s reasonable to want to avoid anything potentially risky during pregnancy. That’s why people often decline medications and procedures that can wait until after they give birth. But in the case of a COVID vaccine, the choice isn’t between the vaccine and nothing at all; it’s between the vaccine and potentially being infected with COVID.
People who are pregnant, or who have recently been pregnant, are at increased risk of severe illness (including hospitalization and death) if they do contract COVID. People who contract COVID are also at a greater risk of giving birth prematurely or having a baby with worse health outcomes, compared to people who are not infected with the virus.
For these reasons, the CDC now agrees with the American College of Obstetricians and Gynecologists and the Maternal-Fetal Medicine Society in strongly urging pregnant patients to get the vaccine.
You can read the CDC’s full recommendations for people who are pregnant, thinking about becoming pregnant, or who are breastfeeding here. If you have further questions about the safety of vaccines in pregnancy, talk to your regular doctor or provider. The CDC also recommends contacting MotherToBaby, which can answer questions over the phone or via email in English or Spanish.