Pregnant people are at much higher risk for complications and death from influenza and COVID-19. Vaccination during pregnancy also helps to protect the newborn from many infections during the first few months after birth, like whooping cough.
After rigorous research, many vaccines are now strongly recommended for pregnant and breastfeeding people by the CDC, and tens of thousands of obstetricians, midwives, family physicians and other OB providers -- including the COVID-19, seasonal influenza, and the Tdap (whooping cough) vaccine.
When it comes to you and your baby's health, having accurate information is vital. This resource is updated with the latest research into vaccine safety, pregnancy and the whooping cough and COVID-19 vaccines. Find the answers to all your questions, curated by medical professionals, with links to verified research.
Resources: We have developed a trifold brochure to educate patients and community members about the recommended vaccines during pregnancy. Please print it for your communities!
1) Brochure: Color (English & Spanish)
2) Brochure: Black & White (English & Spanish)
3) EPIC Dot Phrases for Medical Staff: 1-Page Resource
RSV, or respiratory syncytial virus, is a common respiratory virus that usually causes mild, cold-like symptoms in healthy adults. In infants and children, however, RSV can cause severe respiratory symptoms, and can even lead to hospitalization or death.
Each year in the United States, an estimated 58,000-80,000 children younger than 5 years are hospitalized due to RSV infection. In the U.S., RSV cases start in the fall and are highest around the middle of February.
Source:
CDC - Respiratory Syncytial Virus (RSV) Immunizations
There are two ways. You can choose to get the RSV vaccine (Abrysvo) during weeks 32 through 36 of your pregnancy during September to January, or your baby aged 8 months or younger can get the RSV monoclonal antibody (Beyfortus) during their first RSV season. The antibody has been used in premature infants since 1998 and was recently approved for all babies under 8 months as well.
Children between 8 and 19 months of age who are at higher risk due to medical conditions or weak immune systems can also get Beyfortus in their second RSV season.
Children between 8 and 19 months of age who are American Indian and Alaska Native are also recommended to get Beyfortus in their second RSV season since they are at more risk of getting severe RSV disease.
Beyfortus costs about twice the amount of Abrysvo, but health insurance companies are updating their coverage to include both. Some clinics and pharmacies may not carry both. Check with your insurance and physician or pharmacy to see what is covered and available for you.
Source:
Use of Immunoprophylaxis for Prevention of Severe Respiratory Syncytial Virus Bronchiolitis
CDC - Vaccine Price List
KFF Health News - Timing and Cost of New Vaccines
The RSV vaccine is recommended during the third trimester of pregnancy because it helps protect your newborn from the RSV virus, which can cause serious lung infections in newborns. When you are vaccinated for RSV during pregnancy, your body produces germ-fighting cells that cross the placenta and can help protect your newborn baby. This is similar to how the Tdap (Whooping cough) vaccine can protect your baby.
Source:
CDC - RSV Vaccination for Pregnant People
Pregnant people should be vaccinated between weeks 32 through 36 of pregnancy from September through January, which is the season when people tend to get sick with RSV. This way, your baby is protected against lung infections related to RSV in the first months of life. The vaccine can reduce a baby’s risk of being hospitalized from RSV by 57% in the first six months after birth.
Source:
CDC - RSV Vaccination for Pregnant People
You are eligible to be vaccinated for RSV in pregnancy if you are between 32-36 weeks during RSV season, from September through January. See the table below for a helpful timeline of when you can first get the vaccination based on your due date.
If you are due between April and October, it is recommended that your newborn receive the RSV vaccination within one week after birth.
Yes! The RSV vaccine has undergone safety studies in populations including pregnant individuals. Any vaccine can carry the risk of a temporary injection site reaction, like itching or pain. It is safe to breastfeed after getting the vaccine as well. It has not been shown to be excreted in breast milk.
Source:
Respiratory Syncytial Virus Prefusion F Vaccine
People at risk of preterm labor are not usually included in drug and vaccine trials, so it can be hard to assess this. Additional studies are underway to evaluate this risk, so the vaccine is currently approved in the late third trimester to reduce any potential safety concerns.
Source:
Healthcare Providers: RSV Vaccination for Pregnant People
There is evidence that the RSV vaccine is associated with preeclampsia, and further studies are ongoing to evaluate this risk. However, RSV infection itself is also associated with preeclampsia, so it is important to protect pregnant people from RSV.
The RSV vaccine (Arexvy or Abrysvo) is recommended for adults over 60 years old based on a discussion with their primary care provider. Currently, there is no vaccine approved for non-pregnant adults under 60 years old.
Most clinics carry the RSV vaccine during the RSV season, and you can receive the vaccine at one of your routine visits. If your provider does not carry the RSV vaccine, most local pharmacies can provide the vaccine. Check with your pharmacy to make sure they carry the Abrysvo vaccine. You can use this link to locate a clinic or pharmacy near you that offers the RSV vaccine.
Abrysvo Vaccine Locator: Find ABRYSVO™ (Respiratory Syncytial Virus Vaccine)
If you do not get vaccinated against RSV during your pregnancy, your baby can receive the RSV monoclonal antibody in the hospital shortly after birth.
When we are exposed to a new germ, our bodies make proteins called “antibodies” that help us fight off viruses and bacteria. Beyfortus is an antibody product that protects your baby from RSV. The effect of Beyfortus is similar to getting a vaccine but it skips the step where the vaccine activates your body’s immune system to make the antibodies. Instead, Beyfortus provides the antibodies directly to your baby to prevent them from getting sick from RSV!
Source:
CDC - Respiratory Syncytial Virus (RSV) Preventive Antibody
If you elect not to receive the RSV vaccine, an alternative option to protect your newborn is to give them the RSV monoclonal antibody within 1 week of birth.
Source:
CDC - RSV Immunization for Infants and Young Children
They are both effective! As of now, studies have not compared the two options directly. However, both have been shown to provide protection against RSV to vulnerable infants. You should choose what works best for you and your family, taking into account whether you are eligible to receive the vaccination in pregnancy based on your due date.
Influenza, which is commonly called the flu, is a highly contagious respiratory illness. The flu is transmitted through droplets from coughing and sneezing. You can catch the flu from contact with an infected person or by touching something that an infected person has coughed or sneezed on. Although the flu spreads year-round, it is most common during “flu season” which is from October through February.
During pregnancy there is a higher risk of the flu causing serious illness in both the mom and baby. In pregnancy, there is a greater chance that catching the flu might lead someone to become so sick that they need a breathing tube, become hospitalized or even die from the flu. Catching the flu during pregnancy can also increase the risk of preterm and stillbirth.
The flu can also cause serious disease in newborns, whose immune systems aren’t fully developed yet. Newborns younger than six months old have the highest risk of hospitalization and death from flu infections. 1 These babies are too young to be vaccinated against the flu themselves.
Source:
Protecting Babies & Young Children From Flu
The flu vaccine is the best protection against the flu for you and your baby. Studies have shown that getting the flu shot during pregnancy reduces the risk of being hospitalized for flu symptoms by about 40%.The vaccine during pregnancy also helps protect babies against the flu after they are born. Because newborns cannot get their own flu shots until they are 6 months old, they rely on flu-fighting antibodies they receive from their mothers being vaccinated to fight off illness.
Yes! The flu vaccine has undergone extensive safety studies showing that the vaccine is safe and effecting during any trimester of pregnancy. Multiple studies have shown that people who receive flu shots during pregnancy do not have an increased likelihood of miscarriage, adverse fetal outcomes, or other pregnancy complications.
Source:
Obstetrics & Gynecology - Trivalent inactivated influenza vaccine
Obstetrics & Gynecology - Inactivated influenza vaccine during pregnancy
The influenza virus changes from year to year which is why last year’s vaccine may not protect you from this year’s influenza virus. It is recommended that everyone 6 months and older receive the flu shot each year.
Yes. Pregnant patients should receive the flu shot because it is made from inactive or “killed” virus, meaning it is no longer infectious. It is not possible for you or your growing baby to catch the flu from this flu shot. The nasal spray vaccine is made from live virus particles and is not recommended during pregnancy. That said, after you give birth, it is safe to receive either the flu shot or the nasal spray, even if you are breastfeeding.
The side effects from the flu vaccine are generally mild and resolve within a few days. Side effects include soreness and/or swelling where the shot was given, headache, fever, nausea, muscle aches, and fatigue. Side effects are similar in pregnancy.
Most clinics carry the flu vaccine during flu season if not year-round, and you can receive the vaccine during one of your routine visits. You can also get the flu vaccine at your local pharmacy.
Vaccine Finder: www.vaccines.gov
In September 2023, the FDA 2023-2024 COVID-19 vaccines to help protect people against the COVID-19 virus. The Centers for Disease Control (CDC) recommends that everyone older than 6 months of age receive at least one dose of 2023-2024 COVID-19 vaccine. Children 6 months - 4 years old may need more than one dose to be up to date.
Source: https://www.cdc.gov/media/releases/2023/p0912-COVID-19-Vaccine.html
Viruses such as COVID-19 can mutate and change over time. The 2023-2024 COVID-19 vaccines are specially formulated to help protect you against the current COVID-19 variants. COVID-19 illness can still be very dangerous, even if you have been vaccinated or had a COVID-19 illness in the past. Additionally, immunity to COVID-19 decreases over time, regardless of if you have been vaccinated or had the illness in the past. Staying up to date on COVID-19 vaccination helps keep your immune system strong so your body can fight the virus.
Source: https://www.aamc.org/news/new-covid-boosters-what-doctors-and-patients-need-know
Yes, any of the 2023-2024 COVID-19 vaccines are safe to receive anytime during pregnancy, when breastfeeding, while trying to get pregnant or if you may become pregnant in the future. Studies looking at the potential risks of the COVID-19 vaccines during pregnancy have been ongoing since before COVID-19 vaccines first became available. Thankfully, these studies have shown no increased risks of bad outcomes such as miscarriage, preterm delivery, or birth defects.
Source:
CDC - Getting the Updated COVID-19 Vaccine in Fall 2023
CDC - COVID-19 Vaccines While Pregnant or Breastfeeding
Safety and Effectiveness of Maternal COVID-19 Vaccines AmongPregnant People and Infants
Yes, the 2023-2024 COVID-19 vaccines have been proven to be safe to receive at any point in time, including while breastfeeding and while trying to get pregnant. In fact, getting the vaccine while breastfeeding can help protect your baby from COVID-19 infection as well.
Learn more here!
The 2023-2024 COVID-19 vaccines can help protect you from getting very sick from a COVID-19 infection. In past years, the COVID-19 vaccines have helped protect people from severe illness, including the need for hospitalization and even death. If you are pregnant or are recently pregnant you are more likely to get severely sick from COVID-19 compared to people who are not pregnant. Keeping yourself healthy during pregnancy is important for your and your baby’s health.
Sources:
CDC - Updated COVID-19 Vaccine for Fall/Winter Virus Season
CDC - Getting the Updated COVID-19 Vaccine in Fall 2023
You should wait at least two months from your last COVID-19 vaccine before receiving a 2023-2024 COVID-19 vaccine. If you have had the COVID-19 disease recently, you can wait three months before getting the vaccine. The CDC and the American College of Obstetrics and Gynecology say that any point in pregnancy, or while breastfeeding, is a safe and effective time to get a COVID-19 vaccine.
Source:
CDC - COVID-19 Vaccines While Pregnant or Breastfeeding
Numerous studies including thousands of pregnant and breastfeeding individuals have shown that COVID-19 vaccinations are safe and effective. More than 100,000 pregnant individuals in the US have already received one of the COVID-19 vaccines.
We have included a Google Doc table that summarizes the findings on the safety of COVID-19 vaccination in pregnancy from more than 25 studies in different countries that include more than 315,000 pregnant women. Overall, there was no harmful effect of COVID-19 vaccination on pregnancy outcomes found in any of these studies. Some studies found that women vaccinated for COVID-19 had a lower risk of preterm birth, stillbirth, a small baby, or having a newborn that required admission to a neonatal intensive care unit. This means that these studies found that COVID-19 vaccination supported healthier pregnancy outcomes. If you read this document, it uses abbreviations to describe the many pregnancy outcomes that were studied. Here is what some of these abbreviations mean. "PTB" means a preterm birth that occurs at least 3 weeks earlier than the expected due date. "NICU" stands for a neonatal intensive care unit. "SGA" means having a smaller baby than would be expected based on the time (gestational age) in pregnancy when the baby was delivered.
Thank you to Viki Male, a Lecturer in Reproductive Immunology at the Imperial College London for updating this document.
Source:
https://docs.google.com/document/d/19FNXcmdI0MU6RPmvKYo_g9zEWPKl2-l760OX_8zww3E/edit
Yes. Getting vaccinated for whooping cough and flu when you’re pregnant has been recommended for decades and is a normal part of maintaining a healthy pregnancy. Vaccination against COVID-19 is now highly recommended as well.
Sources:
CDC: Vaccines During and After Pregnancy
• The American College of Obstetricians and Gynecologists Podcast: Pregnant? Top 3 Reasons Why You Need a COVID-19 Vaccine
Great question! Thousands of Americans have been unfortunately surprised when they acquired COVID-19 despite being very careful. It’s tough to control for every possible exposure especially when masking isn’t universal in all communities. The Delta variant of COVID-19 is highly infectious and two times as contagious as the original COVID-19 strain. It is as infectious as chicken pox. Given the risks in pregnancy of COVID-19 and the safety of the COVID-19 vaccines, it is highly recommended to become vaccinated in pregnancy or while breastfeeding. This is the best way to protect you and your family.
No. Commonly reported side effects across the different types of vaccines include fevers, fatigue, headaches, and body aches which is the same side effect profile for non-pregnant persons. Interestingly, a study of nearly 8,000 pregnant women found that there were fewer reports of side effects, like fever and muscle pain, compared to non-pregnant women.
Source: JAMA Network Open: Short-term Reactions Among Pregnant and Lactating Individuals in the First Wave of the COVID-19 Vaccine Rollout
No. About 3-5% of babies in the United States are born with a birth defect each year. Among 1,612 women receiving the COVID-19 vaccine while pregnant, 45 had birth defects for a rate of 2.7%. This is what we would normally expect and does not indicate any relationship to the COVID-19 vaccine.
Sources:
• March of Dimes: Birth Defects And Your Baby
• CDC Awardee COVID-19 Vaccination Planning Meeting
No. Normal estimates of miscarriage in pregnancy range from 11% to 22%. In a study following 2,456 pregnant people who received the COVID-19 vaccine, a miscarriage occurred in 12.8%. This is what we would normally expect.
Sources:
• American College of Obstetrics and Gynecology: In Vitro Fertilization and Early Pregnancy Outcomes After COVID-19 Vaccination
• The New England Journal of Medicine: Covid-19 Vaccination during Pregnancy and First-Trimester Miscarriage
• JAMA Pediatrics: Spontaneous Abortion Following COVID-19 Vaccination During Pregnancy
None of the COVID-19 vaccines change your DNA. They never go into the cell nucleus, which is the control center of the cell where your DNA lives.
None of the COVID-19 vaccines contain a microchip or can make your arm magnetic. These are myths.
Yes. The immune system is very skilled at making protective antibodies to different vaccines or infections at the same time. Common prenatal vaccines like the influenza and the TdAP (tetanus/pertussis) are recommended in all pregnancies and can safely be paired with the COVID-19 vaccines.
Breast milk is so much more than nutrition and has long been known to protect infants against numerous infections by passing protective antibodies from the mother to the infant. Many studies have shown that breast milk from individuals vaccinated against flu while pregnant contains protective antibodies that can be passed to the infant. Recent studies have shown that protective antibodies against COVID-19 transfer in breast milk following COVID-19 vaccination.
Sources:
• PLoS ONE: IgA and Neutralizing Antibodies to Influenza A Virus in Human Milk: A Randomized Trial of Antenatal Influenza Immunization
• Science Translational Management: COVID-19 mRNA vaccines drive differential antibody Fc-functional profiles in pregnant, lactating, and nonpregnant women
• Vaccines: COVID-19 Vaccine mRNABNT162b2 Elicits Human Antibody Response in Milk of Breastfeeding Women
• JAMA Pediatrics: Association of Human Milk Antibody Induction, Persistence, and Neutralizing Capacity With SARS-CoV-2 Infection vs mRNA Vaccination
The COVID-19 vaccine was developed quickly, but the clinical trials to examine the safety and efficacy were not rushed. Vaccine development and testing often takes years because there is a lot of bureaucratic and administrative hurdles that often take a long time. Due to the pressing public need, these administrative blocks were minimized without compromising the many months needed to conduct thorough testing. And while companies do make money off of vaccines, they are often the least profitable product in comparison to other drugs like Viagra.
We understand that it can be difficult to trust pharmaceutical companies, especially considering their role in the current opioid crisis. However, the vaccine still has no individual cost to you and is an important measure in protecting the health of you and your child, just like taking prenatal supplements and wellness checks.
There has been so much conflicting information online, especially in the media. We recommend following traditional misinformation debunking techniques:
1. First, identify the source of the information you are seeing. Is it a reputable source? Is the source from a well-established, scientifically credible organization such as the CDC, American College of Obstetrics & Gynecology or the, Society for Maternal and Fetal Medicine etc. If the source is an individual, what are their credentials? If it's difficult to assess, always feel free to ask your OB provider. They are on your care team and happy to help you find accurate and trusted information about the COVID-19 vaccine.
2. Find coverage on the topic from multiple sources. What do multiple experts, outlets, and organizations say about the topic?
On this page, we have referenced all of our answers with scientific studies and recommendations from highly credible medical societies. Thousands of pregnant and breastfeeding individuals have contributed to these studies.
Sources:
• The American College of Obstetricians and Gynecologists Podcast: Episode 1: “COVID-19 Vaccine Development and Safety”
• The American College of Obstetricians and Gynecologists Podcast: Episode 2: “Maternal Health Disparities and COVID-19”
• The American College of Obstetricians and Gynecologists Podcast: Episode 4: “Dismantling Myths about COVID-19 Maternal Health”
• The American College of Obstetricians and Gynecologists Podcast: Episode 5: “The Mental Health Toll of COVID-19 and Looking to the Future”
Racism in medicine is a grave injustice and failure to support the health of the communities we are meant to serve. We recognize your very valid concerns about the COVID-19 vaccine given your lived experiences with racism with the medical establishment and healthcare providers. We are worried about the disproportionately high rates of COVID-19, associated suffering and death amongst communities of color. We hope that by increasing vaccination rates, especially amongst pregnant individuals, this will protect the health of you and your babies. We hope that you will connect with trusted family members, community leaders and healthcare providers to learn more about their experiences with the COVID-19 vaccine. We highly recommend getting vaccinated against COVID-19 in pregnancy to protect the health of yourself and your baby.
Yes. In a study of 3,750 infants born to pregnant individuals with COVID-19, 8.1% of newborns tested positive for COVID-19.
Source: CDC: COVID Data Tracker
Pregnant or recently pregnant individuals acquiring COVID-19 have a much higher risks of dying, being hospitalized, needing a breathing tube, and having a preterm birth or stillbirth. In a short time, 15 pregnant women died of COVID-19 in Mississippi alone and 8 of those deaths occurred in a few months during a Delta variant peak in 2021. Being overweight at the start of a pregnancy or having diabetes further increases these risks. Overall, pregnant individuals with COVID-19 are 22 times more likely to die in pregnancy compared to uninfected pregnant people.
When pregnant individuals become ill with COVID-19 and need a ventilator, one way to improve their breathing is by delivering the baby. This means that delivering a baby prematurely (weeks or months too early) could help the pregnant person survive, but at the expense of the baby’s health. One study found that unvaccinated pregnant individuals with COVID-19 had a 59% higher rate of preterm birth compared to those without COVID-19. Preterm birth is harmful for your baby and can lead to serious complications including developmental and physical disabilities, long NICU stays, and even fetal death.
Sources:
• CDC: COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19
• WJTV: 72 unborn babies, 15 pregnant women have died due to COVID-19 in Mississippi
• CDC: People with Certain Medical Conditions
• JAMA Pediatrics: Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection
Yes. When pregnant people become ill with COVID-19,damage can occur to the placenta. Pregnant people with COVID-19 disease had double the risk of stillbirth with the early SARS-CoV-2 variants. The Delta variant has been linked with a 4x higher risk of stillbirth. High levels of virus have been found in a stillborn fetus in several cases after the mother had COVID-19.
Yes. In a study of 3,750 infants born to pregnant individuals with COVID-19, 8.1% of newborns tested positive for COVID-19.
Source: CDC: COVID Data Tracker
Pregnant or recently pregnant individuals acquiring COVID-19 have a much higher risks of dying, being hospitalized, needing a breathing tube, and having a preterm birth or stillbirth. In a short time, 15 pregnant women died of COVID-19 in Mississippi alone and 8 of those deaths occurred in a few months during a Delta variant peak in 2021. Being overweight at the start of a pregnancy or having diabetes further increases these risks. Overall, pregnant individuals with COVID-19 are 22 times more likely to die in pregnancy compared to uninfected pregnant people.
When pregnant individuals become ill with COVID-19 and need a ventilator, one way to improve their breathing is by delivering the baby. This means that delivering a baby prematurely (weeks or months too early) could help the pregnant person survive, but at the expense of the baby’s health. One study found that unvaccinated pregnant individuals with COVID-19 had a 59% higher rate of preterm birth compared to those without COVID-19. Preterm birth is harmful for your baby and can lead to serious complications including developmental and physical disabilities, long NICU stays, and even fetal death.
Sources:
• CDC: COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19
• WJTV: 72 unborn babies, 15 pregnant women have died due to COVID-19 in Mississippi
• CDC: People with Certain Medical Conditions
• JAMA Pediatrics: Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection
Yes. When pregnant people become ill with COVID-19,damage can occur to the placenta. Pregnant people with COVID-19 disease had double the risk of stillbirth with the early SARS-CoV-2 variants. The Delta variant has been linked with a 4x higher risk of stillbirth. High levels of virus have been found in a stillborn fetus in several cases after the mother had COVID-19.
Any time, and the sooner the better! It is safe for you and your baby to receive the COVID-19 vaccine at any stage in pregnancy. Given the risks of COVID-19 in pregnancy and complications for your health and your baby’s health, the sooner you can get vaccinated, the more protected you both will be.
Source:
• The American College of Obstetricians and Gynecologists: Get Your Recommended COVID-19 Vaccine during Pregnancy
• The American College of Obstetricians and Gynecologists: Vaccinations Needed during Pregnancy
As of May 6, 2022, the Washington Department of Health paused the use of the Janssen COVID-19 Vaccine (Johnson & Johnson) for people 18 years and older. The update followed guidance and recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) and the Western States Scientific Safety Review Workgroup.
The update followed data presented to the ACIP about thrombosis and thrombocytopenia syndrome, or TTS. TTS is a rare but serious condition involving blood clots and a low blood platelet count seen in some people who received the J&J vaccine. Though TTS was rare, the FDA showed the risk of certain side effects warranted limiting the vaccine. Nationwide, 54 cases of TTS, including nine confirmed deaths, were reported, which is a fraction of a percent of the 14 million doses of J&J given overall. While TTS was been seen in both men and women, the most at-risk group was women 30 through 49 years old.
The Pfizer-BioNTech and Moderna COVID-19 vaccines, both of which are mRNA vaccines and use a different method than the J&J COVID-19 vaccine to protect against the virus, have not been linked to blood clots at this time.
Sources:
Yale Medicine - The Link Between J&J’s COVID Vaccine and Blood Clots: What You Need to Know
All of the COVID-19 vaccines “train” the immune system to identify, attack and destroy a tiny piece of the virus. This is how your immune system “learns the enemy” and can then quickly respond and bring in waves of immune cells to defeat the real virus in the future.
The Pfizer and Moderna vaccines work by introducing messenger RNA (mRNA) into muscle cells. The cells make lots of copies of the COVID-19 spike protein, which triggers the body to make a protective immune response. The mRNA is quickly degraded, because the cell breaks it up into small harmless pieces after a few days. mRNA is very fragile, which is one reason the Pfizer vaccine needs to be kept in very cold freezers. There is no “live virus” in the COVID-19 vaccine or any other harmful ingredients, thus making the COVID-19 vaccine safe for pregnant and breastfeeding individuals.
Source: CDC: Understanding mRNA COVID-19 Vaccines
This is being studied, but appears to be rare. Period changes might occur in far less than 1% of individuals and are short-lived. In the United Kingdom, out of more than 49.1 million women who have been vaccinated there were 41,332 reports of possible menstrual cycle changes (0.0008%).
A normal period can vary widely from person to person and month to month. Exercise, diet and even stress can change a period, as well as lots of medications including birth control. Several studies in different countries indicate that the psychological stress of the pandemic has increased the irregularity of women’s periods. In a study of 127 women with the COVID-19 disease, 16% noticed changes in their menstrual cycle, which most commonly was reported as an irregular period. Interestingly, women reporting more COVID-19 symptoms were more likely to have an abnormal period. In summary, it appears that irregular periods are commonly reported after COVID-19 disease (16%), especially when women are ill, and rare after COVID-19 vaccination (<1%). More research is still being done on this topic.
Sources:
• National Institute of Child Health and Development (NICHD): NIH funds studies to assess potential effects of COVID-19 vaccination on menstruation
• American Journal of Obstetrics & Gynecology (AJOG): SARS-CoV-2 infection and subsequent changes in the menstrual cycle among participants in the Arizona CoVHORT study
• Frontiers in Endocrinology: The Impact of the COVID-19 Pandemic on Women’s Reproductive Health
• The Journal of Obstetrics and Gynaecology Research: The impact of COVID-19-related mental health issues on menstrual cycle characteristics of female healthcare providers
• The Journal of Obstetrics and Gynaecology: Triangle of COVID, anxiety and menstrual cycle
• The American College of Obstetricians and Gynecologists Labor of Love Podcast: Episode 3: “Understanding COVID-19 and Fertility”
Yes. There are many studies now supporting that COVID-19 disease can temporarily harm a man’s fertility or permanently harm a man’s ability to have an erection. After reviewing research databases, the American Society for Reproductive Medicine said, "No evidence of any connection between COVID-19 vaccines and male infertility was found, but there were 50 reviews, 17 commentaries/letters to editors and nine original articles on how COVID-19 disease could possibly impact male fertility." We have listed some of the ways that COVID-19 disease can do this below:
1. Temporary decrease in sperm count and quality: A severe illness (of any kind) is known to lower sperm counts in men for 3-6 months, as having a fever during a severe illness disrupts the process of making sperm. Therefore, it is not surprising that men who have had COVID-19 disease have been reported to have lowered sperm count and quality. In general, changes in sperm count due to an infection are typically short-term and recover after 3 months of time. Longer term studies of sperm count and quality in men recovering from COVID-19 are needed.
2. Testicle swelling and pain. Several studies indicate that about 10-22% of men with COVID-19 disease will experience swelling of the testicles and pain, possibly due to a direct infection of the testes.
3. Erectile dysfunction. COVID-19 is known to injure blood vessels in many organs including the lungs, heart and brain leading to higher rates of heart attack and stroke. A penile erection depends on strong blood flow into the penis and healthy veins as well as, testosterone. There are many reports and studies of men losing their ability to have an erection after COVID-19 disease, which may be due to blood vessel damage, lower testosterone and/or psychological distress. How frequently this might occur is unknown.
Sources:
• First International Journal of Andrology: Impaired semen parameters in patients with confirmed SARS-CoV-2 infection: A prospective cohort study
• Canadian Urological Association Journal: Effect of SARS-CoV-2 infection on semen parameters
• The World Journal of Men's Health: Evaluation of SARS-CoV-2 in Human Semen and Effect on Total Sperm Number: A Prospective Observational Study
No. Thousands of women have become pregnant after receiving one or more COVID-19 vaccines. More than 4,800 people had a positive pregnancy test after receiving a first dose of either the Pfizer or Moderna COVID-19 vaccine. Another report documents more than 1,000 people becoming pregnant after receiving any COVID-19 vaccine. Medical societies that serve women who would like to become pregnant have overwhelmingly recommended that people thinking about becoming pregnant get the vaccine. Studies that included patients undergoing fertility treatments who also received the COVID-19 vaccine found that there were no problems with implantation or early pregnancy development.
In addition, there is no link to male infertility after receiving the COVID-19 vaccine. In fact, sperm count and quality has been studied in men before and after COVID-19 vaccination. Not only were there no harmful effects found, but sperm counts were also actually higher after vaccination. This was within normal individual variation and not thought to be due to the vaccination.
Sources:
• The New England Journal of Medicine: Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons
• COVID-19 Vaccination Coverage Among Pregnant Women During Pregnancy — Eight Integrated Health Care Organizations
• The American College of Obstetricians and Gynecologists: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care
• American Society for Reproductive Medicine (ASRM): Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic
• American Society for Reproductive Medicine (ASRM): Joint Statement Regarding COVID-19 Vaccine in Men Desiring Fertility from the Society for Male Reproduction and Urology (SMRU) and the Society for the Study of Male Reproduction (SSMR)
• JAMA Network: Sperm Parameters Before and After COVID-19 mRNA Vaccination
Yes. Compared to natural infection, the vaccine triggers the body to make powerful protective antibodies, which are successfully transferred to fetuses during pregnancy. Many people have become sick with COVID-19 more than once, which is likely the case due to the weaker immune response that comes from natural infections.
Your disease is likely to be very mild and in some cases, people have no symptoms at all with a breakthrough infection. This means that your vaccine worked – it prevented a severe disease that could have killed you or caused a bad outcome in pregnancy. In studies of pregnant people hospitalized with COVID-19, 97% were unvaccinated.
Source: CDC: COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19
Yes. The COVID-19 booster shot is recommended in pregnancy. If you are 5 months out from your second dose of the Pfizer or Moderna COVID-19 vaccines and are pregnant, you are due for your booster shot. You can receive your COVID-19 booster at any stage in pregnancy. This will help give your immune system an extra memory booster to continue protecting you and your baby against exposure to COVID-19. Receiving a COVID-19 booster vaccine when you are eligible is extremely important in protecting you and your baby from severe disease.
Sources:
• The American College of Obstetricians and Gynecologists: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients
• Society for Maternal Fetal Medicine (SMFM): Provider Considerations for Engaging in COVID-19 Vaccine CounselingWith Pregnant and Lactating Patients
• American Society for Reproductive Medicine (ASRM): Patient Management and Clinical Recommendations During The Coronavirus (COVID-19) Pandemic
The CDC is recommending that an individual should get any of the current COVID-19 vaccine boosters that are currently available. The timing of boosters and which booster to obtain continues to change and evolve. Please check the latest information on boosters from the CDC.
Sources:
• CDC: COVID-19 Booster Shots , Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions
• medRxiv: Heterologous SARS-CoV-2 Booster Vaccinations - Preliminary Report
Every few months it seems that we are confronted with a new COVID-19 virus variant. In the case of the Delta variant, pregnant people acquiring this COVID-19 variant were reported to have a 2-4 times higher risk of severe disease, preterm birth and needing to be placed on a ventilator. Whether new COVID-19 variants will cause more or less infections and severe disease in pregnancy will take time to figure out. As pregnant individuals are one of the highest risk groups for severe COVID-19 disease and death, it is extremely important to get vaccinated, receive a COVID-19 vaccine booster when eligible, stay careful with masking, social distancing and keeping your “bubble” small.
Tdap stands for tetanus, diphtheria, and acellular pertussis. The Tdap vaccine helps protect you and your baby from three diseases: diphtheria, tetanus and pertussis. You may have also heard of the Tdap vaccine referred to as the “whooping cough” vaccine. “Whopping cough” is another name for pertussis.
The Tdap (whooping cough) vaccine is recommended during the third trimester of pregnancy because it helps protect your newborn from whooping cough (pertussis). Babies are not able to get the whooping cough vaccine until they are two months old, so they are vulnerable to whooping cough infection in the first few months of life. When a pregnant individual is vaccinated for whooping cough during pregnancy, their body produces germ fighting cells that cross the placenta and can help protect their newborn baby until they can be vaccinated.
Whooping cough, or pertussis, is an infection that causes severe coughing and sometimes difficulty breathing. It can affect anyone, but the infection is most serious in newborn babies, and can even cause death. Unfortunately, the CDC reports that about 30% of babies in the U.S. <1 year-old who get whooping cough are hospitalized and 1 in 100 who need treatment in the hospital die. Newborns whose mothers did not receive the Tdap vaccine in pregnancy are at greater risk of severe illness.
Source:
https://www.cdc.gov/pertussis/about/complications.html
The most reputable society of doctors caring for pregnant women, the American College of Obstetrics and Gynecology, recommends that pregnant individuals get the Tdap/whooping cough vaccine between 27 and 36-weeks of pregnancy. Vaccinating during this time allows the pregnant person’s body to make cells that detect and fight off germs and transfer those cells to the baby. Pregnant individuals should receive the Tdap vaccine during every pregnancy.
Source:
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/update-on-immunization-and-pregnancy-tetanus-diphtheria-and-pertussis-vaccination
Yes! Studies have shown that there is no increased risk to you or your baby after receiving the Tdap vaccine during pregnancy.
Most adults will have received the Tdap vaccine at some point during adolescence. If an adult in close contact with your baby has never received a Tdap vaccine, the American College of Obstetricians and Gynecologists recommends the adult receive a Tdap vaccine 2 weeks before visiting your baby.
Source:
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/update-on-immunization-and-pregnancy-tetanus-diphtheria-and-pertussis-vaccination
Most clinics carry the Tdap vaccine and you can receive the vaccine at one of your routine visits. If your provider does not carry the Tdap vaccine, most local pharmacies can provide the vaccine.
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